What if a simple test could help determine the exact mutations that cause cancer in each patient and inform the exact treatment they should receive?
Such a test is the holy grail of precision medicine – a promising framework for cancer research and care that would allow doctors to treat patients based on the specific characteristics of their cancer. But making it a reality isn’t simple: it requires that researchers work together to generate, share and analyze data from thousands of patients, allowing them to pinpoint the patterns that cancer uses to grow and spread in each patient.
This kind of collaboration is unprecedented, which is exactly why the Terry Fox Canadian Comprehensive Cancer Centre Network (TF4CN), a TFRI- funded pilot that brings investigators from BC Cancer (Vancouver) and Princess Margaret (Toronto), is fostering it. The TF4CN is allowing scientists in two of Canada’s biggest cancer research centres to work together like never before to tackle four distinct projects that will help make precision medicine a reality.
“It's as much a social experiment as it is a science one,” says Dr. Trevor Pugh, a geneticist at Princess Margaret Cancer Centre who leads one of the network’s four sub-projects. “And we need to undertake these experiments if we want to personalize treatments for cancer patients to increase their efficacy and decrease negative side effects associated with current therapies.”
Dr. Pugh’s sub-project focuses on metastatic colorectal cancer and brings together teams in Toronto and Vancouver to perform genomic profiling of 20 patients with the disease.
While their long-term goal is to use this data to begin identifying molecular signatures linked to cancer relapse that could help diagnose aggressive diseases earlier and inform treatment, Dr. Pugh doesn’t kid himself. He knows that the data set is much too small to reach those conclusions, and that the goal of the project is more basic: to come up with standardized protocols for the collection, sharing and analysis of high-quality genomic and transcriptome data that can be adopted by centres across Canada.
“We've really built this system to scale. It's only 10 patients at each centre right now, but we've built it with every colorectal cancer patient in mind,” Dr. Pugh says.
Dr. Pugh will soon have a chance to expand this project to more centres, thanks to the creation of the Marathon of Hope Cancer Centres Network. This network will take the learnings from the TF4CN and apply it a greater scale to centres across Canada, allowing them to generate, share and analyze the data needed for precision medicine to become a reality.
“This network is the only effort I know of that is capable of delivering on this idea of unbiased, complete whole genome and transcriptome analysis with an eye toward guiding clinical care,” says Dr. Pugh. “It provides the best opportunity for us to start creating a system where every patient that comes through the door gets a full-blown clinical genome and transcriptome analysis that really becomes THE overarching clinical test that is used to manage a patient’s cancer treatment.”