• Generate evidence about what works
• Establish pathways to increase uptake of evidence-based innovations
• Engage with policymakers and clinicians
• Translate knowledge to diverse audiences

Implementation Science Co-Lead
Dr. Christine Williams, PhD
Executive Vice President, OICR

Implementation Science Co-Lead
Dr. Harriet Feilotter, PhD, FCCMG, FACMG
Director, Ontario Molecular Pathology Research Network

Project Manager
Victor Szymanski
Implementation Science

• Dr. David Berman of Queen’s University created a system to objectively grade bladder cancer so that it can be treated more effectively. ‘High-grade’ and ‘low-grade’ bladder cancers are treated very differently, but the process to determine grading is highly subjective. Expert pathologists will disagree on cancer grades in 20 to 40 per cent of cases. With I2I funding, Berman and colleagues will test a computer-aided grading system for bladder cancer based on quantitative measures and work with industry, academic and patient partners to help it make it available to clinicians.
• Dr. Yvonne Bombard of the University of Toronto and St. Michael’s Hospital, a site of Unity Health Toronto, is investigating how to make genetic services for cancer more equitable for all people across Ontario. Genetic testing can help identify people at high risk of developing cancer so they can be screened earlier and treated more effectively should cancer develop. But racialized communities have a more difficult time accessing genetic services and getting a definitive diagnosis, in part because most genetic research is done on people of European ancestry but also because of the barriers built into our healthcare system. With funding from OICR, Bombard and colleagues will interview people from diverse backgrounds as well as genomics researchers, healthcare providers and other stakeholders to identify barriers to accessing genetic services and work together with racialized communities on strategies to overcome them.
• Dr. Kelvin Chan of Sunnybrook Research Institute is studying the impact of CAR-T cell therapy on quality of life for patients with lymphoma. CAR-T cell therapy shows a lot of promise in treating blood cancers like lymphoma and works by training the body’s immune cells to find and kill cancer. But it is very costly to manufacture and administer, making it difficult for regulators to measure its cost-effectiveness and manage access. In their I2I study, Chan and colleagues will ask lymphoma patients about their quality of life before and after undergoing CAR-T cell therapy so that their experiences can be factored into policy decisions surrounding this potentially life-changing new treatment.
• Dr. Geoffrey Fong of the University of Waterloo is studying the positive impact of government policies aimed at reducing the negative effects of tobacco smoking, the world’s largest cause of preventable cancer. With this funding, he will work with Ontario and international experts to model the impact of ‘endgame’ tobacco control policies, like reducing nicotine levels in cigarettes to non-addictive levels, if they were to be implemented in Canada.
• Dr. Harriet Feilotter of Queen’s University and colleagues have created the Implementation Laboratory (IL), a central lab that can advise Ontario hospitals on the best way to test tumours for cancer biomarkers. I2IS funding will help them generate more evidence for the use of the lab and design educational and clinical tools to help Ontario hospitals access it.
• Dr. Monika Krzyzanowska of the Princess Margaret Cancer Centre at the University Health Network is exploring remote interventions to help cancer patients to manage the side effects of chemotherapy between visits to the clinic. Support from OICR will help Krzyzanowska and her team capitalize on the recent growth of virtual healthcare by implementing and evaluating a telephone-based symptom management program at a large Ontario cancer centre focusing on high-risk patients undergoing chemotherapy.
• Dr. Alexander Louie and Dr. Ambika Parmar of Sunnybrook Research Institute are investigating how to best determine the cost-effectiveness of publicly funding new cancer drugs for metastatic lung cancer. With OICR’s support, they and their colleagues will develop a framework to assess cost-effectiveness that considers the many sub-types of lung cancer and use the results to engage with Canadian drug-funding agencies.
• Dr. Anthony Nichols of Lawson Health Research Institute and London Health Sciences Centre is developing a molecular test to predict how patients with HPV-related head and neck cancers, the fastest rising cancers in North America, will respond to treatment. Standard treatment for these cancers is high doses of chemotherapy and radiation, which carry significant side effects, so it’s important to know which patients will benefit from treatment and which patients could be spared unnecessary side effects. Nichols and colleagues will use their I2I award to confirm that their test is accurate and explore how it could be integrated into clinical care.
• Dr. Rola Saleeb of St. Michael’s Hospital, a site of Unity Health Toronto, is exploring the use of a new tool to standardize genetic testing for glioma, the most common type of brain cancer. This technology uses a more affordable DNA sequencing technology and could make genetic testing more accessible. Existing genetic tests are done using large, expensive equipment that isn’t available in all laboratories, meaning tests are often sent away to other labs and patients must wait weeks for results before they can begin treatment. OICR funding will allow Saleeb and colleagues to develop a single test that looks for all relevant glioma biomarkers and runs on the nanopore sequencing platform, which costs only about $1,000 and can fit on a desktop.
• Dr. Kednapa Thavorn of The Ottawa Hospital and the University of Ottawa is exploring how patient voices can improve economic evaluation – an important part of how health systems assess the value of new technologies. In an earlier OICR-funded study, Thavorn and colleagues invited patients and caregivers to provide input on the financial benefits and burdens of CAR T-cell therapy, a groundbreaking immunotherapy that has delivered promising results for people with blood cancers. This new I2I study will engage a broader range of stakeholders, including patients, researchers and policymakers, to identify barriers that prevent patient engagement in economic evaluations and recommend ways to involve patients more meaningfully.
• Dr. William Wai Lun Wong of the University of Waterloo is studying real-world evidence – data generated outside of clinical trials – about the clinical impact and cost-effectiveness of CAR T-cell therapy, a promising but expensive immunotherapy. With I2IS funding, he will engage patients, healthcare providers and other stakeholders to understand how this evidence can be harnessed to guide healthcare decision-making about the future of CAR T-cell therapy.