Oncology

Over the past few years, patient survival has increased for several types of cancer. For example, in the case of leukemia, the likelihood of a person being alive 5 years after their diagnosis, compared to the likelihood of survival in the population of the same age, rose from 43% to 58% between the periods 1992-1994 and 2006-2008, a 34% improvement. In Quebec, 26% of research investments are devoted to breast cancer, while leukemia research accounts for 17%, prostate cancer 10% and colorectal cancer 9%. Canada ranks first among the 10 most prolific countries with respect to oncology scientific publications (per capita). 2006-2017 worldwide production is 1,153,811 publications. Quebec compares favorably with 132 publications per 100,000 inhabitants, compared to 128 for Canada. Quebec researchers have contributed close to one quarter (23%) of the national scientific productivity, et 17 % of their publications are about breast cancer.

Many researchers specialize in identifying diagnostic methods as well as treatment for various cancers. These researchers include Dr. Claude Perreault, who works at the Institute for Research in Immunology and Cancer (IRIC) of Université de Montréal, where he studies T lymphocytes and their role in the recognition of cancer cells. He discovered leukemia-associated antigens in the mouse using ProteoGenomics. These antigens induce a strong immune response that eliminates leukemia cells. This discovery would perhaps be a start in the direction towards the creation of a therapeutic vaccine against acute myelogenous leukemia (AML). Dr Perreault also has the leadership of the biotechnology business called  SpecificiT pharma. It aims to develop new therapies to treat leukemia.

Dr. Morag Park and her colleagues at the Rosalind and Morris Goodman Cancer Research Centre form the Montreal Breast Cancer Functional Genomics Group where strategies of genomics and proteomics are used to identify molecular determinants of breast cancer diagnosis.T

the Faculty of Medicine and Health Sciences (FMSS) of Université de Sherbrooke discovered alternative PACE4 enzyme, which plays a significant role in prostate cancer. Unlike PACE4, which is found in all body cells, alternative PACE4 only occurs in cancer cells.

Given the increase in the number of cancer new cases, and the proliferation of diagnostic tools, drugs and treatments, artificial intelligence (AI) is one of the avenues currently being explored in order to deal with the growing volume and complexity of information. For example, AI applications could help in implementing digital pathology, meaning acquiring, managing, sharing and interpreting pathology information in a digital environment, in a faster and less expensive way than traditional methods, while also reducing the risk of errors. It could also help developing clinical decision support systems, which are software platforms helping clinicians make evidence-based decisions by providing comprehensive information about treatment.

Imagia is a company that aims to develop a collaborative ecosystem in the area of artificial intelligence. The company has developed Deep Radiomics biomarkers that can predict, on a personalized level, the disease’s progression and its response to treatments. This technology could become the digital equivalent of the genomic and proteomic biomarkers that researchers are endeavouring to extract from cancer tissues.

Sébastien Lemieux is a Principal Investigator at the Institute for Research in Immunology and Cancer at Université de Montréal and works in tandem with the Institute for Data Valorization (IVADO) to support the use of raw health data. His Functional and Structural Bioinformatics research unit therefore uses artificial intelligence and machine learning in health with the purpose of contributing to the valorization of data stemming from chemical screening, transcriptomic and proteomic experiments carried out at the IRIC.

Cell therapy is a recent avenue of immunotherapy that consists of collecting cancer-fighting immune cells, culturing and manipulating them in the laboratory to increase their tumor-fighting potential and reinjecting them into patients. CAR-T Cell therapies (for Chimeric Antigen Receptor-T cell) are one of the approaches that has generated very promising results in cases of advanced cancers. This type of immunotherapy relies on a combination of cell therapy and gene therapy.

For a few years and still today, physicians use stem cell transplants as a treatment for leukemia. Dr. Sauvageau is part of the Institute for Research in Immunology and Cancer at Université de Montréal. He has focused on the side effects of this therapy and is looking for a way to relieve them. Dr. Sauvageau and his team are developing an agent, ECT-001, allowing blood stem cells to multiply while avoiding the differentiation between them. ExCellThera is a biotechnology company headed by Dr. Sauvageau, which uses this technology, namely ECT-001, for Phase I and II clinical trials.

Immunotherapy is a type of biological therapy that harness the immune system to help destroy cancer cells. Cancer is no longer only seen as a genetic disease, but also as a disease of the organism, the tumor environment and the immune system. Christopher E. Rudd of the Centre de recherche de l’hôpital Maisonneuve-Rosemont recently received a grant or his T-cell signaling and cancer immunotherapy research project. His objectives are to uncover the signaling mechanisms that control the T-cell immune function and to develop new strategies for the treatment of cancer through immunotherapy.

The Center for Commercialization of Cancer Immunotherapy(C3I) is a Canadian Centre of Excellence supported by the federal government and various partners. C3I operates out of the Maisonneuve-Rosemont Hospital where it has access to a cell production centre that is unique in Canada. C3I specializes in cancer immunotherapy, a rapidly growing field that uses the immune system to fight cancer.

In Quebec, almost one clinical trial out of four targets oncology and that therapeutic field ranks first.Since 2014, the number of clinical trials and of patients recruited have been on the rise. Between 2013 and 2017, 281 clinical trials were completed in Quebec in oncology, which represents 22,9% of the clinical trials conducted in the province, all therapeutic fields included. At the same time, the number of patients recruited to be part of these trials went from 942 in 2014 to 1,412 in 2017, an increase of 50% (+470). Academic trials recorded the highest increase (+116% over the period), notably as a result of the Canadian Cancer Clinical Trials Network (3CTN) effort with the scientific community; an initiative coordinated in Quebec by the Quebec –Clinical Research Organization in Cancer(Q-CROC). Although most tumor types are represented, over 50% of ongoing clinical trials in oncology as of May, 2018, are concentrated in the following three types: hematological cancers (27%), genitourinary cancers (16%) and breast cancer (12%).

The Quebec –Clinical Research Organization in Cancer(Q-CROC) is a not-for-profit organization whose mission is to optimize patient recruitment and the quality of clinical research in oncology. The research community is at the heart of the organization’s actions. Q-CROC coordinates a clinical research network bringing together 17 of the most active health care institutions in the oncology field in Québec.

The CATALIS initiative aims to position Québec on the world stage of early clinical research (Phase I, II and II/III). Officially launched in 2016-2017, this public-private project basically plans to double the investments and the number of patients recruited for early clinical research (ECR) in Québec by the private industry. This 5-year initiative more specifically targets the optimization of the institutions operational efficiency, as well as the promotion of Québec’s ECR expertise on an international level.

Novartis is a Swiss pharmaceutical company. Its Canadian subsidiary includes a clinical research team in the Greater Montréal area. On December 6, 2018, Novartis received first approval from Health Canada for CAR-T cell therapy. Kymriah is an immunocellular therapy that uses patients’ T cells and transforms them, in vitro, into a CD19-directed genetically modified autologous T-cell immunocellular therapy. The single dose of the drug then injected in the patient fights and kills cancer cells. Novartis has therefore allowed a CAR-T therapy to enter the cancer treatment market.

Repare Therapeutics is a global leader in the identification of synthetic lethal interactions in cancer cells. Their Montréal-based research platform uses technologies such as CRISPR/Cas9 with the goal of staying on the cutting edge of innovations in oncobiology and genetic screening of synthetic lethal interactions. In June 2017, Repare Therapeutic raised US$68 million for the Canadian market. This amount enabled them to lead three products to the development stage intended both for new and well-characterized targets, likely to treat, with precision, populations of identified suffering from genetically-defined cancers. For more information on Repare Therapeutics, watch this entrepreneurial video capsule.

Selected as one of Montréal’s Top Employers in 2018, the mission of Bristol-Myers Squibb Canada  is to develop medicines for the treatment of serious diseases such as cancer. This pharmaceutical company recently received approval from Health Canada for the combination of OPDIVO (nivolumab) and YERVOY (ipilimumab) as a treatment in immuno-oncology. It would be the first treatment significantly improving the overall survival rate compared to that of the current standard treatment in intermediate- or poor-risk patients suffering from advanced or metastatic renal cell carcinoma.

In Montreal, 696 researchers work in oncology research. 10 183 publications in this niche of excellence were published this year. These researchers are working on:

• L’Institut de recherche du CUSM, l’Hôpital général juif and the Centre de recherche sur le cancer Goodman are affiliated with McGill University.
• Centre de recherche du CHUM, CHU de Sainte-Justine, Hôpital Maisonneuve Rosemont and the Institut de recherche en immunologie et en cancérologie (IRIC) are affiliated with the Université de Montréal.

As a project maturation cluster in the fiels of drug discovery, IRICoR is a not-for-profit organization based at the Institute for Research in Immunology and Cancer of the Université de Montréal. Its mandate is to accelerate the discovery, development, and commercialization of noel therapies in cancer, immunotherapy and related fields. IRICoR provides selected academic and industry projects, from Canada and abroad, with access to its network of experts and cutting-edge infrastructure, including one of the largest academia-based medicinal chemistry groups in Canada.

The NÉOMED Institute is a response to the changing R&D business models in the pharmaceutical industry. It seeks to bridge the gap between basic research and bringing new drugs on the market. The Institute provides industrial expertise in drug discovery and development combined with funding and a favorable environment to transform innovations into therapeutic solutions.

The Oncopole’s mission is to act as a catalyst leveraging actions made by the key players in Québec’s oncology and innovation research ecosystem. As a result, it aims to position the province as a leader in the field. Its priorities of action, namely research, entrepreneurship, commercialization and integration of innovation, as well as clinical relevance, are orchestrated in order to foster the mobilization of stakeholders, the discovery of innovative approaches to fight cancer and, ultimately, a positive impact for the benefit of patients.

IVADO aims to bring together industry stakeholders and academic researchers to develop cutting-edge expertise in data science, operational research and artificial intelligence.  With over 1000 affiliated scientists, IVADO is an advanced multidisciplinary centre of knowledge in various sectors.