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The chances of surviving cancer are about to get better

 

New cancer-fighting drugs are being developed every year. But which one is the right one for you and your particular cancer?

By 2019, cancer clinics across Canada will finally have the information they need to start answering that question. That’s when Exactis Innovation expects to have enough genetic and molecular data in a digital registry to begin matching individual patients with the correct clinical trials and new innovative treatments.

Through decades of research, scientists have come to recognize that cancer is not a single disease, but a collection of over 200 distinct conditions. Personalized medicines, including immune- and gene-targeted therapies, can help deliver clinical benefits to suitable patients, while sparing others from needless treatments.

However, studies designed to test potential drug candidates need to have enough patients screened in order to identify only those suitable for treatment with personalized medicine. This can become a difficult and costly barrier against finding such treatments.

The industry-led Exactis Innovation has come up with a solution. Its Personalize My Treatment” (PMT) registry combines research with targeted therapies to increase the chances of patients surviving. The registry also allows Canada to compete against countries with much larger patient cohorts in attracting targeted clinical trials.

“We believe the PMT initiative is going to improve patient outcomes. It’s going to bring new insights into our oncology practice and it’s going to help us bring more research and development opportunities into the Canadian market,” says Dr. Hany Moselhi, VP Medical Affairs at Roche, a Swiss-based pharmaceutical company and partner in Exactis Innovation.

Currently, only about 4% of oncology patients participate in clinical trials. “The PMT registry will change that,” adds Dr. Moselhi. “Every patient should be offered an opportunity to participate in a clinical trial.”

More than 470 patients in Quebec and New Brunswick are the first to consent to donate their tumour samples to the PMT registry. This pan-Canadian effort aims to have 8,000 cancer patients from across the country enrolled by the end of 2019. This treasure trove of data means that highly targeted clinical trials can be held with as few as 80 patients – providing patients with access to new treatments as quickly as possible.

“As cancer is more precisely defined, matching patients to clinical trials has become more challenging,” says Dr. Gerald Batist, Co-Founder and Chief Medical Officer of Exactis Innovation and Director of the Segal Cancer Centre of the Jewish General Hospital. “No single cancer centre, no matter how large, can identify enough patients of a very specific type eligible for studies using precision medicines. The Exactis PMT program allows us to pool patients from a coordinated network of centres and to attract the most innovative research to Canada.”

First targets: breast and colorectal cancer

The first trials are expected to focus on triple negative breast cancer and colorectal cancer, followed by small cell lung cancer, metastatic melanoma, metastatic colorectal cancer, prostate cancer, and cancer of the ovary.

“Patients have been very enthusiastic about participating in the registry and see the potential long-term benefits,” says Dr. Mark Basik of the Jewish General Hospital, one of five Quebec sites participating in PMT. “With breast cancer it can be four or five years before the cancer comes back and in some cases as long as 10 years. However, aggressive forms of breast cancer may come back in the first three years. By having access to tumor samples that were taken before it comes back, we can use these samples to more rapidly find the right drug, the one that matches the genetic profile of that person’s tumor. That could be a lifesaver for some patients.”

Historically, researchers recruited cancer patients for clinical trials without knowing the genetic signatures of their tumours. “There’s a lot of guessing going on in trying to match drugs to the genomic profile,” explains Dr. Basik. This shotgun approach has resulted in experimental treatments failing many patients while causing painful side effects. However, in some clinical trials there were always subgroups of patients who responded very well to the experimental drugs with their tumours shrinking.
The goal of PMT is to go after those subgroups, recruiting patients whom researchers know in advance will likely respond well because of the genetic profiles of their tumours.

In addition to providing clinical samples of their tumors and giving access to their medical records, patients also consent to be re-contacted if a match is found.

“This is an important differentiator for Exactis and PMT,” says Richard Fajzel, CEO of Exactis Innovation and a former pharmaceutical industry executive. “People are followed through the duration of their disease. If they are currently in remission and then relapse we would have the opportunity to re-contact them. That creates a very powerful opportunity to match patients to treatment and learn a lot about how their tumors are behaving.”

The PMT database will be available to large drug manufacturers as well as small Canadian biotech companies looking to match their promising therapeutics with the right patients.

“The opportunity here is even greater for SMEs (small and medium-sized enterprises),” adds Fajzel. “They don’t have the same infrastructure or funding as a large pharma or biotech company. Through our network, they have access to data that will help them enrol patients in clinical studies, but also access to some of Canada’s best cancer research centres and researchers, opening opportunities to access services they don’t have in house.”

Exactis Innovation passed two major milestones in 2016. In April, it received $2 million from Merck, and $1 million each from the Cancer Research Society and the New Brunswick Health Research Foundation to expand the PMT registry throughout Atlantic Canada. Manitoba is also participating and the first Ontario centre has come onboard.

“Through its PMT registry, Exactis is creating a one of the best business cases for personalized medicine in Canada,” says Dr. Moselhi. “There are many great initiatives underway in Canada but they have been fragmented. A national network like Exactis was needed to bring everyone together.”

Participating cancer centres to date:

  • Atlantic Cancer Research Institute, New Brunswick 
  • Centre hospitalier de l'Université de Montréal, Quebec
  • Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Quebec
  • CHU de Québec-Université Laval, Quebec
  • Georges L.-Dumont Hospital, New Brunswick
  • McGill University Health Centre, Quebec
  • Ottawa Hospital Cancer Centre, Ontario
  • Segal Cancer Centre of the Jewish General Hospital, Quebec