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Medical Care



Fall 2012 Edition
Website Updates

Personalizing Tamoxifen Therapy in London
The Lawson Translational Cancer Research Team (LTCRT) based in London has been facilitating the development
and adoption of personalized cancer medicine using pharmacogenomics. Dr. Richard Kim, a recipient of the Cancer
Care Ontario (CCO) Research Chair (Tier-1) Award in 2010 and leader of a program of Personalized Medicine at
the London Health Sciences Centre, has been working closely with a team of oncologists and the LTCRT to ensure
a group of breast cancer patients experience the best outcomes possible.
Tamoxifen is an important drug for the treatment and prevention of certain breast cancers, and is metabolized in the
liver by a drug metabolizing enzyme called CYP2D6. This enzyme is responsible for converting tamoxifen to its
active form, endoxifen. The CYP2D6 enyzme occurs in different forms in human beings (called "polymorphisms")
which may metabolize the same drugs differently. There is compelling research that shows that women with less
active variants of CYP2D6 are at greater risk for breast cancer recurrence compared to those without such
polymorphisms when treated with tamoxifen.
In March of 2010, Dr. Kim started a
personalized medicine clinic for breast
cancer patients on tamoxifen therapy using
the research funds available through his
CCO Chair award. Patients referred to his
clinic have their CYP2D6 genotyped as well
as tamoxifen and endoxifen blood levels
assessed using state-of-the-art genotyping
and drug level analysis technologies. Dr.
Kim then provides a detailed report to the
referring oncologist in terms of the patient's
ability to metabolize tamoxifen. He now has
data from over 200 patients that show not
only are CYP2D6 polymorphisms important
to tamoxifen bioactivation to endoxifen, but
so are polymorphisms in a another enzyme
(CYP3A4) and the patient's vitamin D level.
Dr. Richard Kim and his team. "With the continued support of the High Impact Clinical Trials Program, it is hoped that Dr. Kim's work will help oncologists deliver the best experience and outcomes possible for breast cancer patients" said Dr. Eric Winquist, Medical Oncologist and Lead Principal Investigator, LTCRT. Further study of these findings in collaboration with oncologists at Princess Margaret Hospital is planned to validate and apply these findings. Work continues with the LTCRT to expand the study of pharmacogenomics for better predicting patients at risk for toxicity or loss of therapeutic benefit to other cancer types and other types anticancer drug therapies.
For more information on the Lawson Health Research Institute Translational Research Team, clickor contact
Research Coordinator, LTCRT.
2012 HICT Program Funding Opportunities: Results from Small Project Submissions
The HICT Program together with the Ontario Translational Research Network released a 4th call for Small Project
Submissions (SPS). As a result, three SPS were approved:
Project Title
Funded Amount
Correlation of Baseline Biomarker Levels with Clinical Outcomes and Christina Addison Response to Zactima in Bone Metastatic Breast Cancer Patients Stem Cell Gene Expression Signatures in Clinical Pancreatic Cancer Translating the clinical utility of cancer microparticle enumeration and functional tumor imaging for combined prognosis of colorectal cancer.
For more information, please click
Standardizing Biospecimen Collection in Ontario

The availability of high quality biological specimens is of utmost importance for cancer clinical trials and research.
While many samples are collected across a multitude of sites, lack of standardized methods and lack of consistent
standard operating procedures jeopardize quality of the samples and the ability to use the samples for future
research. Over the past year, through collaborative efforts between OICR, the Ontario Translational Research
Network (OTRN) and sites, biospecimen specific standard operating procedures (SOPs) were developed.
The OICR-OTRN SOPs committee reviewed,
modified and harmonized existing biospecimen
SOPs from the International Society for Biological
and Environmental Repositories, Canadian
Tumour Repository Network, National Cancer
Institute and OTRN. The result is a set of 37 SOPs,
organized into three levels:
Overall General SOPs (000 series) to guide both clinical trials and biorepositories; Biorepository SOPs (100 series); Clinical Trial Related SOPS (200 series).
In addition to this "overarching" set, to be adopted by each site to guide the overall practice, each site may develop
additional SOPs, appendices and/or tools to complement this set to outline specific local details. General clinical trial
related SOPs are available through the Network of Networks (N2).
On June 15, OICR and OTRN conducted a train-the-trainer workshop to roll out the SOPs and the associated
maintenance processes. The workshop was well attended and received excellent feedback. The committee is
pleased to make these SOPs publically available on the OICR-HICT Program website, locat Since early
August, the Biospecimen SOPs webpage has been viewed 631 times.
It is hoped that the use of these SOPs will be instrumental in standardizing practices and increasing the quality of
the samples and the ability to use the samples for future research.
For more information on the biospecimen specific SOPs, please clickor contact
Upcoming Events
 September 17, 2012: HET Submission Deadline at 5 p.m.  September 20, 2012: TRT Survey Completion Deadline  September 26, 2012: HICT Webinar Series: Response Evaluation Criteria in Solid Tumours (RECIST)  September 27, 2012: HICT Program Management Committee Retreat  September 27, 2012: Robert A. Phillips Lecture 2012: Selection of Adjuvant Chemotherapy for Breast Cancer: Can Biology Trump Anatomy? Speaker: Dr. Daniel F. Hayes. Registration required. For more information and to register, cli  November 2-3, 2012: Clinical Trials Project Management Workshop
For additional events, please visit t
Education/Articles of Interest

From HealthLeaders Media
From the New York Times
From Canada Newswire
From EurekAlert
From Lawson Health Research Institute
From Ontario Cancer Research Ethics Board
From CTV
From the Los Angeles Times
OICR News on Twitter:
Reporting Reminder
Financial and Progress Reports are due 30 days post end of quarter. The next quarterly report is due October 31,
2012. For more information, contact
Report Due
July – September October – December January – March
HICT Project Updates

Updates are current as outlined in the April 1 – June 30, 2012, progress reports.
Lead PI: Richard Cook, University of Waterloo
 Started on May 1, 2012, placement of five internships (all M.Sc.): o One at OICR; o One at NCIC Clinical Trials Group; o Two at Princess Margaret Hospital; o One co-supervised at University of Waterloo and University of Western Ontario.  Interns trained to date: nine (seven M.Sc., two PhD)
Lead PI: Mark Levine, McMaster University
Patients Accrued

Lead PI: Alison Allan, Lawson Health Research Institute
Patients Accrued

Lead PI: Mark Levine, McMaster University
Patients Accrued

Lead PI: Masoom Haider, University Health Network/Sunnybrook Health Sciences Centre
Patients Accrued

Lead PIs: Lillian Siu, University Health Network; John McPherson, Ontario Institute for Cancer Research; Suzanne
Kamel-Reid, University Health Network
Patients Accrued
Translational Research Teams

TRT Site
TRT Coordinator
Catalina Vasquez Pamela Degendorfer and Katherine Karakasis Katherine Andriash and Sandra Stoger Dimitrios Vergidis HICT electronic updates are provided for the stakeholders of the Ontario Institute for Cancer Research, High Impact Clinical Trials Program. Comments and feedback are always welcome. To email the editor please click


Implementation of methods translation between liquid chromatography instrumentation

Implementation of Methods Translation between Liquid Chromatography InstrumentationMichael D. Jones, Peter Alden, Kenneth J. Fountain, and Andrew Aubin Waters Corporation, Milford, MA, U.S. AP PLICATION BENEFITS Future proof your laboratory Pharmaceutical research and development (R&D) organizations were early adopters who recognized the many benefits of UltraPerformance LC® (UPLC®) Technology

Name /oak/jn 122_5y4356/M _226 05/01/2000 07:52AM Plate # 0 Sertraline in theTreatment of MajorDepression FollowingMild TraumaticBrain InjuryJesse R. Fann, M.D., M.P.H.Jay M. Uomoto, Ph.D.Wayne J. Katon, M.D. An 8-week, nonrandomized, single-blind, placebo run-in trial of sertraline was conducted on 15 pa- oftraumatic brain injury (TBI) in both inpatient