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Garron Family Cancer Centre

GFCC Research Fellows

Garron Family Cancer Centre Research Fellows 2017/18

The GFCC fellowships support clinicians, scientists and graduate students on an annual basis who are looking to advance their knowledge of cancer care and research. These fellowship opportunities aim to provide training through direct participation in basic science or clinical investigation under the supervision of world leaders in oncology research and clinical care. Through a competitive selection process the following fellowships were awarded for the 2017/18 academic year:

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Dr. Julie Bennett, Sears Childhood Cancer Fellowship
Supervisor: Dr. Uri Tabori, Staff Haematologist/Oncologist, Division of Haematology/Oncology, Senior Scientist, Research Institute and The Arthur and Sonia Labatt Brain Tumour Research Centre 

The Clinical and Molecular Characterization of Low Grade Glioma in Adolescents and Young Adults
Low grade glioma is the most common type of brain tumour in children.  Most children with this tumour survive, but may require multiple treatments including surgery, chemotherapy and radiation.  Low grade glioma can also be seen in adults, where we know there is a much higher risk of transformation into a highly aggressive tumour that is incurable despite aggressive treatments.  Recent studies have described different genetic mutations occurring in children versus adults in the tumour cells.  Certain mutations are generally considered to lead to a better prognosis compared to others in both age groups.
Currently, there is limited information on the frequency and behavior of low grade glioma in adolescents and young adults under the age of 40 years.  It is unknown what the long-term outcome is for these patients, whether the mutations in the tumour resembles childhood or adult tumours, and the impact this has on prognosis.  This study aims to correlate molecular and clinical characteristics with long term outcome in a large group of patients from hospitals across Toronto.  We believe the type of mutation in the tumour may be predictive of response to treatment and long-term outcome.  This study will help us offer better care for these people with a deeper understanding of their disease.  Certain groups may benefit from personalized medicine using newer drugs targeted specifically to the tumour cells when the mutation is known.  This information has the potential to transform care of adolescents and young adults with low grade glioma.           

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Dr. Jack Brzezinski, Scotiabank Clinician Scientist Fellowship
Supervisor: Dr. Rosanna Weksberg, Senior Scientist and Staff Geneticist, Department of Clinical and Metabolic Genetics, SickKids Research Institute and Associate         Professor, Department of Pediatrics, University of Toronto

Combining Genetic and Epigenetic Data to Define a Biologically and Clinically Relevant Stratification of Wilms Tumors  
Wilms tumour is the most common kidney cancer in children with approximately 50 new cases each year in Canada. Although many children can be cured with a combination of surgery, chemotherapy, and radiotherapy, the long-term side effects of these therapies can be significant and include kidney failure and second cancers. With a more precise system of predicting which children are more likely to have a relapse or second tumour, clinicians could tailor therapy to minimize the risk of these late side effects and also intensify therapy for those more likely to relapse. Dr. Brzezinski’s research is focussed on discovering the genetic and epigenetic determinants of outcomes in Wilms tumours. These factors can then be used to identify biomarkers that will improve our ability to choose the best therapy for each child.

 

GFCC 2018-19 Research Fellows

Genetic Contribution to the Development of Subsequent Malignant Neoplasms in Childhood Cancer Survivors: an Ontario Population-Based Nested Case-Control Study

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Dr. Noelle Cullinan, BMO Financial Group Oncology Fellowship
Supervisor: Dr. Paul Nathan
Co-Investigators: Catherine Goudie, MD, Jason Pole PhD, Anita Villani, MD, MSc, David Malkin, MD
Collaborators: Bruna DiMonte, RN, BScN

Improvements in pediatric oncology care through the incorporation of risk-adjusted protocols, personalized therapies and advancements in supportive care strategies over recent decades have led to increasing survival rates amongst children with cancer. A significant proportion of childhood cancer survivors develop subsequent cancers. Risk factors for the development of a subsequent cancer include a history of exposure to certain chemotherapeutic agents, receipt of therapeutic irradiation, and the presence of an underlying cancer predisposition syndrome.
This nested case-control study in a population-based cohort of childhood cancer survivors will be performed using established provincial cancer registries in Ontario. We will characterize the associations between primary cancer and subsequent cancer types in this population and will describe and compare treatment exposures in cancer survivors who have and have not developed a second cancer. We will then evaluate our ability to predict which survivors are at increased risk of developing a subsequent cancer using treatment-related exposures and perceived genetic risk. Perceived genetic risk will be estimated using a newly developed tool, the MIPOGG (McGill Interactive Pediatric OncoGenetic Guidelines) that aims to identify children at increased risk of having an underlying cancer predisposition syndrome. Incorporating all three exposure variables (chemotherapy, irradiation and perceived genetic risk), we will evaluate if risk for second cancers can be predicted in childhood cancer survivors.

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Genomic Landscape of Pineoblastoma
Dr. Bryan K Li, BMO Financial Group Oncology Fellowship
Supervisor: Dr. Annie Huang

Pineoblastoma is a rare brain cancer affecting mainly young children. They are difficult to treat, with only half of patients surviving despite aggressive therapy.  Little is known of pineoblastoma due its rarity and the surgical difficulty in acquiring enough of a sample for detailed analysis. Through the international Rare Brain Tumour Consortium, we have gathered and are analyzing the largest known collection of pineoblastoma samples. We are currently working to find what molecular factors drive these cancers to behave so aggressively. Our goal is to determine which of these can be targeted with current and experimental drugs, then validate them using cell culture and mice studies. Our findings will be used to design the next clinical trial for children with pineoblastoma to advance treatment and improve survival.