We are one step closer to the future of cancer care with the launch of the Marathon of Hope Cancer Centres Network (MOHCCN). The initiative is being led by the Terry Fox Research Institute and three leading cancer research centres: the Princess Margaret Cancer Centre, British Columbia Cancer and the Montreal Cancer Consortium.
“This one-of-a-kind network will unite Canada’s top cancer research centres, allowing them to share their clinical and observational data in order to accelerate discovery and innovation in precision medicine,” says founding council member and UHN’s Executive Vice President (EVP) of Science and Research, Dr. Brad Wouters. “Today represents the beginning with three of these centres and we are excited about the vision for an inclusive cross-Canada network.“
Precision medicine’s tailored approach to care allows physicians to better predict which treatments and prevention strategies will be successful for each individual patient. By centralizing data from three research institutes, MOHCCN aims to create a high quality and shareable dataset of 15,000 cases in the first five years and 100,000 cases within the decade.
The network’s scientists will initially focus on four key themes: immunotherapy and precision cancer medicine treatment, the use of genomic data in clinical decision making, the impact of tumour dynamics on treatment resistance, and the clinical and treatment courses for rare cancer subtypes.
The Terry Fox Research Institute developed a secure platform called The Digital Health and Discovery Platform (DHDP) that will centralize patient data from all participating research centres. Operating with the utmost privacy and security, the DHDP is based on a federated data sharing model, which means data from each centre will be stored on local networks and only shared if requested by a MOHCCN scientist.
“This is a powerful collaborative network that utilizes the joint expertise of clinicians, pathologists, data and laboratory scientists as well as software developers,” says Dr. Wouters. “We are working with key partners at the Ontario Institute for Cancer Research and the other Cancer Centres to establish the network and work towards collaborative approaches to reduce the burden of cancer on Canadians.”
For more information about the MOHCCN, please contact MOHCCN Project Manager Sevan Hakgor at sevan.hakgor@uhn.ca. To watch a video from the Terry Fox Research Institute on how precision medicine is transforming cancer care, click here.
Welcome to the latest issue of The Krembil.
The Krembil is the official newsletter of the Krembil Research Institute (formerly the Toronto Western Research Institute). Research at Krembil is focused on finding innovative treatments and cures for chronic debilitating disorders, including arthritis and diseases of the brain and eyes.
Stories in this month’s issue include:
• Virtual Krembil Research Day 2020: Krembil trainees are encouraged to persevere as scientists are needed now more than ever.
• Coming Together for Dementia: Popular Krembil virtual event explored the future of dementia research and care.
• Neurophysiologist Joins Krembil: Dr. Luka Milosevic, biomedical engineer and neurophysiologist, returns to UHN.
• More than Face Value: Machine learning enables in-depth mapping of abnormalities caused by trigeminal neuralgia.
• Losing Sleep after Critical Illness: Study links sleep problems after release from intensive care unit with cognitive decline.
• A Promising Candidate: Early data suggest that furosemide may reduce the severity of COVID-19 infection.
• A Matter of Perception: Disagreement found between self-reported and performance-based measures of physical function.
Read these stories here. To read previous issues, see the newsletter archive.
An extensive network of branching nerves enables the face to feel a wide range of sensations.
However, when these nerves become damaged or irritated—as is the case in a condition known as trigeminal neuralgia—they can become a source of chronic and excruciating bursts of pain. For individuals with the condition, even simple actions like chewing food can trigger debilitating pain.
Krembil Scientist and neurosurgeon Dr. Mojgan Hodaie, together with her research team, has mapped out key differences in the nerves of people suffering from trigeminal neuralgia to better understand the disease.
“This is the first in-depth survey of microarchitectural abnormalities in nerves associated with trigeminal neuralgia,” says Dr. Hodaie. “We traced the entire nerve pathway—from peripheral segments of the trigeminal nerve to where its branches gather, all the way to the brain.”
Using magnetic resonance imaging (MRI), the research team collected detailed images of the tissues in the faces of patients with or without the condition. To study whether the disease causes structural differences in the trigeminal nerve or its connections, the researchers used programs to automatically generate 3D models of the nerve pathways from the MRI data for all the subjects, with little human intervention.
Because these 3D models were highly complicated, Dr. Hodaie’s team applied machine learning algorithms—a form of artificial intelligence—to pick out the hidden differences. These algorithms enabled the team’s computer to learn which features corresponded to patients with trigeminal neuralgia and pinpoint where the differences occurred.
The team’s analysis revealed abnormalities in the nerves of individuals with trigeminal neuralgia that could be used to distinguish them from healthy subjects with more than 80% accuracy. For patients with pain in only one side of the face, these abnormalities could likewise be used to distinguish the unaffected and affected sides.
The latter analysis also revealed a peculiarity: patients with pain in only one side of their face still had some abnormalities on both sides. This intriguing result, along with other findings, lays the foundation for future research and the development of therapeutic strategies to target the observed differences.
This work was supported by the Multiple Sclerosis Society of Canada and Toronto General & Western Hospital Foundation.
Chen DQ, Zhong J, Chu PPW, Fei Li CM, Hodaie, M. Trigeminal Neuralgia Diffusivities using Gaussian Process Classification and Merged Group Tractography. Pain. 2020 Jul 21. doi: 10.1097/j.pain.0000000000002023.
Last month, UHN researchers were awarded nearly $1.4 million in funding from the Canada Foundation for Innovation for cutting edge research equipment. The investment, provided through the John R. Evans Leaders Fund, will support the following three projects from the Toronto General Hospital Research Institute, the Krembil Research Institute and the Princess Margaret Cancer Centre:
Cardiac Regeneration and Disease Modelling. Led by Dr. Sara Vasconcelos of Toronto General Hospital Research Institute, this project will develop realistic models of heart failure using advanced bioengineering methods. Dr. Vasconcelos will explore new regenerative medicine techniques to repair damaged hearts using stem cells and engineered blood vessels. The research will shed new light on the mechanisms of heart disease and how they are affected by related factors such as diabetes.
Defining Cancer and Immune Landscapes in Multiple Myeloma. A team comprising Drs. Trevor Pugh, Rodger Tiedemann and Suzanne Trudel of Princess Margaret Cancer Centre will use funding to advance research for multiple myeloma—a cancer that originates in the bone marrow and occurs in blood cells. The researchers will determine the genetic sequences of individual tumour cells to assess how these cells avoid detection by the immune system; find ways of boosting the immune response against cancer; examine the genetic features of multiple myeloma that enable the tumours to resist anti-cancer drugs; and reveal the primitive, cancer-initiating cells that are not destroyed by conventional treatments and that ultimately cause cancer re-growth.
Tracking down neurodegeneration in the human brain: from functional systems to the subcellular level. This project is being led by Dr. Gabor Kovacs at the Krembil Brain Institute and the Tanz Centre for Research in Neurodegenerative Disease. Funding will enable the research team to evaluate the distribution of neurodegeneration-related proteins in the functional systems of the human brain in three dimensions. The project will also reveal—at the molecular level—the interactions among these neurodegeneration-related proteins, as well as how they interact with other pharmaceutically targetable proteins (ie, proteins such as cell receptors, which are located at the surface of cells). The research will lay the foundation for the discovery of therapeutic targets for neurodegenerative diseases and diagnostic tests that could help to widen the treatment window for these diseases.
Congratulations to Drs. Vasconcelos, Pugh, Tiedemann, Trudel and Kovacs!
Total knee replacement surgery is a last-resort treatment for people whose osteoarthritis can no longer be managed through other approaches.
Although reduced physical function is a key decider for whether surgery is the right treatment, there is currently no clinically standardized way to measure physical function in individuals with knee osteoarthritis. A team of Krembil researchers compared and contrasted two ways that are often used to assess function: a physical test and a self-reported questionnaire.
The study, published in PloS ONE, revealed that self-reported physical function scores in younger individuals tended to be worse compared to performance-based scores. In older adults, self-reported and performance-based scores were more consistent.
“An osteoarthritis diagnosis can be perceived as untimely and upsetting for middle-aged adults (45-65 years of age), particularly as they tend to be more engaged in activities such as working and activities with young children. These perceptions and experiences of disruption to normal activities may be expressed by worse self-reported function relative to measured physical function,” explains Krembil Scientist Dr. Anthony Perruccio who led the study with then graduate student Jessica Wilfong.
Disagreement between self-reported and performance-based scores was also found in individuals with more intense knee pain. Additionally, discordance, depending on sex and obesity, was associated with:
The performance test used by the research team involved timing how long it took patients to stand up from a chair, walk a short distance and return to the chair to sit. Longer times indicated worse functionality. They compared the results of the performance test with how patients ranked their functionality on a questionnaire.
“Our research shows that self-reported and performance-based measures provide distinctive and complementary information that lend to a holistic understanding of a patient’s physical functionality and how it impacts their life,” says Dr. Perruccio.
This work was supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program.
Wilfong JM, Badley EM, Power JD, Gandhi R, Rampersaud YR, Perruccio AV. Discordance between self-reported and performance-based function among knee osteoarthritis surgical patients: Variations by sex and obesity. PLoS ONE. 2020 Jul 30. doi: 10.1371/journal.pone.0236865.
The UHN Office of Research Trainees (ORT) is proud to announce the release of the latest issue of The ORT Times!
The ORT Times is UHN's monthly trainee-focused newsletter. It highlights news and editorials about trainee life, articles to help developing researchers get the most out of their training experience at UHN, tips on career development, and research training opportunities within and outside of UHN.
Feature Stories:
● The Viruses Within from Joe Walton
● Supervising an Undergraduate Student from Laura Aronoff
● Working with Multiple Supervisors from Scott Rich
● Submitting a Manuscript from Tyler Saumur
Featured Trainees: Angela Sekely from Princess Margaret Cancer Centre and Mi Lai from Toronto General Hospital Research Institute are featured this month!
Read and download the full issue now!
To see past issues of The ORT Times, please visit ORT’s website.
Research conducted at UHN's research institutes spans the full spectrum of diseases and disciplines, including cancer, cardiovascular sciences, transplantation, neural and sensory sciences, musculoskeletal health, rehabilitation sciences, and community and population health.
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