By: Colleen Seto
Just as Terry Fox united Canada with his determination to raise money for cancer research, the new Marathon of Hope Cancer Centres Network (MOH Network) will unite the country by bringing together Canada’s top cancer researchers and clinicians to share knowledge, harness technology and work together toward finding a cure for cancer. Led by The Terry Fox Research Institute with support from dozens of research and funding partners across Canada, the MOH Network aims to accelerate the adoption of precision medicine for cancer.
But, just what is precision medicine, and why is it important to the future of cancer treatment?
“Cancer is very individual,” says Dr. Jennifer Chan, director of the Arnie Charbonneau Cancer Institute and the Calgary lead for the Prairies Cancer Research Consortium (Alberta, Saskatchewan, Manitoba) of the MOH Network, one of four consortiums total. “Precision medicine involves trying to know the right therapy for the right patient at the right time. There are many factors — the patient’s unique genetic makeup, their environment and the tumour itself. Precision oncology is about understanding the molecular makeup of a tumour that will give information about what the patient will most respond to.”
Precision oncology has been decades in the making. With the advent of genomic sequencing, there’s been “an explosion of knowledge in cancer in the last decade to 15 years,” Chan says. “Traditionally, someone like me would look down a microscope and say that something looks like breast cancer. Now we know things that look the same may have different genetic underpinnings that can be targeted.”
There used to be a debate in the cancer field as to whether targeting one alteration could bring about therapeutic success with all of cancer’s mutations. The debate has now turned into the overarching question of which mutations or combinations of mutations are targetable. As it turns out, particular cancers can be targeted, even at advanced stages. “It was remarkable that you could change one thing to turn a cancer into a chronic condition, for example,” affirms Chan. “The notion that you could do that is what drew me to this field. That was the birth of precision oncology.”
The MOH Network will help hone precision oncology to become more and more precise at developing targeted therapies and, as a result, better outcomes for cancer patients. A major component will be building a dataset and a collaborative sharing platform for that data.
“It’s a national endeavour where we’re working together to gather data from 15,000 cancer patients,” says Chan, who adds patients will sign a consent form to have their information included in the dataset.
The effort will involve collecting and sharing extremely detailed information such as sequencing of molecular tumours, clinical data and imaging in a standardized way for investigators to determine patterns.
“We need clinical data, not just molecular information,” she explains. “We need as much information about patients as we can get — medications, lifestyle, demographics, everything. And we need as many people from as many backgrounds as we can get. We can only derive as high quality conclusions as the quality of data we put in.”
From there, researchers will take advantage of artificial intelligence to analyze the data. “We will use machine learning — high-powered computers — to help us sort, analyze and discern relationships,” Chan adds.
Additionally, the work completed through the Prairies Consortium will directly inform cancer care in Alberta. “To improve and apply changes to care for Alberta patients, we need Alberta data,” Chan says. “Health-service delivery is its own science, and it’s really strong here. To work at a health-systems level where we build infrastructure to help everybody, that’s super exciting. It’s not just for academic or pharma interests. There are future real-world outcomes at stake. What’s driving this is the potential of taking complex information and turning it into action or tools that benefit the patient.”
The MOH Network offers an excellent opportunity for Alberta to demonstrate its leadership in health and medicine. All the new technology and research development that will take place also holds great economic potential and avenues for diversification.
In particular, it’s a unique chance for patients to support and be engaged in groundbreaking research. “For cancer patients now, they can say ‘yes’ to contributing their data or samples,” affirms Chan. “If they’re in a cohort [for a study], they will get their tumour sequenced. There might be something actionable we can do — a trial or a therapy that they didn’t know they were eligible for. We might not find something for everyone, but everything we learn will improve the future of cancer therapy.”
Ultimately, the MOH Network enables all the necessary resources for precision oncology to converge. “This is an era of team science,” says Chan. “No one person can do it. It takes oncologists, surgeons, molecular biologists, pathologists, data scientists and patients for a precision medicine approach to be a success. Everything the MOH Network stands for — patients, research, data, sharing, engagement, genomics — it’s the catalyst for what we need to build to fight cancer.”