Ontario Institute for Cancer Research

Challenges and Solutions to Clinical Issues in Cancer The Ontario Institute for Cancer Research (OICR) is a new center of excellence. It is moving Ontario to the forefront of discovery and innovation in cancer research. Funded by the Government of Ontario, through the Ministry of Research and Innovation, the Institute received a grant of $350 million for its first five years of operation. Located in the MaRS Centre, in the Discov

Ontario Institute for Cancer Research
Jan 13, 2010

Challenges and Solutions to Clinical Issues in Cancer


The Ontario Institute for Cancer Research (OICR) is a new center of excellence. It is moving Ontario to the forefront of discovery and innovation in cancer research. Funded by the Government of Ontario, through the Ministry of Research and Innovation, the Institute received a grant of $350 million for its first five years of operation.

Located in the MaRS Centre, in the Discovery District of Toronto, OICR is in the center of Ontario’s life sciences community. With a multi-disciplinary, multi-institutional approach to research, OICR is making rapid progress in addressing the challenges posed by cancer. The Institute has established major partnerships with public organizations such as Cancer Care Ontario in Ontario, the Terry Fox Research Institute and five federal agencies in Canada, and with the world’s foremost cancer and genome funding agencies in Asia, Australia, Europe and North America. Major corporate partners...


The Ontario Institute for Cancer Research (OICR) is a new center of excellence. It is moving Ontario to the forefront of discovery and innovation in cancer research. Funded by the Government of Ontario, through the Ministry of Research and Innovation, the Institute received a grant of $350 million for its first five years of operation.

Located in the MaRS Centre, in the Discovery District of Toronto, OICR is in the center of Ontario’s life sciences community. With a multi-disciplinary, multi-institutional approach to research, OICR is making rapid progress in addressing the challenges posed by cancer. The Institute has established major partnerships with public organizations such as Cancer Care Ontario in Ontario, the Terry Fox Research Institute and five federal agencies in Canada, and with the world’s foremost cancer and genome funding agencies in Asia, Australia, Europe and North America. Major corporate partners include Pfizer Global Research and GE Healthcare.

OICR’s research is focusing on prevention, detection and treatment of cancer. By investing in translational research, OICR is moving new discoveries from the bench to practical application in patients. OICR has identified issues in clinical management where significant progress is currently being made in Ontario that could benefit patients in the next five years.

OICR’s commercialization of Ontario discoveries
OICR created a targeted investment funding and commercial development mechanism, the Intellectual Property Development and Commercialization Program. It aims to de-risk and accelerate the advancement of particularly promising cancer innovations by providing meaningful funding and expert development, as well as regulatory and commercial guidance. The Program has gained considerable attention in the community and is widely regarded as having value both as a barometer of commercially viable technology as well as a desired partner that provides useful and timely guidance. In just over two years the Program has funded 12 projects and several more are under review. OICR’s contributions have been helpful in advancing a number of these projects to commercially important milestones such as licensing agreements, clinical development strategies, first-in-man clinical studies and sales initiatives.

Prevention/Early Detection

Colon Cancer
Colorectal cancer is the second leading cause of cancer-related death in Canada. It is one of the key causes of avoidable cancer-related death because mortality can be reduced through screening programs. There is strong evidence that regular screening using fecal occult blood testing (FOBT) reduces both incidence and mortality from this cancer. Ontario has had poor rates of colon cancer screening although they have started to improve with the introduction of the ColonCancerCheck program. Previously, only 23 per cent of people over 50 years of age reported ever having had screening. The rate has increased to more than 40 per cent for FOBT, and the total number appears to exceed 50 per cent when primary screening colonoscopy is added to the mix. Further improvements are needed.

OICR Actions
OICR and Cancer Care Ontario (CCO) are partners in efforts to increase colorectal cancer screening and participation in ColonCancerCheck, a five-year investment of $193.5 million by the Province of Ontario aimed at reducing deaths from colorectal cancer by increasing early detection of the disease. OICR supports studies into the genetic and environmental causes of colorectal cancer. OICR supports the development of optical/computed tomography dual probes to screen for colorectal cancer. OICR and CCO are developing and evaluating risk assessment tools to make screening programs more effective.

Detection

Prostate Cancer
The availability and frequency of PSA screening has resulted in an increase in the diagnosis of prostate cancer. All patients diagnosed with prostate cancer are treated even though the treatment, radical surgery or radiation therapy, can seriously affect quality of life. It can result in sexual, urinary and rectal dysfunction and creates financial and emotional burdens. Screening and surveillance methods are needed to identify the tumors that would not progress and pose no risk, and those that require immediate treatment. There is also a need for treatments that have fewer side effects than current approaches.

OICR actions
OICR is developing urine, serum, imaging and pathological markers that predict aggressive disease. OICR’s imaging groups have developed technologies to guide repeat prostate biopsies and identify significant tumors needing treatment. Studies using Magnetic Resonance Imaging suggest a role for this diagnostic tool in active surveillance and screening. OICR will generate genomic data from indolent and aggressive tumors. This data will allow researchers to identify biomarkers that will tell us whether the prostate cancer is aggressive or not.

Diagnosis

Breast Cancer
Over-diagnosis of breast cancer refers to the possibility that not all diagnosed cancers would become lethal. Some cancers might pose no risk or might even regress. Scientists have suggested that a less aggressive treatment could be successful for certain types of breast cancer. The estimate of how much over-diagnosis actually exists varies. Currently there are no reliable screening methods to distinguish between aggressive cancers and those that are not. More specific diagnostic tools and pathology techniques that provide better prognostic information are needed to avoid over-diagnosis. This could help define whether a cancer requires treatment and how aggressive the treatment should be.

OICR actions
OICR is developing imaging and pathological markers that predict the risk of metastatic disease. OICR has brought breast cancer biologists and imaging probe developers together with Ontario teams that have made significant contributions to breast cancer imaging, including MRI. Targeted ultrasound using micro-bubble imaging technologies that evaluate tumor vessels are being developed to characterize the aggressiveness of breast tumors. OICR supports the development of 3D image visualization tools and software for pathologists that will allow better assessment of tumor margins and quantitative measures of cancer biomarkers in tumor biopsies.

Therapy

Pancreatic Cancer
Although pancreatic cancer is less common than breast, colon, lung or prostate cancer, it is usually fatal. Only five per cent of pancreatic cancer patients survive for five years, making it the fifth leading cause of cancer death. Most cases are diagnosed after the cancer has already spread. Only 15-20 per cent of patients with pancreatic cancer can benefit from surgery as most present with disease which already involves major vessels or vital organs.

OICR actions
OICR is conducting a large-scale genomic analysis of pancreatic cancer, as a member of the International Cancer Genome Consortium. OICR is also establishing and characterizing hundreds of pancreatic cancer cell lines and xenograft models to be used in pre-clinical studies of novel therapeutics. Integration of genomics with clinical trials will enable physicians to select patients that have tumors with mutations in gene pathways that can be targeted by existing drugs or compounds in clinical development.

Survivors

Pediatric and young adult cancer survivors
There are currently more than 150,000 Canadians who were diagnosed with cancer and treated prior to middle age. These survivors face a number of challenges not shared by patients diagnosed later in life:

  • Growth and developmental disorders;
  • Long-term toxicities appearing several years after discontinuation of initial treatments;
  • Emotional and social integration problems.

This group of cancer survivors has received relatively little attention.

OICR actions
OICR is working with other Canadian agencies to create a national program to improve quality of life for young cancer survivors. OICR has expertise from its pharmacovigilance research initiatives examining the long-term effects of cancer drugs and variation in follow-up practices. It also has the expertise of scientists from the radiation oncology, surgical oncology, and social science communities.