By Jacquie Moore
Photographs by John Ulan
People may wonder: is cancer research making a difference? In a resounding, all-caps word, YES.
Understandably, it can sometimes be difficult to perceive a difference in the conversation around cancer because statistics, treatments and diagnostic methods are constantly evolving. We might, for instance, read about a new cancer-related breakthrough only to realize that it’s at the discovery stage or awaiting approval for phase I or II of a clinical trial and not yet a viable treatment.
Still, as technology evolves and researchers, scientists and clinicians build momentum from the tremendous, global depth of knowledge and experience, profound advancements are making the transition from research lab to clinical practice faster and more successfully than ever.
These three Alberta researchers prove that exploration, discovery and a collective, laser- focused aim to save lives are at the heart of transformative change in cancer prevention, diagnosis and treatment.
Better reconstruction after skin-cancer surgery
While the successful removal of skin cancer is always a coup, a patient’s relief can be diminished by the difficult reconstructive surgery that may follow. Indeed, with rates of non-melanoma skin cancer on the rise in Canada, surgery to repair areas of the face and neck, or rebuild the nose, for instance, are also growing.
Dr. Adetola Adesida is a bioengineer working to transform experiences and outcomes for skin-cancer patients by reducing post-surgical complications and improving both health and aesthetics.
Adesida explains that rebuilding a nose following surgery for non-melanoma is an intensely complex business. Traditionally, surgeons have had to borrow cartilage for the nose from either the patient’s ear, which can cause scarring and deformity, or from their rib. The latter is particularly undesirable: it’s major surgery that exposes the vital organs to harvest a bit of cartilage, which may or may not be too brittle for use.
“This is where I come in,” says Adesida, who oversees a cartilage bioengineering and regenerative medicine lab at the University of Alberta’s department of surgery. “What we can do is take a small biopsy from the nose septum and digest that tissue using enzymes to release the cells — those become the building blocks for cartilage that a surgeon can now use,” he says. Not all the cells, however, are efficient at making quality cartilage; Adesida’s work allows for selection of the best cells for making cartilage after discovering a marker that defines them.
Those cells can be multiplied in the lab using growth factors until there are enough for Adesida and his team to put into a 3D printer to take the shape of a patient’s nose. “We then take that printed structure and put it into an incubator at body temperature where the cells build tissue and cartilage.” Six to nine weeks later — after the cartilage has been rigorously tested to ensure the cells are expressing the correct genes for the patient — it’s given a green light for the surgeon to use.
It’s a major discovery that, Adesida believes, “will give patients the best quality cartilage for them, based on the markers in their own cells.”
Using immunotherapy to target cancer cells
For decades, “cancer treatment” called to mind two pillars of care: chemotherapy and radiation. The relatively novel field of immunotherapy, however, is now part of cancer care that’s making profound strides in positive outcomes for patients with B-cell (non- Hodgkin) lymphomas and leukemia. By stimulating the immune system to target certain biomarkers, immunotherapy can take the disease from terminal to long-term remission. A new, early stage clinical trial set to open at seven sites across Canada will test a newly developed, Canadian-made product that could improve and expand the success of immunotherapy.
Dr. Kevin Hay is the biomanufacturing medical director at the Riddell Centre for Cancer Immunotherapy at the Arnie Charbonneau Cancer Institute. An expert in early phase clinical trials, Hay will lead the multi-centre trial.
“The immune system is nicely designed to help us fight infections,” says Hay. “It can also help us fight off cancers before they become cancer.” Early stage trials in novel cell and immune therapies for cancer are an important part of the mission at the Riddell Centre; the most advanced of these so far is the CAR T-cell therapy, which is moving toward rapid clinical translation.
“CAR T-cell therapy is what we call a ’living drug’ in that what we do is take
the T-cell from a patient and engineer it in the lab,” says Hay, whose team hopes to accrue patients in pediatric and adult cohorts over the next 18 months. “We put the new gene-modified cells, grown in the lab for a period of a week, back into the body to reinvigorate their response against the targeted tumour cells.” The hope is that the immune system would then recognize those cells as cancerous and fight them.
“Part of our overall vision of this program is to make these cells in Canada so that it’s affordable, and we can not only help fight cancer, but support Canadian science and jobs, as well as improve our health-care system.” It’s
a tall order — entirely on par with the tremendous ambition and success of cancer research in Calgary.
Boosting immune cells with vitamin B3 to counter brain tumours
Dr. Wee Yong refers to the focus of his current phase I-II clinical trial
as “the battle for the brain.” Yong is a professor at the Hotchkiss Brain Institute at the University of Calgary and holds the Canada Research Chair in Neuroimmunology; his extraordinary research has been translated into clinical trials in multiple sclerosis, spinal cord injury and glioblastoma. The latter is the subject of potentially transformative research right now, as Yong and his team aim to rejuvenate the immune system to target deadly brain cancer.
“In our lab work, we discovered that vitamin B3, also known as niacin, could mobilize immune cells to win the fight over brain tumours,”
says Yong. By screening more than 1,000 compounds in laboratory models, he and his colleagues, including Drs. Gloria Roldan Urgoiti, Paula de Robles and Candice Poon, found that niacin was one of two drugs that may have the potential to extend the lifespan of people with glioblastoma. As Yong explains, the cancer-compromised immune system can’t fight the brain tumour cells, and so, “the cancer cells win the battle.” This trial, he says, demonstrates the value of collaborative research and gives the brain a fighting chance.
“As a lab scientist, I know that many discoveries get stuck in the lab,” says Yong. “But we’ve been successful in getting funding to bring in clinical colleagues who then design and conduct the clinical trials in patients.” By doing so, his hope is that, within the next couple of years, the niacin trial will illuminate a probable new addition to standard of care to extend the lives of people diagnosed with glioblastoma.