Leaders from the Terry Fox Research Institute, BC Cancer and the Princess Margaret Cancer Centre pose during the launch of the TF4CN in February 2017.
FOSTERING UNPRECEDENTED COLLABORATIONS, harmonizing complex research methods and creating the basic framework for a digital platform that allows patient data to be shared, stored and analyzed. These are just three of the many achievements that some of the nation’s top cancer researchers are crediting to an ambitious cancer centre network led by The Terry Fox Research Institute.
The Terry Fox Canadian Comprehensive Cancer Centres Network (TF4CN), a two-year pilot project that brings together investigators from Vancouver’s BC Cancer and Toronto’s Princess Margaret Cancer Centre, has reached these milestones in just over a year—making researchers hopeful about the potential benefit the network could have on patients across the nation.
“Over the past year we’ve been working closely with Dr. Pamela Ohashi’s lab in Toronto and have been able to harmonize how we manufacture T-cells for use in immunotherapy,” says Dr. Brad Nelson (BC Cancer), a world-famous cancer researcher who co-leads one of the four projects being piloted as part of the TF4CN. “While this may not seem like a very big deal it actually opens doors for fascinating new collaborations between the two teams that could have a real impact on patients.”
According to Dr. Nelson, using similar methods to create T-cells will allow investigators in both centres to share samples for use in research and make it possible for them to collaborate on clinical trials that reach a higher number of patients—something that was infeasible in the past.
“Our vision is that we will be able to do immunotherapy trials in the future at different centres throughout the TF4CN network and generate data that is comparing apples to apples from centre to centre,” says Dr. Nelson. “If we pull this off, Canada would be one of the only places in the world that is organized this way for immunotherapy research.”
Helping to make precision medicine a reality
When the TF4CN was launched in April of 2017, authorities from the three participating institutions were aware of the challenges that would need to be overcome for true inter-institutional collaboration to occur. They would need to step out of silos, try to reduce the red tape associated with project implementation and identify new ways to work within and across the boundaries of institutional practices and policies.
While they knew this would take some time, they were motivated by the project’s end goal of making the promise of precision medicine a reality.
“Bringing researchers and institutions together is always tough, but what we’ve seen so far is that TF4CN has been extremely successful in creating a space for researchers and administrators to collaborate and decide how they are going to collect and share information with each other in the future, which is helping to accelerate the implementation of precision medicine in Canada,” says Dr. Victor Ling, TFRI’s president and scientific director.
For him, breaking down institutional silos and creating true collaboration between researchers is necessary if this promising framework for care, which is based on providing the right treatment at the right time for the right patient, is to become a reality.
“Precision medicine could allow doctors to tailor treatments to suit their patient’s unique needs, but making it a reality depends on our ability to create, share and analyze large amounts of data collected from patients across the country,” says Dr. Ling. “Unless we come together to decide how we’re all going to collect this data in the same way and figure out how we can share this data between each other, this promise will never materialize.”
Piloting the medicine of the future
During the first phase of the project, the TF4CN is helping to make this happen by bringing researchers together to work on four distinct projects, including the genomic profiling of patients with metastatic colorectal cancer, the improvement of immunotherapy for patients with high-grade serous ovarian cancer, the use of quantitative molecular imaging to improve the management of prostate cancer, and the creation of an IT and data governance platform that will make data sharing and analysis possible.
This last project is perhaps the most pivotal part of the network, as getting it right could be the basis on which a national infrastructure to store, link, share, and learn from data in digital form could be built.
After a year of hard work, this infrastructure is steadily coming to life, with experts in Toronto and Vancouver coming together to create joint policies for data sharing, as well as developing a beta version of an IT platform that can be used to share clinical, genomic, imaging and pathology data between the two centres.
As it moves into its second year, network leaders hope to test this platform by sharing data collected in the three other projects that make up this pilot phase. They also hope to slowly start expanding the network by linking up with research facilities in Montreal, which recently came together under another TFRI-led pilot project known as the Montreal Cancer Consortium.
For Dr. Ling, these inter-institutional collaborations are at the forefront of collaborative science and provide a model on which a pan-Canadian network of cancer centres could be built.
“The Terry Fox Canadian Comprehensive Cancer Centre Network is providing much-needed evidence on how best to do this by modelling a broader vision for data sharing and collaborative translational and clinical research that will hopefully accelerate the implementation of precision medicine in Canada,” he says.
TF4CN Partner Institutions