INSIDE THE CLINIC
Blood Cancers: A Promising New Era Begins at BC Cancer
"I'm truly excited to get started on projects that will make a real difference for people here in B.C. and beyond."Dr. Florian Kuchenbauer, clinician-scientist, BC Cancer
“Treatment strategies for acute myeloid leukemia have remained mostly unchanged for over three decades,” says Dr. Florian Kuchenbauer, clinician scientist at BC Cancer. “Through optimizing established therapies, we aim to improve treatment outcomes for patients in British Columbia.”
Over 2,000 British Columbians are diagnosed with blood cancers each year. Dr. Kuchenbauer has come from Germany to B.C. to find solutions: “Our understanding of how blood cancers develop has expanded tremendously over the past decade,” he says. “With this new knowledge, we have an unprecedented opportunity to identify and develop more effective targeted drugs or immune-based treatments that will improve the standard of care.”
Blood Cancers: A Closer Look
The human body produces three types of blood cells: red, white and platelets. When blood cancer occurs, this process is interrupted by uncontrolled growth of an abnormal type of blood cell. The rapidly growing cancer cells prevent the blood from performing its key functions, such as fighting off infection.
There are three main types:
- Leukemias are grouped into acute and chronic leukemias based on how rapidly or slowly the disease progresses. Intensive chemotherapy often results in long-term side effects and a diminished quality of life.
- Lymphoma affects the lymphatic system, which removes excess fluids from the body and produces immune cells. It is the fourth most common cancer type in Canada with many different subtypes. Although immunotherapy is effective in some patients, certain lymphoma subtypes remain difficult to treat.
- Multiple Myeloma is a cancer of the plasma cells – white blood cells that fight disease and infections. Many new drugs have been approved in recent years, yet multiple myeloma remains an incurable disease.
Dr. Kuchenbauer’s Vision for the Future
Dr. Kuchenbauer was recently recruited to BC Cancer to focus on new treatment solutions for leukemia and multiple myeloma. As a clinician-scientist, he brings a unique skill set and level of expertise that will see treatment protocols in the clinic advance based on evidence uncovered in the lab.
Dr. Kuchenbauer aims to pioneer a unique translational research program bridging the Leukemia/Bone Marrow Transplant Program of BC with state-of-the-art research at BC Cancer’s Terry Fox Laboratory (TFL). The priority is for more effective, less toxic treatments to be effectively delivered to patients as soon as possible.
“Through years of clinical work, I’ve gained valuable knowledge of the needs of patients which will enable me to address ‘real life’ questions in the lab,” says Dr. Kuchenbauer. “By translating our research findings back into clinical practice, we can improve treatment options for people in British Columbia and beyond.”
The TFL conducts research into a wide spectrum of blood cancers. Dr. Kuchenbauer aims to bring groundbreaking research happening within the TFL labs to patients in the clinic. He will focus on three innovative areas of exploration:
- Leukemia: exploring underlying causes and creating more effective, less toxic therapies to replace and enhance older treatments which have remained unchanged for over three decades;
- Stem Cell Transplantation: tailoring chemotherapies prior to stem cell transplantation and reducing leukemia patients’ recovery period following transplantation;
- Multiple Myeloma: supercharging the immune system and targeting myeloma cells to prevent relapse.
Immune-Based Solutions for Blood Cancers
Stem cell transplantation is the most established type of immunotherapy in B.C. and has improved the lives of leukemia patients for decades.
Today, with the expansion of immunotherapy approaches, BC Cancer is spearheading two innovative clinical trials for blood cancers that aim to supercharge the existing immune system to respond whenever and wherever cancer may recur:
- In the CAR-T (chimeric antigen receptor t cell) trial, patients’ T cells will be genetically modified to target B-cell cancers, such as acute lymphoblastic leukemia; and
- In the lymphoma trial, scientists will seek to identify, isolate and expand mutation-specific anti-tumour T cells to eradicate the disease.
Patient enrollment will commence soon, with the CAR-T trial planned for early 2019 and the lymphoma trial projected to commence in summer 2019.
Solving Treatment Failure in Relapsed Lymphoma
Every year in Canada, 16,000 people are diagnosed with a lymphoid cancer, and more than 4,000 patients with lymphoma will relapse. With a relapse, the chances of survival drop drastically.
In January 2018, BC Cancer scientists Drs. Marco Marra, Christian Steidl and David Scott were awarded an $11.9 million Large-Scale Applied Research Project (LSARP) grant to uncover new solutions for patients facing a relapse of lymphoid cancer. They plan to develop genomics-based clinical tests to identify targeted treatment options that will improve patient outcomes and quality of life, which hinges on a $1.9 million campaign in donor matching funds.
Support blood cancer research today.
You can help the more than 2,000 diagnosed with blood cancer in our province each year. To learn more, please contact Laura Ralph at 604.877.6156 or email@example.com
BC Cancer boomerang aims to prevent cancer in British Columbians
"The hope is that with the answers we seek through our research, new policy can be put in place to remove risk, as well as allow us to continue to provide more recommendations for British Columbians to make positive changes to improve their health."Dr. Parveen Bhatti, scientific director, cancer prevention, BC Cancer
Dr. Parveen Bhatti, senior scientist and director of cancer prevention at BC Cancer describes his return to B.C. as “coming home.”
Born in Terrace and raised in Houston, British Columbia, Dr. Bhatti, has returned to BC Cancer after 15 years to pursue his passion – cancer prevention research. It was at BC Cancer in 2001 when Dr. Bhatti first completed a nine-month research position solidifying his interest in epidemiology and cancer prevention. “My dream was always to come back to BC Cancer to do research to benefit my fellow British Columbians. I’m very excited to be back in Canada and to be of service to B.C.”
Upon completing his bachelor and master’s degrees at the University of British Columbia, Dr. Bhatti moved to the U.S. to pursue his PhD, and worked at the National Cancer Institute in Washington, D.C. His initial foray into this field began with a research project looking at how genetic differences in people who work with radiation may make them more susceptible to developing cancer.
He re-joined BC Cancer this spring after holding a faculty position at Fred Hutchinson Research Center in Seattle, where his research shifted away from radiation epidemiology to explore new areas of cancer prevention research.
Melatonin suppression may lead to higher cancer risk
Dr. Bhatti’s primary research for the last decade has investigated shift work and its connection to cancer. Studies have shown people who work nights have a higher risk of cancer. His research aims to understand the mechanisms behind this and how to prevent it with modifications.
Melatonin suppression is thought to lead to higher risks of cancer. At night, we get a big surge of melatonin which is critical to a lot of biological systems, and as soon as we perceive any sort of light exposure, melatonin production is shut down. Dr. Bhatti’s work has found that because shift workers aren’t producing enough melatonin, this leads to higher levels of DNA damage, a major cause of cancer.
Dr. Bhatti hopes to conduct a clinical trial to explore melatonin supplementation in shift workers while testing levels of DNA damage.
WHAT IS CANCER PREVENTION?
Cancer prevention research focuses on population-based studies, which involves recruiting sample groups and collecting biospecimens with an overarching goal of understanding what the risk factors are of getting cancer in day-to-day life. These risk factors can be environmental, occupational or lifestyle, and once these factors are identified, researchers look at what modifications can be made to lessen cancer risk.
While treatment is vital in extending lifespans and improving quality of life, prevention seeks to preclude people from getting cancer in the first place.
Paving the way forward
In collaboration with BC Cancer's population oncology and cancer control rsearch teams, Dr. Bhatti and his colleagues are excited about the future of cancer prevention research with the advent of new technologies, including new tests and systems that can be applied to analyze data at a deeper level. “There are things that the team can do now that weren’t possible decades ago and I’m excited to take it in new directions,” says Dr. Bhatti.
The team is also inspired by the BC Generations Project as part of the Canadian Partnership for Tomorrow Project – a cohort of about 30,000 people in B.C. who provided extensively detailed questionnaire data for research purposes, including medical data like height, weight, lung function, body fat content and bone density. This rich resource was collected in 2006 and is just maturing now, allowing the team to start digging into the data and asking questions about lifestyle and genetic factors linked to increased cancer rates in B.C. and beyond.
“Prevention is a very important area of research – there is great benefit to preventing people from getting serious illness in the first place,” adds Dr. Bhatti.
Your Gift will be matched until Oct. 31
You can help expand the high quality research at BC Cancer and your donation will be matched dollar-for-dollar by William and John McCarthy until October 31, 2018. Donate at bccancerfoundation.com/prevention or contact Elissa Morrissette at 604.707.5992 or firstname.lastname@example.org.
Unique Cloud Computing Partnership Will Break Down Cancer
BC Cancer and Microsoft have established a game-changing partnership that is answering cancer’s most complex questions at a rate never thought possible.
Fuelled by advances in molecular biology, genomics and computer science, BC Cancer researchers are applying a radically investigative approach known as single cell genomics to analyze the millions of individual cells that make up cancer, made possible by cloud computing. Together, BC Cancer’s single cell genomics expertise and Microsoft’s innovative computing resources are accelerating the pace of research to understand cancer at a granular level.
“We have taken a unique approach to try to dissect cancer to its most elemental level through single cell genomics. Partnering with Microsoft has empowered our group to analyze hundreds of thousands of individual cancer cells with the Azure cloud computing platform,” says Dr. Sohrab Shah, senior scientist, BC Cancer, and co-leader of the project.
Thanks to innovations in molecular biology, biophysics, microfluidics and DNA sequencing, single cell genomics can capture cancer mutations at the highest resolution. This level of detail will enable targeted and specific combinations of treatments for individuals, based on the unique characteristics of their cancer. The valuable information gathered and stored in the cloud will allow researchers to predict how individual cells within a patient’s tumour will respond to chemotherapy.
“This technology gives us an unprecedented look inside a tumour – like looking into a microscope for the first time. We’re able to see the genomes of single cells, which reveals the cellular makeup of individual cancers. Through the cloud we can store, analyze and share this data with the international research community,” says Dr. Shah.
For patients, this could one day mean a more precise understanding of their cancer at diagnosis with a targeted treatment plan that is the most effective for them, and ultimately, more time.
“Our project would not be possible without this partnership. Microsoft’s cloud infrastructure and Azure platform are essential, and because of these programs, we see promise in changing the outcomes for many Canadians,” adds Dr. Samuel Aparicio, distinguished scientist, BC Cancer.
BC Cancer has operated at the cutting edge of the field in developing and applying algorithms and statistical models to interpret the evolutionary properties of cancer.
In partnership with colleagues at BC Cancer’s Genome Sciences Centre, Dr. Shah and Dr. Aparicio also plan to generate millions of whole genomes in the next three years, each with ~100,000 genomic features that will be analyzed, stored and shared that will accelerate further research on the data the team is generating.
To learn more about how BC Cancer is leading the way with unique and innovative partnerships, please contact Fatima Hassam at 604.877.6226 or email@example.com.
Inside the Lab
Better Tests, Better Outcomes: Predicting treatment response in bladder cancer
"Donors are at the heart of this progress. Their support is helping us move forward in our quest to improve treatment and outcomes for British Columbians.”"Dr. Bernie Eigl, provincial director, clinical trials, BC Cancer
Bladder cancer is the fifth most common cancer diagnosis in British Columbia and advanced disease is often deadly.
Although most patients initially respond well to chemotherapy, the five-year survival rate is only 5-15%.
Yet there is hope. Knowledge of the genetic characteristics of bladder cancer is expanding and researchers have identified several unique subtypes. They’ve also discovered that bladder cancer has the third highest mutation rate of all cancers, which explains why treatment often fails.
Currently, metastatic bladder cancer patients receive chemotherapy as a first line treatment, followed by immune checkpoint inhibitors (drugs that block proteins to allow immune cells to more easily kill cancer cells), but less than 50% of patients respond to either treatment.
ctDNA: The Future of Cancer Care
Scientists have known for several years that cancers shed small fragments of tumour DNA into the circulating bloodstream, but lacked the tools to extract these DNA fragments from patient blood samples and conduct meaningful analyses.
Thanks to recent technological advancements, leading experts at BC Cancer are now certain that circulating tumour DNA (ctDNA) has a powerful role to play in the future of cancer care: not only does ctDNA signal the presence of cancer in its earliest stages, it has the potential to reveal the unique mutational profile of each patient’s cancer and predict their response to treatment.
This approach is particularly promising for bladder cancer, given the high mutation rate and known release of abundant ctDNA into the blood. Over the past two years, BC Cancer researchers have established a suite of custom tools and bioinformatics pipelines designed to capture and analyze ctDNA in metastatic bladder cancer, but the potential clinical uses of ctDNA for bladder cancer remains largely unexplored.
Dr. Bernie Eigl, provincial director of clinical trials at BC Cancer, and Dr. Alexander Wyatt, leader of a genomics team at Vancouver Prostate Centre, are currently developing a biomarker program specific to bladder cancer with an overarching goal to discover bio-markers or “signatures” that might help experts determine which cancers respond to which treatments.
The collaborative study aims to determine whether ctDNA collected via a blood sample from patients with metastatic bladder cancer could help identify mutations that correspond to treatment response or resistance.
The results will help to refine the molecular landscape of aggressive bladder cancer and will lead to future clinical trials of targeted treatments.
A deeper understanding of the genetic changes within bladder cancer will also facilitate patient access to precision medicine and new, more effective treatment strategies for patients facing the disease, and BC Cancer Foundation donors are helping support these significant findings.
For more information on bladder cancer research, contact Katherine Pui at 604.707.5912 or firstname.lastname@example.org.
World-Class Care, Closer To Home
“An expanded, new pharmacy will allow us to treat more patients and develop the most advanced treatments for patients in need.”Dr. Gary Panseagrau, regional leader, medical oncology, BC Cancer
Over the next decade, the Fraser Valley will see the most significant increase in cancer diagnoses in the province, with a projected increase of 65% by 2030. This year alone, BC Cancer – Surrey will see 38,365 patient visits and 3,014 new patient consultations.
To help keep up with this demand, the Fraser Valley community banded together to support a much-needed upgrade to Surrey’s only cancer centre that provides diagnostic services, chemotherapy, radiation and supportive care.
Thanks to $1 million in donor support, BC Cancer – Surrey completed an expanded new chemotherapy unit and ambulatory care area that will see world-class cancer treatments provided close to home and have a direct impact on the lives of patients and their families facing cancer.
Harnessing the power of the airwaves, RED FM held a radiothon to raise funds for a brand new pharmacy at the centre. Thanks to the generosity of its listeners, the one-day event raised $240,000 and a major expansion for the state-of-the-art on-site pharmacy is now underway.
The newly expanded BC Cancer – Surrey centre now features nine additional patient chairs for a total of 33.
“With the expansion of our centre comes the ability to deliver exceptional care to our patients and their families, and for this we are both excited and grateful,” says Dr. Gary Pansegrau, regional leader, medical oncology at BC Cancer – Surrey.
Located adjacent to Surrey Memorial Hospital, the centre serves some of the fastest growing communities in Canada: Surrey, White Rock, North Delta, New Westminster, Port Coquitlam, Coquitlam and Port Moody. When it was built in 1995, it was originally constructed to accom modate 2,500 patients per year.
With the new expansion, the centre will now be able to accommodate a growing population by offering the latest in treatment and care.
relaxing your mind and body
“Cancer doesn’t just impact the physical; it also impacts the emotional, the patient and the family.”Melanie McDonald, patient and family counselor at BC Cancer
When someone receives a cancer diagnosis, it can bring forth a whole range of emotions that aren’t always easy to deal with.
Between 35% and 45% of all cancer patients experience significant emotional distress at some point. This is also true for family, friends and caregivers.
Through Patient & Family Counselling services at BC Cancer, patients are learning how to equip themselves with tools to help them both deal with their diagnosis and guide them through their treatments.
Support programs focusing on relaxation, mindfulness and stress reduction aim to provide patients with techniques they can practice on their own when dealing with heightened stress or anxiety.
Carrying feelings such as these on a day to day basis can wear on a person’s body, according to Dr. Kirk Austin, patient and family counselor at BC Cancer.
“When a doctor comes in and says you have cancer, your head all of a sudden tries to make sense of ‘what does this actually mean for me?’” he says. “Quite often it provokes an emotional response and your ability to think logically and actually stay in the present goes offline.”
When feeling stressed and anxious, Dr. Austin emphasizes the importance of breathing diaphragmatically – using your abdomen to breathe slowly in and slowly out so breathing is more moderated and regulated.
It’s an essential skill he shares with his patients.
“It’s really about teaching people about the nature of stress and the nature of anxiety, but also the nature of relaxation and teaching practical skills they can take home and try,” he says. “With practice, the new way of breathing can calm their overall stress response and help their overall quality of life and healing.”
Melanie McDonald, a patient and family counselor at BC Cancer, teaches programs in stress reduction, relaxation and mindfulness and says cancer impacts more than just the physical being of a patient.
“We need to look at the experience as a whole,” she says. “Cancer doesn’t just impact the physical; it also impacts the emotional, the patient and the family.”
Melanie teaches patients about bringing awareness to their breathing, trying to get them to practice “breathing down into their lower belly” to help calm their nervous system.
According to Melanie, research into practicing this type of breathing has shown significant benefits – including improved sleep.
“Bringing awareness to your breath and slowing down your breath is so good for your health and for your nervous system,” she says.