Focus on Cancer Research

"It’s very exciting to witness the impact of research on our practice. I have rarely seen one of our cancer patients say no to participate in research."

— Dr. Donna Johnston, CHEO oncologist.

Cancer. It’s quite simply a dreadful word that everyone wants to avoid in their lifetime; but in reality – and more frequently than not – cancer strikes people we love. Unfortunately, children are no exception. CHEO saw 105 pediatric cancer patients in 2011 and our clinicians and patients all share a common goal: to fight it. CHEO researchers in the lab and at the bed side continue to wage a relentless battle against cancer by tackling it from multiple angles.

From the bench

In its purest scientific form cancer is “the deregulation of cellular programs that normally control cell proliferation, metabolism, cell death, motility, adhesion, and innate and acquired immune functions.” However biology is dynamic and tumors often evolve strategies to evade therapeutics that are available today. So, CHEO researchers are investigating unique ways to use biology to fight biology. An excellent example of this strategy is found in the emerging field of oncolytics or cancer-killing viruses. Oncolytic virology uses live viruses to sense the genetic difference between a tumor and normal cell. Once the virus finds a tumor cell, it replicates inside that cell, kills it and then spreads to adjacent tumor cells to seed a therapeutic “chain reaction.” In 2011, Dr. David Stojdl from the Children’s Hospital of Eastern Ontario Research Institute published groundbreaking findings in the esteemed scientific journal Cancer Cell. He found a way to trick resistant cancer cells into committing suicide following oncolytic virus therapy. His success in mouse models is the beginning of a laborious journey that should see this discovery tested in clinical trials in a couple of years.

Dr. Robert Korneluk is also taking an innovative approach to advance cancer survivorship. His team is studying targeted anti-cancer therapies that will complement current treatments (such as surgery, chemotherapy, radiation therapy) by providing a safe and effective way to kill tumor cells. Several years ago, Dr. Korneluk’s research group had discovered a new family of cancer-causing genes, called the Inhibitors of Apoptosis or IAPs. The IAPs have become one of the most important targets in cancer and there are numerous research groups and drug companies who are testing novel IAP-neutralizing drugs in the clinic. Dr. Korneluk is currently exploring ways to combine oncolytic virus therapy with the anti-IAP drugs, an approach he believes will eventually become an effective treatment for a variety of cancers, including those that affect children.

From the bedside

CHEO is a proud member of The Children’s Oncology Group (COG) which strives to understand the causes of cancer and find more effective treatments for the children we care for. As part of this international research network, CHEO’s clinical cancer researchers, led by Dr. Jacqueline Halton, have access to funding, treatments, research support and services specifically aimed at better outcomes for pediatric cancer patients.There are numerous COG research projects underway at CHEO and they range in topics from biology (e.g. analyzing tumor biopsies), and treatments (e.g. looking at what timing is optimal for administering chemotherapy) to supportive care (e.g. evaluating whether or not acupuncture helps to alleviate nausea). Dr. Halton is also the Senior Medical Officer of COG named by delegates at Health Canada, making her responsible for securing approval to use novel cancer treatments in Canada and at CHEO.

CHEO oncologists are also proactively pursuing many of their own research interests, independent of the COG network. Our cancer researchers including Dr. Halton, Dr. Donna Johnston, Dr. Robert Klaassen, Dr. Karen Mandel, Dr. Raveena Ramphal, Dr. Myléne Bassal are individually collaborating on 20 multi-centre studies ranging in topics from evaluating the social skills of brain tumor survivors; looking at what dose of steroids help to alleviate nausea; determining if parent-delivered massage helps to relieve a child’s discomfort; and even equipping patients with iPhones to record their pain scale.

We are also leading many funded projects that have the potential to change cancer treatment on an international scale. For instance, Dr. Donna Johnston has launched a phase one clinical trial to determine what dose of melatonin (a natural health product) is tolerable by pediatric cancer patients when it’s used as an appetite stimulant. Another great example is Dr. Halton’s C17 funded study looking at osteonecrosis or joint and bone problems in children receiving treatment for leukemia.

CHEO is a longstanding member of C17, an organization that aims to improve the outcomes and quality of life for children and adolescents with cancer and serious blood disorders in Canada. Last year, CHEO’s clinical cancer research group was selected as one of only eight institutions to be part of a prestigious Development Therapeutics Group as part of C17. This means that CHEO now runs phase one drug trials that offer clinical trials with novel agents for patients with relapsed cancers.

The amount of energy, passion and commitment to cancer research at CHEO is exemplary. Congrats, all on a remarkable 2011.