The inaugural Atlantic Precision Medicine Conference will be held in Halifax next week with an agenda focused on delivering the right cancer treatment to the right patient at the right time.
Precision medicine, aka personalized medicine, takes into account the genetic makeup of an individual and their cancer when devising treatment. Specialists analyze the genes and other biomarkers in patients and their cancers to assess which therapies will be effective in each case.
At a time when many don’t even have a family doctor, it might be surprising to learn that these innovations are quite advanced in this region, thanks to the work of various centres of excellence.
“Saint John Regional Hospital in New Brunswick was the first laboratory in Canada to offer comprehensive genomic profiling, which analyzes over 500 genes for tumour mutations that can guide treatment,” conference organizer Dr. Michael Carter told Entrevestor.
“Nova Scotia is leading in a number of ways,” said the doctor who is Medical Director of the Molecular Diagnostics Laboratory at Nova Scotia Health, among other roles.
“In Nova Scotia, we have been performing biomarker testing on every patient diagnosed with lung cancer, regardless of stage, since 2017, a first in Canada. We were also one of the first hospitals to introduce testing for all patients with metastatic colon cancer.”
Carter said research conducted at Dalhousie University and the Beatrice Hunter Cancer Research institute is driving progress.
“It’s an advantage to be a province with one big city because it allows a concentration of infrastructure and expertise, leading to efficient centralized biomarker testing and cutting-edge research.”
Precision medicine is still in its infancy but the number of targeted therapies is increasing.
An emerging technology is liquid biopsies of solid tumours, which means patients can have a blood test instead of having a tumour biopsied with a needle.
“We can identify tumour DNA that is circulating in the patient’s blood,” Carter said. “By performing testing on the blood, we don’t need to biopsy the tumour, which avoids the risks associated with a needle biopsy in the lung or liver, such as bleeding or infection.
“A patient can provide a blood sample in Yarmouth or Sydney which can be couriered to Halifax, meaning there’s no need for the patient to travel to get a biopsy, which often requires paying for a hotel and taking time off work.”
AI is an increasingly important tool.
“AI is very exciting. We are now digitizing glass slides for analysis by AI,” Carter said. “The AI can identify aspects of tumours that we as humans cannot. AI could replace some molecular testing down the road but it’s still too early, the algorithms will sometimes make incorrect predictions.”
Precision medicine can actually save the healthcare system money, Carter said.
“On balance, precision medicine can save money, at least in some cases, as it can save patients from having to undergo therapies that are ineffective and unpleasant.
“The side effects and toxicity of conventional chemotherapy are very significant. Getting a patient on the best drug for them can sometimes spare them these side effects and lead to savings.”
The advances in treatment are particularly valuable as cancer cases are rising, especially in the young.
“In people under 50, colon cancer rates have doubled and rectal cancer rates have quadrupled,” Carter said. “I see it every day, sadly. It is a shock to see metastatic colon cancer in people that age.”
There are lots of theories about why rates are rising: microplastics; obesity; ultraprocessed foods; chemical exposure are all mooted, but no one is sure.
The conference will bring together specialists from many disciplines and will include the personal experiences of cancer patients.
Carter hopes the comprehensive approach will allow attendees to break out of their respective silos and see the broader picture, leading to better and more equitable access to care across the region.
He is optimistic about the survivability of cancer, foreseeing a time when cancer will be a manageable chronic disease.
“The North Star would be turning cancer into a manageable chronic disease like high blood pressure or diabetes. We have already seen this in one kind of blood cancer – chronic myelogenous leukemia. We identified a mutation and created a drug to target the mutation. Patients can now live into their 80s.
“Thanks to immunotherapy (treatment that stimulates a patient’s immune response), some patients with metastatic cancer are being cured. This is not infrequent with melanoma and a certain type of colon cancer. We are seeing patients walk away from metastatic cancer.”
He spends most of his working life in the lab analyzing tumours and says he loves helping direct treatment:
“Working with oncologists, and hearing stories of patients’ amazing responses to treatment gives me the motivating hope to show up every day and try to make a difference.”
The conference will open with a networking event at the Halifax Marriott Harbour Front Hotel on November 7, continuing with a full day of discussions and presentations on November 8.
The conference is supported by Life Sciences Nova Scotia.
Tickets here.
