Positron emission tomography (PET) imaging provides the most accurate and sensitive detection of cancer in patients. Yet PET is challenged by cumbersome methods that impede the clinical production of PET imaging agents and diminish their distribution and use. A critical unmet need for PET imaging is access to user-friendly methods to simplify and speed up time-sensitive radiosynthesis to deliver imaging agents to clinics.
Dr. Perrin and team have invented a chemical tag that lets chemists turn any molecule into a PET imaging agent. Now, Dr. Perrin will deploy this method to develop commercial products for imaging prostate cancer, which affects 23% of Canadian men and demands the use of PET imaging for early detection.
These tags create novel prostate cancer-specific probes which allow tumours to be labeled in record time and in a user-friendly manner for clinical radiosynthesis, and provide superior pre-clinical mouse images. These must be tested and evaluated before progressing to human trials and clinical production.
This innovation could allow prostate cancer to be detected earlier and better, increasing cure rates and the long-term survival rates of this deadly and common disease.
Chronic rhinosinusitis (CRS) is an inflammation of the nasal sinuses, and is one of the most common medical complaints in North America, affecting up to 16% of the population. It leads to around 24 million physician visits per year, with an aggregated cost of more than $6 billion. Although the pathophysiology behind CRS isn’t fully understood, it appears to be largely triggered by bacterial biofilm infections. The microbes associated with these biofilms are diverse, and treatment options (including antibiotics) are limited and often fail to cure the disease.
Dr. Hancock will develop a novel topical intranasal treatment for CRS, based on anti-biofilm peptides. These peptides have already been shown to kill multiple species of bacteria in biofilms, especially the most resistant pathogens. Dr. Hancock has screened a library of peptides for their efficacy against multiple bacterial species, including several significant CRS pathogens.
Dr. Hancock will select a lead and backup anti-biofilm peptide with the most efficacy against sinusitis bacteria in their biofilm state, minimal toxicity when provided topically, and with optimal anti-inflammatory properties both in vitro and in animal models.
This research could directly lead to a new therapy for CRS, which would trigger immediate clinical and commercial development. Dr. Hancock has brought on partners for the first two years—Dr. Armin Javer of the St. Paul’s Sinus Clinic, and the Centre for Drug Research and Development, and has already identified a prospective development partner, Victoria-based company ABT Innovations Inc.
In the current landscape of endometrial cancers (ECs), there is a shortfall in the management, treatment and evaluation of EC patients. Treatment tends to not be standardized, patients are commonly over- or under-treated, and diverse ECs are grouped together in clinical trials. Because of this inconsistency in diagnosis, it is difficult, if not impossible, to properly assess and compare how different treatments work.
In response to this gap, Dr. McAlpine has developed a molecular-based classifier called "ProMiSE” – Proactive Molecular Risk Classifier for Endometrial Cancer, which assigns EC patients to one of four prognostic groups. This classification would greatly improve the reproducibility and reliability of pathological diagnoses of endometrial tumours. The tool can be used to help categorize ECs into different risk classes to help guide surgery, treatment and surveillance based on the molecular features of the individual cancer. It can also identify women who may have inherited conditions placing them at increased risk of other cancers.
The next step for ProMisE is making the tool available across Canada. Although it is low cost and uses methods familiar to pathology laboratories, one of the testing components is currently unobtainable outside of a research lab setting. Dr. McAlpine is currently working with a Vancouver-based company to acquire, add and test this component in order to make ProMisE widely available.
Then, collaborating with eight other cancer centres across Canada, Dr. McAlpine will collect EC data, classify the data with ProMisE, and compare the treatment given with how molecular classification would have directed care.
This study is the last step in bringing this new molecular test to clinical use. With access to ProMisE, not only will there be immediate changes to how women with EC are managed, but it will allow the design of new studies to define the best, most personalized therapies for every woman with EC.
Metastasis, which is the spread of cancer cells from a primary tumor to other areas in the body, remains the main cause of cancer related death. Awareness of the clinical importance of metastasis and our basic scientific understanding of the metastatic process has improved substantially over the past few decades. However, many aspects of metastasis are still not well defined and our ability to identify patients at high risk for cancer spread is limited. In addition, cancer treatments are not metastatic-specific, so despite aggressive treatments many patients still progress to a metastatic disease state. Dr. Williams' research aims to address these issues by identifying aggressive disease early and uncovering key regulators of metastasis for inhibitor development.
Cancer cells are constantly shedding small fragments, which can be readily detected in the blood. This project will develop a test that analyzes these fragments, identifying cancer patients and determining the aggressive nature of their disease. It also aims to uncover how cancer cells move and grow within the body by forming tiny 'feet-like' structures called invadopodia. Understanding their role in cancer progression will shed light on how cancer cells move and grow within the body, validating them as targets for metastatic inhibitor development. Overall, this research program will make powerful strides towards ending metastasis, the most significant cause of cancer mortality.
British Columbia is facing an unprecedented and escalating opioid crisis, underscoring the urgent need for innovative science-driven solutions. There is critical implementation gap of evidence-based care for opioid use disorder (OUD), this research will seek to narrow this gap.
First, Dr. Socias will seek to advance the implementation of evidence-base treatments for OUD, by leading a series of ongoing and planned clinical trials evaluating innovative and promising models of care (e.g. take-home strategies) and alternate treatment options (e.g. slow-release oral morphine).
Second, leveraging vast data from two long-standing cohort studies of over 3,000 people who use drugs, she will apply innovative quality metrics (i.e., cascade of care framework) to evaluate the impacts of addiction health system implementation efforts in BC over time. Identifying individual-, social- and structural-level facilitators and barriers to uptake and effectiveness of novel interventions, as well as to how these new addiction programs may impact health care access and outcomes of OUD care and related comorbidities (e.g. HIV, hepatitis C) will be key to informing efforts to improve the delivery of addiction care in BC.
End of Award Update – April 2024
Results
Findings from the OPTIMA trial showed that more flexible approaches to opioid use disorder care are similarly effective than more traditional approaches requiring people to go to the pharmacy every day. This has important clinical and policy implications as there is substantial evidence, including from my own research, that rigid models of care are one of the main barriers to retention in treatment, and that discontinuation from treatment increase the risk of overdose and death. We are now evaluating the effectiveness of novel pharmacotherapies in real-world settings.
Impact
Findings from my research have informed clinical guidelines, and policy decisions (re-introduction of methadone formulation in the OAT program in BC).
Potential Influence
I expect that findings from my research evaluating slow-release morphine will have implications to better understand its benefits and risks in the continuum of care of opioid use disorder.
Next Steps
I will continue with research to close the implementation gap in substance use care, including opioid use disorder, but also using some of the learnings to address alcohol use, which has a substantial burden of disease.
Acute spinal cord injury (SCI) is a devastating neurological condition resulting in permanent morbidity and impaired quality of life. In spite of advancements in the acute treatment of SCI, preventing neurological deficits in affected patients is highly limited. The hemodynamic management of acute SCI patients to maintain blood supply and maximize oxygenation of the injured spinal cord tissue is currently one of the few aspects of critical care in which clinicians can improve neurologic outcomes. However, optimizing the hemodynamic management in acute SCI is limited and challenging due to the lack of a real-time means for monitoring spinal cord blood flow, oxygenation, and hydrostatic pressure.
The overall objective of Dr. Shadgan's research is to develop a novel optical method, using an implantable optical sensor and system that work based on near-infrared spectroscopy (NIRS) to provide real-time measurements of spinal cord hemodynamics in acute human SCI. Such a tool would provide information to guide clinicians in their treatment decisions and allow them to personalize the hemodynamic management of acute SCI patients to optimize neurologic outcomes. This program includes a sequence of preclinical studies aimed to translate this approach to human SCI patients. Dr. Shadgan's research program will also include the training of highly qualified personnel, intellectual property protection of the method and system, and knowledge translation.
Stroke is a leading cause of death and disability in Canada, costing our economy $3.6 billion per year. More than 405,000 people are currently living with the effects of stroke. This number is expected to rise to 720,000 by 2038.
We all know that a stroke is an emergency health issue requiring immediate medical attention. Fewer people, however, know that strokes also have long-term health effects that patients live with on a daily basis, including muscle weakness and balance and coordination issues. Unlike other diseases with long-term health effects, such as heart failure and diabetes, there has been little research to improve the health services provided to stroke patients after they return home from the hospital. As a result, it is common for these people to have another stroke, have many hospital visits, and report other health issues. More research is needed to improve the access to and delivery of health services to stroke patients to better manage their health over time.
The purpose of this five-year research project is to improve long-term care for stroke patients. Dr. Sakakibara will work with stroke patients to ensure the research focuses on what is important to them, and then evaluate new programs (delivered using mobile technologies and the internet) to help patients plan their return home from hospital; improve lifestyle behaviours to prevent other health issues; and better manage their health and well-being for long-term health benefits.
Dr. Sadarangani's research focuses on preventing severe illness and death in children by ensuring best use of vaccines to protect against three serious infections (meningococcal, pneumococcal, pertussis) which cause blood poisoning, meningitis and whooping cough.
Vaccines have reduced these infections, but we dont know if we are usng the optimal number and timing of dses. Sadarangani's goals are to ensure optimal use of these vaccines and aid development of future vaccines.
The project will:
- Compare the current three doses of pneumococcal vaccine given to infants against two doses. If there is no difference using two doses would mean fewer injections and lower cost.
- Compare the response to meningococcal vaccine in adolescents who have received 1, 2 or 3 previous doses, and compare the three available vaccines to identify any differences between them.
- Compare the effectiveness of pertussis vaccinefor whooping cough at different times of pregnancy to confirm the best time to immunize to protect the infant
- Examine the genetics of the pneumococcal bacteria to understand its transmission and evolution.
This research will improve vaccine schedules and help design future vaccines, ensuring that children continue to be protected against these devastating infections.
Chronic obstructive pulmonary disease (COPD) affects 300 million people worldwide and is the third leading cause of death, responsible for over 3 million deaths per year. It is the number one reason why adults end up in hospitals. However, we do not have good drugs to treat patients with COPD. This is because we do not fully understand how and why COPD develops and progresses.
Smoking can cause COPD but not all smokers get the disease; our genes also play a role. Identifying which genes cause some people to get COPD or lead to disease worsening over time will allow us to understand these processes more and to develop new drugs to treat the disease.
This project will use sophisticated analysis tools called integrative genomics. First, we will identify regions of our DNA that are important for COPD risk and worsening over time. This will be done through studying DNA regions from thousands of subjects with and without the disease and on whom we have information on how well their lungs work. We will then identify the function of these DNA regions by uncovering their effect on gene products and proteins in tissues that are important and relevant for COPD such as lung and blood. These genes and their products will be tested in laboratories to confirm the findings. The goal is to use this information to monitor disease and will additionally allow us to interfere with these gene products to treat disease.
Nearly half of Canadians will be diagnosed with cancer during their life. Healthy eating, a healthy body weight, and regular physical activity can prevent one-third of cancers. Yet, many Canadians do not engage in these lifestyle behaviours. New approaches to improve diet-cancer research are needed to move the field forward and reduce the burden of cancer on Canadians.
Dr. Murphy's research focuses on modifiable risk factors for cancer; nutrition and body weight. The goal is to provide new insight on how and why these factors contribute to cancer development using data from large populations of Canadians and innovative approaches such as lifestyle biomarkers that may explain why factors lead to cancer development.
Advances in cancer prevention are needed to promote the health of people in BC and nationwide. This research will provide new insight into modifiable factors for cancer that may help encourage lifestyle changes and development of new strategies to prevent cancer.
