Drs. Knox and Gallinger
Drs. Jennifer Knox and Steven Gallinger of the Princess Margaret Cancer Centre and Ontario Institute for Cancer Research are among the Principal Investigators of the $5-million, pan-Canadian, precision-medicine initiative known as Enhanced Pancreatic Cancer Profiling for Individualized Care, or EPPIC. (Photos: UHN)

Canadian pancreatic cancer researchers, including a team at the Princess Margaret Cancer Centre, are joining forces under a Terry Fox Research Institute initiative bringing new hope for patients with this deadly disease.

"For many years it's been hopeless from a patient perspective, and we are hoping to help shift this," says Dr. Daniel Renouf of BC Cancer Agency and the University of British Columbia (UBC) who, along with Dr. David Schaeffer of the Vancouver General Hospital and UBC, is leading a $5-million pan-Canadian, precision medicine initiative.

In addition to Drs. Renouf and Schaeffer, other study Principal Investigators are: Drs. Jennifer Knox and Steven Gallinger of the Princess Margaret and Ontario Institute for Cancer Research (OICR), Dr. George Zogopoulos of the McGill University Health Centre and Dr. Oliver Bathe of the Tom Baker Cancer Centre and the University of Calgary.

A lack of early detection tests. Few known symptoms. Very limited treatment options. No known biomarkers that can be used to direct therapy.  These are among the clinical challenges team EPPIC, short for Enhanced Pancreatic Cancer Profiling for Individualized Care, is tackling over the next five years to improve personalized treatments for patients with pancreatic ductal adenocarcinoma (PDAC), a disease with a five-year survival rate of just nine per cent.

"Our project focuses on metastatic cancer versus surgically resectable primary tumours, because this is the clinical problem we see most often," says Dr. Schaeffer, noting a priority is to discern if the metastatic and primary tumour differ in their genetic make-up.

Four out of five patients have metastatic cancer at the time of diagnosis and most will succumb within a year.

This project is currently under way in Toronto and Vancouver, and is expanding to include up to 400 eligible patients in Montreal, Kingston, Ottawa, Calgary, and Edmonton.

More than 100 patients from the McCain Centre for Pancreatic Cancer at the Princess Margaret have already participated in the COMPASS trial, initially funded by OICR, Pancreatic Cancer Canada (PCC) and The Princess Margaret Cancer Foundation. Early results were published in late 2017 in Clinical Cancer Research.

"Only with national collaboration can we move forward at pace with global understanding of this disease and make a significant contribution," says Dr. Knox, Principal Investigator of COMPASS and co-Director of the McCain Centre.

"We love the idea that more Canadians will have the opportunity to potentially impact their care while contributing to scientific advancement."

Genomic sequencing and bioinformatics analyses of patient tumours will be conducted at the OICR and the BC Cancer Genome Sciences Centre.

Many of the EPPIC team's investigators are members of PancOne, an initiative of PCC bringing together pancreas researchers from across the country. The foundational funding from PCC has also been integral in establishing a strong framework from which to build pan-Canadian collaboration.

UHN researchers explain the COMPASS trial, which is giving pancreatic cancer patients the ability to have their tumour genomes sequenced very rapidly. (Video: UHN)

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