We are excited to announce the recipients of round one of the inaugural BC Cancer Clinician Researcher Start Up Competition. The competition will help facilitate stand-alone research projects for clinician researchers at BC Cancer that will support future grant or investigator-initiated studies to be funded by other organizations. 

Applications were awarded across the following disciplines:
•    diagnostic imaging 
•    medical oncology
•    pain and symptom management
•    pathology
•    radiation oncology
•    surgical oncology 

The Office of Research Administration received 22 applications and granted 13 recipients. Nine of the awardees are early career investigators. 

Funding for this competition was made available through the BC Ministry of Health and in collaboration with the BC Cancer Foundation.

BC Cancer Clinician Researcher Start Up Competition 2024 recipients – Round 1

Dr. Mathieos Belayneh (BC Cancer – Surrey): Methadone to treat painful chemotherapy-induced peripheral neuropathy: A randomized double-blind controlled trial

Nearly 70 per cent of people who receive chemotherapy may suffer from chemotherapy induced peripheral neuropathy (CIPN), which can cause nerve pain, weakness, and other debilitating symptoms that can negatively affect a person’s quality of life. 

Duloxetine is currently the only recommended medication to reduce these painful symptoms, however studies indicate that it only has a modest effect. 

This project aims to assess the efficacy of methadone compared to duloxetine to treat chemotherapy induced peripheral neuropathy (CIPN), as methadone has been shown to treat non-cancer and cancer-associated nerve pain with better efficacy when compared to other opioids. 

Dr. Brandon Bernard (BC Cancer – Vancouver ): Sexual function and male breast cancer 

While treatment for male breast cancer mirrors that used in females, males may experience unique side effects from those treatments. In addition, there may be negative effects on male mental health upon being diagnosed with a cancer that many associate only with females. 

There is currently limited data available about the experiences of males with breast cancer. This study will use a standardized questionnaire to measure quality of life, sexual function and body image in male breast cancer patients in British Columbia. Additionally, the study will compare questionnaire responses to those already published, as well as those from people with prostate cancer on hormone therapy to look for similarities. 

Dr. Jessica Chan (BC Cancer – Vancouver): Developing the Linguistic Indicators of Framing Tool: creating equity-oriented language to improve cultural safety in cancer care for First Nations, Inuit, and Métis peoples

A 2020 survey of First Nations, Inuit and Métis peoples in British Columbia found that 75 per cent of participants reported experiencing discrimination from a healthcare provider. 

Some literature consumed by healthcare providers as part of their training and practice may use language that assumes health problems are simple and easy to overcome, and places the blame for these problems on First Nations, Inuit and Métis peoples. This may contribute to some healthcare providers developing negative feelings about First Nations, Inuit and Métis peoples, which can lead to biased actions and eventually result in culturally unsafe care.

There are currently no guidelines to help researchers and healthcare providers properly write, evaluate and interpret this literature. The development of the Linguistic Indicators of Framing Tool will provide specific and concrete guidance to reduce anti-Indigenous bias in published cancer care literature. 

Dr. Emily Jackson (BC Cancer – Vancouver): Understanding and overcoming disparity in care of breast cancer patients in rural British Columbia: Development of a virtual nurse-led model of care

Treatment with adjuvant endocrine therapy (AET) after surgery in patients with early-stage hormone-positive breast cancer has been shown in clinical trials to significantly reduce the risk of recurrence and risk of death. 

However, people who reside in rural locations in British Columbia are less likely to initiate AET and less likely to remain on AET after initiation, as compared to their counterparts in urban locations. This group has also been shown to be at risk for worse breast cancer outcomes, including a higher chance of distant recurrence and worse mortality from breast cancer. 

This study will test the feasibility and patient satisfaction of a virtual, nurse-led model of care in rural BC, involving virtual focus groups to inform the design of an optimal nurse-led program, followed by a pilot virtual nurse-led group clinic and then follow-up visits with individual patients.

Dr. Jean-Michel Lavoie (BC Cancer – Victoria): Predictive biomarkers for patients with genitourinary cancers receiving checkpoint inhibitors: new insights into gamma-delta T-cells

Recent advancements in the treatment of metastatic bladder and kidney cancers involve immune check-point inhibitors, a drug class that triggers a potent anti-cancer immune response. However, these
drugs only work in some cases so they are currently used in combination with other drugs, which can cause an increase in side effects. 

In this setting, there is a great need for biomarkers, which are tests that may predict which patients will benefit from immunotherapy. Such a test could potentially avoid exposing patients to unnecessary drugs and their side effects.

This project aims to demonstrate the important role that gamma-delta T-cells play in the response to immunotherapy and may provide a biomarker to guide treatment, potentially reducing the need for more harmful and unnecessary drugs in cancer treatment. 

Dr. Jonathan Loree (BC Cancer – Vancouver): Liver transplantation in metastatic colorectal cancer (CRC) – a pilot study (Prometheus) and correlative analysis characterizing tumour heterogeneity to inform ctDNA assays in CRC 

Colorectal cancer is the second most common cause of cancer death in North America. If detected early, it can be cured by surgery. However, when detected later the cancer can spread, or metastasize, to other organs – most commonly the liver. Some patients can undergo surgery to cure metastatic colorectal cancer but this is not always possible (unresectable). Liver transplant is a potential alternative treatment for unresectable colorectal cancer in the liver.

This pilot, small-scale study aims to collect the information needed to plan a future, large-scale international trial of liver transplantation in CRC. The goals of the pilot study are to assess patient outcomes, patient safety, patient interest, and the ability to add patients to the trial in a reasonable time-frame.

Dr. Andrew Lytle (BC Cancer – Vancouver): Multiomic characterization of TFH lymphomas and PTCL-NOS for biomarker discovery

Nodal peripheral T-cell lymphomas (PTCL) are a group of uncommon non-Hodgkin lymphomas which typically carry a poor prognosis. TFH lymphomas, a subtype of PTCL which was derived from “follicular helper” T-cells, shows promising responses to therapies targeting epigenetic changes in the tumours. However, TFH lymphomas are challenging to diagnose and can show overlap with other types of PTCL. 

This study aims to define TFH lymphomas and other PTCLs more clearly by studying genetic aberrations, or abnormalities, in the tumours, as well as cells in the tumour microenvironment, which includes surrounding cells. This work aims to help identify patients who might benefit from novel therapies, uncover new biomarkers – which are signs or signals in the body that can provide information about health, disease or the effects of treatment, and accelerate future study of TFH lymphomas. 

Dr. Justin McGinnis (BC Cancer – Vancouver): Advancing gynecologic cancer survivorship through digital innovation

Upon completing their treatment, many individuals in British Columbia with gynecological cancer grapple with uncertainty about how to manage side effects of their surgery and treatments, when to book follow-up medical appointments, what additional health referrals or screening practices are needed, and what resources are available to them. Survivorship care plans hold potential in providing guidance, but they are often not used because they take a lot of time and effort to create. 

This project aims to make it easier for doctors, nurses and patients to create and use personalized survivorship plans, specifically for gynecologic cancer survivors at BC Cancer. “Survivor Advisor”, a new digital solution, uses smart technology to help doctors quickly generate customized care plans to empower patients to take control of their survivorship journey. This new initiative will be tested at BC Cancer, and the platform will be refined based on patient and healthcare team needs.

Dr. Lucia Nappi (BC Cancer – Vancouver): Unveiling B-cell receptor heterogeneity to predict immunotherapy response in patients with metastatic renal cell carcinoma

Currently, metastatic renal cell carcinoma (mRCC) is treated using a combination of immunotherapy drugs, or immune checkpoint inhibitors (ICI), and oral medications. However, no reliable biomarkers currently exist to predict whether patients will respond to these treatments. Since these medications may cause side effects, it is crucial to identify which patients will respond to the treatment.

B-lymphocytes (or B-cells) are white blood cells that produce antibodies (also known as immunoglobulin or Ig). Recent data suggest that these cells are important to fight cancer cells, especially by activating other immune cells (e.g., T-lymphocytes). The production of Ig is highly regulated in the B-cells. Ig are the secreted circulating version of the B-cell receptor (BCR) that is expressed in the B-cells. BCR has a highly variable region that is created by rearrangement of the DNA, which is ultimately responsible for the diverse Ig repertoire that recognize and neutralize pathogens and tumour cells. 

This project will study the BCR in the blood cells of patients with mRCC to identify molecular characteristics associated to ICI response.

Dr. Justin Oh (BC Cancer – Vancouver): Population-based outcomes of stereotactic radiation treatment for brain metastasis

Brain metastasis, which is the spread of cancer to the brain from elsewhere in the body, is common among cancer patients and can cause issues such as functional deficits, headaches, seizures or even death. Stereotactic radiation treatment is an effective method of treating brain metastasis by preventing its growth when treated intact or recurrence after surgery. However, it can also be associated with radiation necrosis, a serious complication that can cause symptoms like a recurrence of brain metastasis such as headache, nausea or neurological deficits, and may reduce patient’s quality of life.

It is difficult to predict individual patient response to stereotactic radiation as patient outcomes after radiation treatment are not well described in current medical literature. This project will review the provincial outcomes of all patients treated with stereotactic radiation for brain metastasis and to create a database to conduct a prospective study that can help to track the success, complication, and quality of life outcomes after stereotactic radiation treatment in the future.

Dr. Robert Olson (BC Cancer – Prince George): Single vs Hypofractionated Irradiation For Timely access to Partial Breast radiotherapy – SHIFTPB

Radiotherapy is commonly indicated for early stage, node negative breast cancer. The rationale is to decrease the local recurrence rate and allow breast conservation through the use of partial mastectomy (i.e., lumpectomy). 

Radiotherapy usually requires multiple trips to a regional cancer centre which can be far from a patient’s home, especially for patients who live in rural and remote locations. Some patients decline adjuvant radiotherapy to avoid travel for treatment away from their local supports and resources. 

To minimize patient time away from home, this trial will test the feasibility of delivering single treatment radiotherapy within one to five days of radiotherapy planning scans.

Dr. Ying Wang (BC Cancer – Vancouver): Mitigation of lung cancer decline with Virtual platforms to deliver Exercise therapy across British Columbia (MoVE-BC) – Phase Two

Individuals with advanced lung cancer often face physical and emotional challenges due to either the cancer itself or its treatment. A pilot study conducted by this research team, MoVE (Mitigation of decline with Virtual Exercise), revealed that lung cancer patients undergoing systemic treatments such as chemotherapy and immunotherapy are both willing to participate in, and also experience improved physical function with, a virtual exercise program paired with in-person physical assessments.

Given the success of this initial program it has become important to consider how to expand enrolment. Although patients showed a lot of interest in joining MoVE, the challenge that arose with program expansion was that many individuals in rural and remote areas could not attend in-person assessments. 

To address the inequity in access to the program and extend the program’s reach to patients across the province, this project will build on the pilot study to create a fully virtual version MoVE-BC program. 

Dr. Ren Yuan (BC Cancer – Vancouver): Artificial Intelligence Models to Predict Response and Survival in Advanced NSCLC Patients with PD-L1 >= 50% Receiving 1st-Line Pembrolizumab Monotherapy

More than half of patients with advanced non-small cell lung cancer are unlikely to respond to a current standard first-line treatment, so physicians may consider offering a different first line regimen early on for more timely and effective disease control. On the other hand, the other half of patients benefit best from a standard first-line treatment and most of these “responders” are also long-term survivors. This clinical dilemma of choosing a standard versus alternative first line regimen could be avoided if the two subsets could be separated before treatment initiation. 

This project will use advanced computer-assisted analysis technology to address this clinical dilemma of choosing a standard versus alternative first-line regimen. Researchers will assess a special form of x-ray - computer tomography (CT) imaging to identify people less likely to respond to usual care. This will allow care teams to provide more appropriate care decisions. 

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