Clinical trial: Using MRI for prostate cancer diagnosis equals or beats current standard

Phase III clinical trial of men with a clinical suspicion of prostate cancer finds MRI with targeted biopsies to be more accurate at diagnosis and less intrusive than current standard

Toronto – (February 4, 2021) The results of a Phase III randomized clinical trial have shown that when it comes to detecting clinically significant prostate cancer, Magnetic Resonance Imaging (MRI) with targeted biopsies (MRI-TBx) matches the current standard and brings a multitude of advantages. The PRostate Evaluation for Clinically Important Disease: MRI vs Standard Evaluation Procedures (PRECISE)study will help to make prostate cancer diagnosis more accurate and less invasive.

PRECISE included 453 participants at Canadian academic cancer centres who were either assigned to receive MRI imaging followed by MRI-TBx of suspicious areas (identified by MRI), or the current standard of care of a systematic 12-core transrectal ultrasound-guided (TRUS) biopsy (TRUS-Bx).

Key findings:

MRI with targeted biopsy found five per cent more clinically significant prostate cancers compared to those receiving systematic TRUS-Bx biopsies, conclusively demonstrating the method can at least match the performance of the current standard of care.
Compared to standard TRUS-Bx, the MRI-TBx were found to be better in identifying clinically significant cancers.
More than a third of patients in the MRI arm of the trial avoided biopsies altogether following negative imaging results. Those individuals received a follow-up MRI in two years’ time.
Those who did have biopsies in the MRI arm had significantly fewer samples taken when compared to systematic TRUS-Bx, resulting in less pain and discomfort for patients. Moreover, the MRI arm had a decreased adverse event profile, including less hematuria (blood in the urine) and incontinence.
There is a major unmet need for a test that identifies clinically significant prostate cancer while avoiding overdiagnosing clinically insignificant cancers. Use of MRI reduced the unnecessary diagnosis of slow growing, clinically insignificant prostate cancers by 55 per cent.

These findings show decisively that MRI together with targeted biopsies offer patients a less invasive procedure, the chance to avoid a biopsy all together and can help avoid the over-treatment of clinically insignificant prostate cancer – all while detecting a higher rate of clinically significant cancers.

“My colleagues and I are thrilled about these results that show, without a doubt, that imaging and targeted biopsies are the future of prostate cancer diagnosis. We can catch more of the cancers we should be treating, avoid unnecessary treatment at the same time and improve the quality of life for our patients.” says Dr. Laurence Klotz, Chair of Prostate Cancer Research at Sunnybrook Health Sciences Centre and lead author of the study. “We thank the study participants and our funders for their support and look forward to continuing our efforts to have this technology used more widely.”

“The study’s findings have influenced Ontario Health-Cancer Care Ontario’s upcoming, updated Prostate MRI Guidelines, which will be released this year,” says Dr. Masoom Haider, co-lead of the study and Professor of Medical Imaging at the University of Toronto, and Clinician Scientist with the Ontario Institute for Cancer Research (OICR). “I am pleased to see our research produce results that will make a real difference in how prostate cancer is diagnosed and improve the lives of patients.”

“I congratulate Dr. Klotz and the PRECISE team on this truly impactful research which will change clinical care and make a difference for men with prostate cancer,” says Dr. Christine Williams, Deputy Director and Head, Clinical Translation, OICR. “It is a great example of how, with our partners, we are moving research innovations to the clinic to improve the lives of patients and treat cancer with improved precision.”

“These practice-changing results will have a significant and positive impact on the roughly 64 Canadians who are diagnosed with prostate cancer every day. Thanks to the efforts of Dr. Klotz and his team, people will need to undergo fewer biopsies and for some of them, they will be spared from unnecessary biopsies and treatments altogether,” says Dr. Stuart Edmonds, Executive Vice President, Mission, Research and Advocacy at the Canadian Cancer Society. “We are proud to support this research, which will help people with prostate cancer live longer, fuller lives.”

“At Movember, we are honoured to play a role in funding cutting-edge research like the PRECISE study, ultimately helping to provide more positive outcomes for men living with or beyond a prostate cancer diagnosis,” says Todd Minerson, Country Director for Movember Canada.

PRECISE was funded by the Canadian Cancer Society with funds provided by Movember and by the Ontario Institute for Cancer Research.

About the Ontario Institute for Cancer Research

OICR is a collaborative, not-for-profit research institute funded by the Government of Ontario. We conduct and enable high-impact translational cancer research to accelerate the development of discoveries for patients around the world while maximizing the economic benefit of this research for the people of Ontario. For more information visit http://www.oicr.on.ca.

About the Canadian Cancer Society

The Canadian Cancer Society (CCS) is the only national charity that supports Canadians with all cancers in communities across the country. No other organization does what we do; we are the voice for Canadians who care about cancer. We fund groundbreaking research, provide a support system for all those affected by cancer and shape health policies to prevent cancer and support those living with the disease.

Help us make a difference. Call 1-888-939-3333 or visit cancer.ca today.

About Movember

Movember is the leading charity changing the face of men’s health on a global scale, focusing on mental health and suicide prevention, prostate cancer and testicular cancer. The charity raises funds to deliver innovative, breakthrough research and support programs that enable men to live happier, healthier and longer lives. Committed to disrupting the status quo, millions have joined the movement, helping fund over 1,250 projects around the world. In addition to tackling key health issues faced by men, Movember is working to encourage men to stay healthy in all areas of their life, with a focus on men staying socially connected, and becoming more open to discussing their health and significant moments in their lives. The charity’s vision is to have an everlasting impact on the face of men’s health. To donate or learn more, please visit Movember.com.

Happy holidays from OICR

A holiday message from Dr. Laszlo Radvanyi, OICR’s President and Scientific Director:

This year has presented immense challenges and hardships for people around the world, including cancer patients, researchers, clinicians and many others in the OICR community.

As I reflect on what has transpired over 2020, I think the most lasting memory will be the amazing adaptability of our staff, funded researchers, leadership and partners that has allowed us to continue pressing ahead in the fight against cancer, all while contributing to COVID-19 research and staying safe. I thank everyone for their remarkable contributions to cancer research during this difficult time and for being part of the historic scientific campaign against COVID-19, while keeping our cancer focus solidly intact.

While the year did not go as anyone planned, we have continued to make a difference for cancer patients by advancing cutting-edge solutions for preventing, screening, diagnosing and treating cancer. Of particular note this year was the Pan-Cancer Analysis of Whole Genomes (PCAWG) project coming to its climax, generating astounding insights into cancer genomics that are fueling entirely new ways to approach cancer such as developing new tools and approaches to interrogate the role of non-coding regions of the genome. This project is emblematic of the efforts of OICR researchers across our programs to collaborate and find truly novel solutions to the many challenges we face in improving the lives of cancer patients. The scientific network of investigators we fund has also made tremendous contributions, including advancing new drug targets and cell therapy approaches against cancer as well as inroads in understanding cancer therapeutic resistance via cancer stem cells and uncovering novel molecular subsets of cancers, such as pancreatic cancer.

Earlier this year a positive international external review found that OICR is making a true impact and is on the right track, having built a firm foundation to reinforce our model and take the next steps in furthering our impact. Through consultations with our stakeholders, we have developed a bold and visionary new strategic plan that will expand our focus on early cancer detection and intervention as well as strengthen our growing and successful drug discovery efforts. This plan builds not only on our current momentum, but also further deepens collaborations with our provincial, national and global partners.

Of course, our progress thus far would not be possible without the support of the Government of Ontario through the Ministry of Colleges and Universities – I thank them for their continued investment in made-in-Ontario cancer innovations and belief in our vision of “cancer solved together”. I also thank our partners in cancer research and care at cancer centres, research institutes and universities across Ontario for their continued collaboration and engagement. Together we have continued to perform world class research, improve cancer care and bring real economic benefits to Ontario’s economy.

In closing, I note that many of us will not be able to celebrate the holidays as we have in years past. While this is unfortunate, we must focus on the good we are doing for ourselves, our loved ones and our communities by doing our part for public health. I wish happy holidays and a happy new year to all as we look forward to a much brighter year ahead. Please take care and stay safe.

Sincerly,

Dr. Laszlo Radvanyi
President and Scientific Director, OICR

Cancer research through COVID: A drug discovery student’s perspective

Despite disruptions, cancer researchers across Ontario are continuing to make scientific progress in labs and at home. Here, Vivian discusses her master’s project, discovering drug targets for future immunotherapies.

Cancer research during COVID19 – Vivian Gao

Vivian talks about the research that OICR is doing during COVID-19 and the kinds of safety precautions that OICR is taking.

Research from home: Kelly McDonald

Learn about the research that the Ontario Health Study has been doing during COVID-19 and how scientists have managed to do this work from home.

Philanthropic donation moves The Alex U. Soyka Pancreatic Cancer Research Project: An International Partnership into Phase II

Ontario-Israel collaboration to explore personalized treatment and improved diagnostics for pancreatic cancer

Toronto – (June 24, 2020) A second significant multi-year commitment from Sylvia M. G. Soyka, Director, and the Alex U. Soyka Foundation to the Canadian Friends of the Hebrew University of Jerusalem (CFHU) will allow researchers from the Ontario Institute for Cancer Research (OICR), the Hebrew University’s Institute for Medical Research Israel-Canada (IMRIC) and Sheba Medical Center to conduct The Alex U. Soyka Pancreatic Cancer Research Project: Phase II – An International Partnership (Soyka Project).

Phase II builds upon the outstanding achievements of Phase I of the Soyka Project by fostering further collaboration between Israeli and Ontario researchers, focusing on three main research avenues in pancreatic cancer – to develop effective patient-specific treatment courses, address the challenges of tumour cell heterogeneity and create new methods for early-stage diagnosis.

As a measure of its impact so far, Phase I of the Soyka Project has been cited in more than 18 peer-reviewed papers on pancreatic cancer including manuscripts in the prestigious journals Nature Genetics, Nature Medicine and Cancer Cell. Phase II of the Soyka Project will provide eight of Israel’s leading cancer researchers with funds to explore the molecular origins of pancreatic cancer, as well as novel diagnostic biomarkers and therapeutic approaches. These fellowships are key to the multi-disciplinary approach of the Soyka Project and this round of funding will see new scientists joining the team with expertise in single-cell RNA sequencing and bioinformatics, some of the most advanced approaches used in cancer research today.

A central component of Phase II is to increase the opportunity for patients at the Sheba Medical Center in Israel to be molecularly profiled according to the COMPASS clinical trial guidelines. COMPASS is a world-leading initiative led by Dr. Steven Gallinger, supported by OICR and based at the University Health Network in Toronto, that uses genomic and transcriptomic information from patient tumours to personalize treatment with the aim of improving outcomes. The data collected through COMPASS will also be used by Soyka Project scientists to dig deep into the inner workings of pancreatic cancer.

“I feel proud and privileged to fund Phase II of this international collaboration in pancreatic cancer research,” says Sylvia M. G. Soyka. “In the world of cancer research, much progress has been made in recent years, but pancreatic cancer remains a deadly disease with a dismal less than 10% five-year survival rate. When we started Phase I in 2014, the five-year survival rate was less than 5%, but there is clearly a long way to go. In 2010, my father, a man fully engaged in every aspect of life who took great pains to look after his health, the sort of person who was going to live well forever, was diagnosed out of the blue and died three months to the day later. The Soyka Project is his legacy. Phase I was highly successful, in no small part due to the collaboration of the dedicated scientists, within and between the teams, which created new directions. In the context of today’s world, I feel strongly that the fact of the collaboration alone, which requires both trust and generosity of spirit, sets an important example which should be emulated. The rewards of Phase II will be ours as well as theirs.”

“I am extremely thankful to Sylvia Soyka for her generous funding of this cutting-edge research program. Pancreatic cancer is notoriously difficult to detect and treat and patients need better options,” says Dr. Laszlo Radvanyi, President and Scientific Director, OICR. “The Soyka Project is an incredible example of the benefits of international scientific collaboration that will reveal important insights into detecting pancreatic cancer earlier and developing precision medicine tools for improved treatment. We are thrilled to continue this important work with our partners in Israel.”

“Sylvia Soyka is the driving force and inspiration behind The Alex U. Soyka Pancreatic Cancer Research Project that started six years ago and now, her recent generous donation will allow the second phase of research,” says Prof. Haya Lorberboum-Galski, Chair of IMRIC. “Her longstanding support is of vast importance to the researchers at IMRIC as it will enable us to continue our ongoing endeavour to decipher the basic molecular aspects of one of the deadliest cancers – pancreatic cancer. We hope this exciting work, in collaboration with OICR, will lead to new approaches for early diagnosis, prevention, treatment and a cure.”

“Sylvia Soyka is an exemplary philanthropic leader who decided to tackle one of the most challenging and underfunded cancers,” says Rami Kleinmann, President and CEO of CFHU. “Together with an outstanding team of researchers and practitioners from Canada and Israel, she managed to help make substantial progress in understanding the disease. We hope that with the current funding of Phase II, we will be able to take it even further.”

About The Alex U. Soyka Pancreatic Cancer Research Project: Phase II – An International Partnership (Soyka Project)

Alex U. Soyka was a committed supporter of the Hebrew University through the CFHU in Montreal. Following his death from pancreatic cancer in 2010, his daughter Sylvia M. G. Soyka, Director, and the Alex U. Soyka Foundation, made a multi-year funding commitment to CFHU to launch The Alex U. Soyka Pancreatic Cancer Research Project.

About the Ontario Institute for Cancer Research (OICR)
OICR is a collaborative, not-for-profit research institute funded by the Government of Ontario. We conduct and enable high-impact translational cancer research to accelerate the development of discoveries for patients around the world while maximizing the economic benefit of this research for the people of Ontario. For more information visit https://oicr.on.ca/

About the Institute for Medical Research Israel-Canada (IMRIC)

The Institute conducts basic and translational/precision research in the field of biomedicine with a main focus on cancer research. The Institute scientists work in a multidisciplinary enterprise that is essential for understanding most of the diseases that currently challenge medical science, including cancer, for the benefit of patients all over the world. For more information visit https://medicine.ekmd.huji.ac.il/En/academicUnits/imric/Pages/Default.aspx

About the Canadian Friends of Hebrew University (CFHU)

CFHU facilitates academic and research partnerships between Canada and Israel, as well as establishes scholarships, supports research and cultivates student and faculty exchanges. Albert Einstein, Martin Buber, Chaim Weizmann and Sigmund Freud were among the university’s founders whose genius inspired a university without limits or borders. CFHU is dedicated to supporting Hebrew University in its efforts to remain one of the most innovative learning institutions in the world.

OICR media contact
Christopher Needles
Director, Communications
Ontario Institute for Cancer Research
416-319-5252
christopher.needles@oicr.on.ca

CFHU media contact
Robert Sarner
Senior National Director, Communication
Canadian Friends of the Hebrew University
416-485-8000, Ext. 111
rsarner@cfhu.org

FACIT backs made-in-Ontario data science and medtech innovations through Prospects Oncology Fund

Replica Analytics & Sunnybrook’s Czarnota Lab receive key seed funding to de-risk Ontario intellectual property

TORONTO, ON (June 23, 2020) – FACIT, a commercialization venture firm, announced the newest recipients of Ontario First seed capital through the latest round of its Prospects Oncology Fund: Ottawa-based data science start-up Replica Analytics Ltd., and medtech innovator Dr. Greg Czarnota of Toronto’s Sunnybrook Research Institute.

Replica Analytics Ltd. is a new venture created by Dr. Khaled El Emam, a serial entrepreneur whose previous venture, FACIT-backed Privacy Analytics, was acquired by IMS Health. Replica Analytics is developing modeling software to create synthetic data based on real clinical datasets. High quality synthetic data is increasingly sought after by researchers, the pharmaceutical industry, and other entrepreneurs who require the datasets to build new models and enable AI innovation in healthcare.

(more…)

Accelerating the development of new cancer drugs in Ontario

Drs. Lisa Porter and John Trant from the University of Windsor are working to develop a drug to block a protein that is elevated in some types of aggressive cancer. Disrupting the activity of this unique protein complex could slow or stop the disease. By providing researchers such as Porter and Trant with funding support and access to expertise, OICR’s Cancer Therapeutics Innovation Pipeline initiative is enabling the development of the next wave of made-in-Ontario cancer therapies.

How HER CODE CAMP aims to fix the diversity gap in computer science

OICR staff members Joanna Pineda, a Master’s Student, and Heather Gibling, a PhD Student, talk about how important it is to introduce young women, non-binary and transgender students to computer science.

Unprecedented exploration generates most comprehensive map of cancer genomes charted to date

Pan-Cancer Project discovers causes of previously unexplained cancers, pinpoints cancer-causing events and zeroes in on mechanisms of development

Toronto – (February 5, 2020) An international team has completed the most comprehensive study of whole cancer genomes to date, significantly improving our fundamental understanding of cancer and signposting new directions for its diagnosis and treatment.

The ICGC/TCGA Pan-Cancer Analysis of Whole Genomes Project (PCAWG), known as the Pan-Cancer Project, a collaboration involving more than 1,300 scientists and clinicians from 37 countries, analyzed more than 2,600 genomes of 38 different tumour types, creating a huge resource of primary cancer genomes. This was then the launch-point for 16 working groups studying multiple aspects of cancer’s development, causation, progression and classification.

Previous studies focused on the 1 per cent of the genome that codes for proteins, analogous to mapping the coasts of the continents. The Pan-Cancer Project explored in considerably greater detail the remaining 99 per cent of the genome, including key regions that control switching genes on and off — analogous to mapping the interiors of continents versus just their coastlines.

The Pan-Cancer Project has made available a comprehensive resource for cancer genomics research, including the raw genome sequencing data, software for cancer genome analysis, and multiple interactive websites exploring various aspects of the Pan-Cancer Project data.

The Pan-Cancer Project extended and advanced methods for analyzing cancer genomes which included cloud computing, and by applying these methods to its large dataset, discovered new knowledge about cancer biology and confirmed important findings of previous studies. In 23 papers published today in Nature and its affiliated journals, the Pan-Cancer Project reports that:

The cancer genome is finite and knowable, but enormously complicated. By combining sequencing of the whole cancer genome with a suite of analysis tools, we can characterize every genetic change found in a cancer, all the processes that have generated those mutations, and even the order of key events during a cancer’s life history.
Researchers are close to cataloguing all of the biological pathways involved in cancer and having a fuller picture of their actions in the genome. At least one causal mutation was found in virtually all of the cancers analyzed and the processes that generate mutations were found to be hugely diverse — from changes in single DNA letters to the reorganization of whole chromosomes. Multiple novel regions of the genome controlling how genes switch on and off were identified as targets of cancer-causing mutations.
Through a new method of “carbon dating,” Pan-Cancer researchers discovered that it is possible to identify mutations which occurred years, sometimes even decades, before the tumour appears. This opens, theoretically, a window of opportunity for early cancer detection.
Tumour types can be identified accurately according to the patterns of genetic changes seen throughout the genome, potentially aiding the diagnosis of a patient’s cancer where conventional clinical tests could not identify its type. Knowledge of the exact tumour type could also help tailor treatments.

“The incredible work of the Pan-Cancer Project team that was unveiled today is the culmination of a remarkable international collaboration that has enriched our understanding and provided new ways to approach the prevention, diagnosis and treatment of cancer,” said The Honourable Ross Romano, Ontario’s Minister of Colleges and Universities. “I congratulate the entire research group on this ground-breaking achievement in cancer research. Ontarians can be proud of the leading role OICR played in this initiative.”

“The findings we have shared with the world today are the culmination of an unparalleled, decade-long collaboration that explored the entire cancer genome,” says Dr. Lincoln Stein, member of the Project steering committee and Head of Adaptive Oncology at the Ontario Institute for Cancer Research (OICR). “With the knowledge we have gained about the origins and evolution of tumours, we can develop new tools to detect cancer earlier, develop more targeted therapies and treat patients more successfully.”

“The Pan-Cancer Project has generated a much-needed deeper understanding of the biology of cancer and how the elusive and untapped “dark matter” in the human genome drives cancer,” says Dr. Laszlo Radvanyi, OICR’s President and Scientific Director. “These discoveries can lead to totally new area of targets for cancer therapy. It is gratifying to know that OICR helped to lead the international effort, while also integrating a collaborative network of Ontario researchers to play a leading role in this global project. It is a further indication of the value of our strategic investments into data infrastructure, research and informatics expertise, as well as the value the Ontario government continues to create in supporting OICR. I congratulate Dr. Stein, his team and all Pan-Cancer researchers on this landmark achievement.”

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Backgrounder

More information

Nature landing page – https://www.nature.com/collections/pcawg/
ICGC – International Cancer Genome Consortium (https://icgc.org/)
TCGA – The Cancer Genome Atlas (https://www.cancer.gov/about-nci/organization/ccg/research/structural-genomics/tcga)
PCAWG – PanCancer Analysis of Whole Genomes (dcc.icgc.org/pcawg)
UCSC – University of California Santa Cruz (pcawg.xenahubs.net)
Expression Atlas (www.ebi.ac.uk/gxa/home)
PCAWG-Scout (pcawgscout.bsc.es)
Chromothripsis Explorer (compbio.med.harvard.edu/chromothripsis)
COSMIC – Catalogue of Somatic Mutations in Cancer (https://cancer.sanger.ac.uk/cosmic)

About the Ontario Institute for Cancer Research

Media contact

Hal Costie
Ontario Institute for Cancer Research
647-260-7921
hal.costie@oicr.on.ca

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