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In 2015, the Rossy Cancer NetworkÌýwill fund $350,000 in Research Funds, enabling the completion of six projects. The grants will impact a number of different cancers, from lung to colorectal, head and neck, hematological as well as cancer pain management. Ìý

The 2015 Rossy Cancer Network CQI Research Fund recipients are:Ìý(in alphabetical order, by principal investigator)

Hematological cancer

Adherence to guidelines in the management of chronic myeloid leukemia in Quebec

Chronic myeloid leukemia (CML) was fatal for most patients until 2002, when a new drug was approved. Now, the majority of patients have a normal life expectancy if they adhere to therapy. Although there are clear treatment guidelines, few data report on physician compliance which can critically impact life expectancy for this patient population.This project will use a registry covering 60% of patients with CML in Quebec — a unique resource in Canada — in order to evaluate the rate of adherence to guidelines and possible barriers, and thereby help physicians provide quality care to patients by identifying where shortfalls can occur and how to avoid them.

Project Team: Dr. Sarit Assouline will lead a team from the JGH, SMHC and MUHC including Dr. Laurent Azoulay, Dr. Pierre Laneuville and Dr. Jaroslav Prchal.Ìý

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Colorectal cancer

Using multimodal prehabilitation to improve outcomes for frail patients undergoing resection of colorectal cancer

Colorectal cancer is the third most common cancer in North America. In over 80% of patients, surgery represents the best way to cure this cancer. However, despite advances in operative technology and surgical care, one in three patients will experience a complication and delayed recovery after this procedure, and frail elderly patients are at considerable risk. This study will determine whether a structured program of prehabilitation, including physical activity, nutrition counseling and relaxation before surgery will favour earlier hospital discharge and fewer complications for frail elderly patients.

Project Team: Dr. Francesco Carli will lead a team from the MUHC and JGH, including Dr. Marylise Boutros, Dr. Julio Fiore,Ìý Dr. Gabriela Ghitulescu, Dr. Thomas Jagoe, Dr. A. Sender Liberman, Dr. Nancy Morin, Dr. Celena Scheede-Bergdahl, along with collaborators Dr. Andreas Bergdahl, Dr. Patrick Charlebois, Dr. Jose Morais, Dr. Barry Stein and Dr. Carol-Ann Vasilevsky.Ìý

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Head and Neck cancers

Marching Ahead: Imaging Biomarkers, a new revolution in patient managementÌý and care for Human Papilloma Virus (HPV) Positive Oropharyngeal Cancer

There is an increasing incidence of human papilloma virus (HPV) related oropharyngeal squamous cell cancer (OPSCC). ÌýHPV-positive patients are given a combination of chemotherapy and radiotherapy; treatments with high toxicity that can negatively impact quality of life for patients. There is a need to modify the current treatment regimens without impacting the patient’s prognosis. This study will examine texture imaging — a mathematical model, which combines a number of scans —Ìý would provide an opportunity to have tailor treatment for each individual, based on their imaging biomarker profile

Project Team: Dr. Jeffrey Chankowsky will lead a team from the MUHC and JGH,Ìý including Dr. Jaykumar Nair, Dr. Stephen Probst, Dr. Caroline Reinhold, Dr. George Shenouda, Dr. Khalil Sultanem, Dr. Carlos Torres, Dr. Martin Vallières and Dr. Anthony Zeitouni.Ìý

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Head and Neck cancers

Spectral dual energy CT and textural radiogenomic analysis for optimal tumor delineation, patient staging, and biomarker for head and neck squamous cell carcinoma

There is increasing interest in advanced image analysis using powerful computer algorithms to identify the characteristics of individual tumors. This new approach isÌý non-invasive and better predicts the results of individual therapies on tumors. By visualizing tumors using new dual-energy CT scans, the research team will create unique imaging profiles that correspond to a tumor’s genetic profile, also known as its radiogenomic signature. The study will validate the usefulness of radiogenomic signatures in evaluating tumor stage, prognosis, and predicting tumor response to different treatments, with the goal of having this targeted approach improve outcomes for head and neck cancer patients.

Project Team: Dr. Reza Forghani will lead a team from the JGH and MUHC, including Dr. Sabrina Daniela Da Silva, Dr. Michael Hier, Dr. Mark Leventhal, Dr. Marcin Aleksander Mlynarek, Dr. George Shenouda, Dr. Khalil Sultanem, Dr. Tan Xianming.

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Pain management

Ultra-low dose methadone as coadjuvant opioid therapy for cancer pain

Roughly 80% of cancer patients will experience moderate to severe pain over the course of their illness. Opioids (substances that act on the nervous system in a similar way to opiates such as morphine and codeine) are considered the first-line treatment for moderate to severe cancer pain, however 20% of patients won’t have their pain sufficiently managed or will develop associated side effects. The combination of methadone, a potent opioid with unique analgesic properties, with other opioids for the treatment of cancer pain has been explored in small studies with encouraging result; these suggest that methadone is well tolerated and may be effective at decreasing cancer-related pain. This randomized controlled trial will evaluate whether cancer patients find their pain better managed with this course of treatment.

Project Team: Dr. Jordi Perez will partner with JGH and MUHC co-applicants, Dr. Bernard Lapointe and Dr. Yoram Shir.Ìý

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Lung cancer

Texture Imaging: A novel technique to guide treatment and improve quality of life in patients with Non-Small Cell lung Carcinoma (NSCLC)

Lung cancer is the leading cause of cancer deaths worldwide, and 85% of cases are non–small cell lung cancers (NSCLCs). Most patients arrive with advanced stage disease and conventional treatment delivers a 15% survival rate after five years. Targeted molecular therapies are the mainstay of treatment, however, there is a need for non-invasive imaging biomarkers which would assess genetic variation within the entire tumor, something that isn’t possible with current methods. Texture imaging — a mathematical model, which combines CT/FDG-PET/MRI scans — could enable better prediction of the response to treatment, as well as the possibility of distant metastasis and recurrence. The project will assess whether this approach leads to more effective targeted therapy and improves outcomes for patients.

ÌýProject Team: Dr. Jana Taylor will lead a team from the MUHC and JGH, including Dr. Geneviève Belley, Dr. Victor Cohen, Dr. Vera Hirsh, Dr. Jaykumar Nair, Dr. Stephen Probst, Dr. Caroline Reinhold and Dr. Martin Vallières.

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