In 2017-18, the Rossy Cancer Network will fund $330,000 in Research Grants, enabling the completion of 4 projects. The grants will focus on 4 major cancers that affect our patient population: bladder, gynecological and lung cancers as well as sarcoma.
The 2017 Rossy Cancer Network CQI Research Fund recipients are: (in alphabetical order, by principal investigator)
GENITO-URINARY CANCER
Prevention and management of intravesical bcg-related lower urinary tract symptoms in patients with non-muscle-invasive bladder cancer
Despite recent advances in the treatment of bladder cancer over the last decades, nearly 60% of patients treated with intravesical BCG therapy (an effective form of immunotherapy) will experience moderate to severe lower urinary tract symptoms. A significant proportion of them won’t have these symptoms sufficiently managed or will develop more intense symptoms which may require that they stop their treatment. Therefore, it is important to find a treatment strategy to control BCG-related urinary tract symptoms. Administering BCG along with Pentosan Polysulphate (PPS), an oral medication with unique analgesic properties used to relieve bladder pain and discomfort related to other conditions, has been investigated in a small study with encouraging results; these suggest that PPS is well tolerated and effective at decreasing BCG-related urinary tract symptoms. Our project involves a randomized controlled trial to evaluate whether this combined approach will overcome the current limitations in the treatment of patients with BCG-related lower urinary tract symptoms and result in a better prognosis for these patients, shortening hospital stay and improving patient outcomes and health-related quality of life.
Dr Lysanne Campeau will lead a JGH-MUHC team including F. Bladou, S. Shamout, N. Maher, J. Roy, P. Cammisotto, S. Tanguay.
GYNECOLOGICAL CANCER
Finding effective discriminators to triage endometrial cancer surgery
The most common type of uterine cancer arises in the endometrium -- the lining of the uterus. Endometrial cancer is the only cancer in which the number of cases and the death rates are increasing. The recommended surgery to treat this cancer requires lymph nodes to be removed along with the uterus and ovaries. This increase the complications associated with the operation and may not be necessary in all women -- only in those women in whom there is a likelihood of the cancer having spread to the lymph nodes. There is evidence that removing lymph nodes in women with low-risk endometrial cancer causes more harm than benefit. The challenge is to identify low-risk patients prior to surgery, so that they can be treated by simple hysterectomy by their gynecologist. Our previous studies on early diagnosis of endometrial cancer suggests that the type of genetic mutations (damaged DNA) in the endometrial biopsy may be a good test to differentiate low-risk endometrial cancer patients. To prove this, we will analyze 200 cases that were identified as “low risk”. We will check the mutational profile in these cases and create a test to correctly identify women who do not need to have their lymph nodes removed. Our proposed test is a form of innovative personalized medicine, where molecular signatures in cancers are used to tailor surgery to the needs of the patient.
Dr Lucy Gilbert will lead an MUHC-JGH team including I. Comeau, R. Hemings, F. Aris, K. Jardon, X. Zeng, J. Arsenau, L. Fu, C. Reinhold, I. Ragoussis, O. Basso, R. Kumar, M. Wolfson
LUNG CANCER
PD-L1 testing of EBUS-TBNA samples for Non-Small Cell Lung Cancer: feasibility, results, turnaround time and impact on patient management
In the treatment of non-small cell lung cancer, some new drugs are targeting a substance, called Programmed death-ligand 1, that is sometimes found in tumour cells and prevents the immune system from fighting the cancer. The effectiveness of the drugs depends on the amount of the ligand in the cells, which has typically been measured using tissue samples obtained from biopsies. However, many lung cancer patients are now diagnosed with a technique called endobronchial unstrasoundguided transbronchial needle aspiration. This technique provides cell samples that are smaller than biopsy samples. Although cell samples are currently being used to measure the amount of ligand and guide treatment decisions, no studies currently confirm that they are suitable to this purpose. The goal of this study is to review the feasibility and results of the tests performed on these samples, and compare them with larger biopsy samples. The study will also examine the turnaround time of the tests and the impact of the results on patient management.
Dr Anne Gonzalez will lead an MUHC-JGH team including H. Wang, S. Beaudoin, A. Benedetti, L. Ofiara, K. Schwartzmann
SARCOMA
Defining the patient experience in extremity soft tissue sarcoma through a sequential exploratory mixed methods approach: the Sarcoma-Specific Quality of Life (SARCQOL) Study
Soft Tissue sarcomas (STS) are a rare group of malignant growths that arise in connective tissue – such as muscle, tendons, fat, lymph or blood vessels and nerves -- and affect nearly 1,200 Canadians per year. The treatment of STS commonly involves radiation, surgery and chemotherapy in patients where the cancer has metastasized beyond its initial location. These treatments can be profoundly disabling, resulting in loss of limb function, severe pain, amputation and possibly the removal of surrounding organs. The patient’s experience of their disease is an increasing focus of health care delivery. Despite the profound impact of STS treatments on patients’ ability to function and quality of life, there are only a small number of quality of life studies in STS and no sarcoma-specific measures. We believe that this knowledge gap compromises the quality of care. We propose to develop and test a patient survey looking at quality of life outcomes associated with the treatment of extremity sarcoma, from active care to survivorship through qualitative inquiry. based on two interrelated frameworks (health-related quality of life and integrated knowledge translation), allowing a dual focus on knowledge production and action.
Dr Krista Goulding will lead an MUHC-JGH team including C. Freeman, A. Tsimicalis, T. Alcindor, A. Mlynarek, P. Chaudhury, F. Cury, S. Meterissian