1. McGill Integrated Cancer Program Institute for Applied Cancer Science
Achievements and Next Steps to Tackle Cancer Grand Challenges
An update for
Faculty of Medicine Retreat
December 2017

2. Cancer Research Continuum
Basic research is the foundation on which the cancer research continuum is built.

3. Cancer Research Continuum
Basic research is the foundation on which the cancer research continuum is built.
WHY DO PATIENTS FAIL TO RESPOND TO THERAPIES?
NEW KNOWLEDGE = NEW THERAPEUTIC STRATEGIES
Genomic and other omic based technologies

4. Optimize patient-treatment matching
Precision Oncology
Cancer diagnosis and treatment are changing
Use of molecular-based profiling of individual patient’s tumor:
Optimize patient-treatment matching
Avoid predictably ineffective, toxic and costly treatments
Improve overall clinical outcomes
97% had at least minor tumor shrinkage
Percent change from baseline 40 20
-20
-40
-60
-80
-100

5. Precision Oncology Cancer diagnosis and treatment are changing
Use of molecular-based profiling of individual patient’s tumor:
Optimize patient-treatment matching
Avoid predictably ineffective, toxic and costly treatments
Improve overall clinical outcomes
molecular
pathology
97% had at least minor tumor shrinkage
Percent change from baseline 40 20
-20
-40
-60
-80
-100

6. Precision Oncology Cancer diagnosis and treatment are changing
Use of molecular-based profiling of individual patient’s tumor:
Optimize patient-treatment matching
Avoid predictably ineffective, toxic and costly treatments
Improve overall clinical outcomes
molecular
pathology
97% had at least minor tumor shrinkage
Percent change from baseline 40 20
-20
-40
-60
-80
-100

7. Precision Oncology
Cancer diagnosis and treatment are changing
Use of molecular-based profiling of individual patient’s tumor:
Optimize patient-treatment matching
Avoid predictably ineffective, toxic and costly treatments
Improve overall clinical outcomes
Driven by and is a driver for cancer research and innovation
Is McGill well positioned to maximise opportunities?
97% had at least minor tumor shrinkage
Percent change from baseline 40 20
-20
-40
-60
-80
-100

8. The Challenge – Increased Collaboration across McGill
McGill: World-class cancer researchers; however….
Relatively small teams
Geographically and administratively dispersed
Resources are fragmented and not centrally planned
No McGill wide brand, identity or shared vision
Lack unification or integration of research efforts -clinical-basic-translational
A history of competition between units rather than collaboration
Interdisciplinarity
Biologist
Clinician
Bioinformatics
Engineer
Statistician
Bridging Silos
Epidemiology
Systems Biology

9. Requires a fundamental shift in the way we conduct cancer research
The challenge- Funding climate is changing
Problem: Increased application pressure
Enhanced: Multidisciplinary large scale team grants with established track records
National Cancer Consortia
(ie. SU2C; NCE)
International Initiatives
(ie. Moonshot – US;
Grand Challenges – UK)
Group Grants (ie. TFRI)
Reduced success rates from traditional funding sources (ie. CIHR, CCS, CRS)
Requires a fundamental shift in the way we conduct cancer research

10. Hard-to-Treat Cancers
Integrated Research Approach- Cancer Grand Challenge
unmet clinical need
Models of
Cancers
Molecular Profiling
&
Personalized
Treatment
Biospecimen
Cancer
Biobank
Data
Repository
Clinical
Trials
• Discover New Targets
Validate Targets
• Develop Therapies
Understand Biology
Efficacy of
Precision Medicine
IMPROVE OUTCOMES
FOR HARD-TO-TREAT
CANCERS
Hard-to-Treat Cancers
Program Overview

11. Current Challenge – the old model
Surgical Clinical and Radiological Practice
Tissue and Data Banks
Knowledge Translation and Patient Impact
Cancer
patient
population
Basic and Translational Research
>8,500
Partnerships with Industry
for Target Validation and Drug Development
Interdisciplinary Research
Non FoM
Genomics/omics
Big Data Sharing
Platform Integration 11

12. Cancer Grand Challenge Research Approach
unmet clinical need
Surgical Clinical and Radiological Practice
Tissue and Data Banks
Knowledge Translation and Patient Impact
Cancer
patient
population
Basic and Translational Research
>8,500
Partnerships with Industry
for Target Validation and Drug Development
Interdisciplinary Research
Non FoM
Genomics/omics
Big Data Sharing
Platform Integration

13. Goals Integrated Approach
Cancer Integrated Network - Grand Challenge Research
Goals
To leverage the power of fundamental, translational and clinical research for the detection, prevention, long-term management and cure of cancers.
Integrated Approach
build close integration of clinical practice with research
harmonize data warehouse-outcomes-across sites
increase and harness clinical trials for discovery
targeted tissue and liquid biopsy repositories for discovery and validation
develop multidisciplinary and interdisciplinary teams apply integrated systems approaches to understanding of disease - patient centric
harness the power of multi-omic big data
exploit clinical data through AI innovations-radiomics

14. 1 2 3 4 5 What would a Grand Challenge Approach Accomplish
Prevention 1
Diagnosis 2
Precision Therapies 3
Therapy Resistance 4
Metastasis 5
What would a Grand Challenge Approach Accomplish
Life Style Choices
Genetic
Predisposition
Host immune
prevention
Point of care devices
Improved Non
Invasive Approaches
Imaging
Liquid Biopsies
Biomarkers
Novel Point of
Care Devices
Precision Oncology
New therapies
Small molecule inhibitors
Antibody-based therapies
Immune therapies
Metabolic therapies
Epigenetic therapies
Improved Detection
Novel Therapies
Tumor/stroma
dependencies
Metastatic niche
Tumor evolution

15. 1 2 3 4 5 Who would be partners at McGill? Inflammation
Prevention 1
Diagnosis 2
Precision Therapies 3
Therapy Resistance 4
Metastasis 5
Who would be partners at McGill?
McGill Initiative in
Computational Medicine
BioX
McGill Interdisciplinary
Initiative in Infection and Immunity (MI4)
McGill Stem Cell and
Regenerative Medicine
Nanotechnology
Innovative devices
Disruptive technologies
Disruptive biologicals
Inflammation
Immune modulation
Microbiome
Cancer stem cells
Resistance
Technologies (IPS)

16. Improve Outcomes to Cancer Therapies
CANCER CHALLENGES
High Burden Cancers
High Fatality Cancers
Real World Evidence
Resistance to treatment and metastases
PRIORITIZED THEMES
New Cancer Treatments
Novel Cancer Vulnerabilities
Metabolic dependencies of cancers
Tumour immune evasion
Synthetic lethality
New Tumor Targets
Drug repurposing
New drugs
STATE OF THE ART HOSPITALS
IMPLEMENTATION STRATEGIES
Annotated Tumour Tissue Banks
Cutting Edge Technologies
-Live Tumour Tissue Core (PDX)
-Omics Core Facilities
-Immune Phenotyping Core
-Synthetic lethality Core
Cancer Genomics-Bioinformatics
Expertise-New Recruitment
Cancer Genomics-Bioinformatics
Technology Development
Forge New Partnerships (clinicians, engineers)
Develop New Funding Opportunities

17. What would an Integrated Cancer Network accomplish?
Foster interdisciplinary multidisciplinary and interinstitutional research:
Training programs: enhance existing MICRTP partner with existing departments and programs to develop co-training models to serve as nodes
Seed grants: small one-time funding opportunities to bring together new teams to tackle priority areas
Shared platforms and harmonization: personnel support, resource sharing and strategic planning to maximize platform usefulness and lifespan
Secure large scale funding: early identification, project management and identification of co-funding for large scale initiatives (MESI, NCE, MESI, Terry Fox)

18. Cancer training stream
Training the Next Generation
Recruit the Best and Brightest in all Disciplines
Cutting-Edge
Technologies
World-Class Mentorship
Nationally and Internationally
recognized clinicians and researchers
Ground-Breaking
Interdisciplinary Research
Training
Generation
next
the
Cancer training stream
Projects at the forefront of basic
and clinically applicable cancer research
Training through integrated core
platforms

19. Funding Opportunities – Ongoing
Terry Fox Comprehensive Cancer Centre Network (PMH, BCCA)
- Montreal Cancer Consortium (JGH, MUHC, CHUM, HMR, GCRC, IRIC)
- harnessing Melanoma Network immunotherapy clinical trials
- $4M/2yr Pilot Project
Terry Fox Research Institute National Networks -
(PYA)
EPIC (Pancreatic)
Multiple Myeloma
Ministère de l’Economie, Science et Innovation (MESI) (LOI Dec 2017)
- MCC (MUHC, CHUM, JGH, HMR, GCRC, IRIC, LDI) $20M/4 yrs
high burden and high fatality increase clinical trial recruitment
- Using AI to Build Radiogenomics-Based Predictors for Response
to Precision Therapies in Cancer (MUHC, JGH, CHUM)
Oncopole EMC2 – Multi-institutional teams against cancer
- At least 3 institutions/research centres/departments, 2 Universities
- LOI: Nov. 2017
- 1.5M/3yrs – Expect to fund 4 grants-opportunities to integrate McGill

20. Fundraising – Need Partnership Approach
McGill University – Capital Campaign
funds raised can support Units at McGill
that are contributing to a Cancer Grand
Challenge – facilities for generation of
data from clinical material
Motivated Donors
- want to contribute to large
research initiatives that
include partnerships
between McGill and
affiliated Hospitals
Hospital Foundations
funds raised can support clinical
trials and tissue banking
efforts – focused on a
Cancer Grand Challenge
Other opportunities?
MESI, Terry Fox, NCE, SPOR
Requires a strategy to highlight that funds are being raised jointly to tackle large scale projects that span the fundamental/clinical/translational continuum of cancer research

21. Ongoing work and Next Steps
Cancer Summit
Spring 2018
Strategic plan development
Establish working groups from all pillars
Develop a governance plan
Define science, priority programs and vision
Determine our needs and draft a budget
Identify the role for donor support in a comprehensive funding plan
Establish next steps
Build our research teams and programs
Generate performance metrics and comparator data
Develop provincial, national and international partnerships

22. Questions