For too long, treating patients with cancer has meant a hodgepodge of drugs and therapy. But governments are now recognizing that personalized diagnosis – more precise screening and medicine – makes better business sense.
To that end, the Ontario Institute for Cancer Research has set aside $18.3-million to fund three new imaging research projects that it hopes will lead to the adoption of more targeted treatments to halt the spread of cancer.
"In many cases, we are using some drugs for the wrong patient or the wrong tumour, or we're using drugs for far too long when they're not benefiting the patients," said OICR's deputy director, Nicole Onetto
This grant, she said, will help fix that.
The thinking around cancer has been changing. One striking example is research from Canada and Britain, released last week, showing there are 10 new breast cancer subtypes. And doctors are learning that this new approach to screening, which looks for specific types of tumours, can avoid over-treatment or under-treatment of cancer and other diseases.
The OICR funding, announced this week, will help develop new tools that can diagnose specific types of cancer and provide the right medicine. The organization said it will benefit cancer patients within the next five years. "This program is not only about new tools and new sophisticated images," Dr. Onetto said. It's also about continuing to understand the characteristics of the tumour and the drug response needed, she said.
The Canadian Cancer Society welcomed the new funding announcement, saying it will help bring more precision to cancer diagnoses. "More specific imaging will help identify which cancers need to be treated and which don't," said Christine Williams, the society's vice-president of research. "For example, we know that some prostate cancers are very aggressive and some are not. If we can better distinguish these different forms of prostate cancer with more precise imaging, men with slow-growing forms of the disease will not be over-treated and subject to toxic side-effects unnecessarily."
Here are the three projects that received the Ontario Institute for Cancer Research grants:
The researchers: Martin Yaffe, senior scientist at Sunnybrook Research Institute in Toronto, and James Mainprize, researcher at Sunnybrook Research Institute.
The project: Ductal carcinoma in situ (DCIS) is breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues. It is known as stage 0 breast cancer. It may progress to invasive cancer if untreated. Dr. Yaffe will use ultrasound and elastography tools (which detect tumours based on their stiffness, or elasticity, compared to normal tissue) to better inform women on the aggressiveness of the disease, providing more personalized diagnosis and improving treatment options. Dr. Mainprize, meanwhile, will look at the characteristics of the DCIS tumour prior to biopsy, using digital mammography. His research will hopefully reduce over-treatment, trim the costs to the health-care system and help women diagnosed with the disease.
The researchers: Aaron Fenster, director and scientist at Robarts Research Institute's Imaging Research Laboratory at the University of Western Ontario, and Glenn Bauman, radiation oncologist at London Health Sciences Centre.
The project: The scientists are looking to reduce the over-diagnosis of prostate cancer and also minimize the side effects of treatment. They will use imaging techniques to better distinguish between aggressive and non-aggressive cancer, and will then conduct clinical trials. The goal is to develop new imaging approaches that can be introduced in clinics and other health-care facilities.
PERSONALIZED PLAN FOR EVERY PATIENT
The researcher: David Jaffray, senior scientist at the Ontario Cancer Institute and head of radiation physics at Princess Margaret Hospital in Toronto.
The project: Dr. Jaffray is creating new systems that will standardize and develop quality control for the collection of imaging data in clinical trials. This will be an important tool to accelerate the testing in the clinic of new imaging technologies and the identification of new imaging biomarkers which may indicate the presence of a cancer.