Terry Fox Research Institute (TFRI)’s overall vision is to create the Marathon of Hope Cancer Centres as a national network that will embed research in the cancer clinic, uniting the top-tier cancer researchers and clinicians throughout Canada. This allows centres to share their data and expertise. In the future, every time a cancer is treated, all Centres will have access to the information about the cancer and how the cancer responded to treatment. This makes the Marathon of Hope Cancer Centres act as accelerators, propelling research forward.
The focus of the national network is on precision medicine as it applies to cancer, taking into account individual variability in environment, lifestyle, and genes for each person. The goal is to create a prospective cohort of Canadian cancer patients to apply precision medicine. Precision medicine requires big data - genetic information about a population of thousands of Canadians. This provides researchers and clinicians with the knowledge and tools to determine which treatments will deliver the best outcomes for each patient.
To be part of this network, we are proposing the creation of the Prairie Cancer Research Consortium (PCRC) comprising the cancer centres in Calgary, Edmonton, Saskatoon and Winnipeg in the three prairie provinces of Alberta, Saskatchewan and Manitoba. The Consortium aims to establish a structure to share and/or link research activities across the Prairie Provinces, invest in essential research infrastructure to align efficiently with other Marathon of Hope Centres, and participate fully with the expertise and capacity of the national network.
The Consortium’s specific objectives are to improve research infrastructure allowing for the sharing of data, to increase training opportunities, and to enhance collaborations. This will be accomplished through the creation of a core platform to integrate clinical and biological data across the prairies and by the execution of two demonstration research projects. These demonstration pilot research projects were prioritized by Consortium members will focus on brain and breast cancer. The projects act as a proof of principle for data and specimen sharing, and collaboration between centres.
Core Platform for integration of clinical and biological data: Ensuring success of the Consortium within the national network requires the existing biobanks and clinical/biological databases to integrate across the Prairie Provinces. This core platform aims to harmonize SOPs for the collection of biospecimens at the time of diagnosis, and then sequentially throughout the course of the disease (where possible). These SOPs will facilitate sharing and will ensure the highest level of quality control.
The local biobanks will also expand to include live cancer biobanking and cell-free DNA. Beyond harmonization of sample acquisition, the core platform will unify clinical and biological data allowing researchers to perform their own sample search and requisition through an online data platform. Each biospecimen in the bank will be linked to that patient’s complete clinical and biological data, including -omic data and data generated in the two pilot projects. Finally, the core biobank platform will coordinate sharing of biospecimens and data between researchers across the prairies with the goal of integration with the Marathon of Hope Cancer Centres Network.
Project 1: Glioblastoma is the most common form of adult brain cancer and one of the most fatal cancers in Canada. New therapies have failed due to the challenges of the tumor microenvironment. It is not well known how cells communicate with each other within the tumour microenvironment (TME) of GBM and how these interactions may change in response to therapies. We will therefore focus on: the genomic/epigenomic heterogeneity of GBM, the immunological landscape of GBM, and vulnerabilities conferred by deficiencies in the DNA repair machinery.
Project 2: Despite many advances in the treatment of breast cancer, many women continue to die from this disease. Our goal is to define TME factors that predict and prevent breast cancer metastasis and therapy resistance in patients, including those with the most frequent breast cancer, Luminal A type tumors. The aims will be to identify a genetic signature for TME interactions that may predict which breast cancers may progress and to decipher mechanisms for TME driven drug resistance and metastasis so new treatment strategies may be realized.
Conclusion: Together these two projects and the biobanking core will create a new Prairie Cancer Research Consortium focused on discovering and developing new approaches to improve cancer outcomes. This will be facilitated by linking research infrastructure and patient cancer cohorts across the Prairies and eventually with the other Marathon of Hope Cancer Centres. The impact will be a clearer understanding of what patients will benefit from the right treatments at the right time for the right cancer, otherwise known as precision medicine.