A Sudbury-based researcher is hoping his discovery of a new medical diagnostic tool will “revolutionize” cancer care.
Dr. Amadeo Parissenti, a scientist at the Sudbury Regional Hospital and a professor with Laurentian University, Northern Ontario School of Medicine and University of Ottawa, said the chemotherapy treatment management tool for breast cancer patients currently under study will likely have other diagnostic applications.
“We really want to see how broadly this technology can be applied,” he said.
The diagnostic tool monitors the response of breast cancer tumours to chemotherapy – specifically by assessing the degree of degradation of RNA (ribonucleic acid) by chemotherapy drugs.
Further validation studies are required but Parissenti's work has led to Laurentian University granting an exclusive license to the technology to a new start-up company, Rna Diagnostics, which has been garnering attention with recent wins in business competitions.
Parissenti is a co-founder of the company and its chief scientific officer. In April, it won best new venture, best business venture in the health-care field and was named co-winner of the best intellectual property award at the TIEQuest Awards in Toronto. Last year, it won top prize in the Sanofi Pasteur Healthcare and Biotechnology Venture Challenge.
Parissenti works closely with colleagues from the National Cancer Institute of Canada Clinical Trials Group and has been interested in the genetics of cancer, “specifically, if there is anything interesting about cancer patients that might predict their response to drugs.”
The discovery he made in 2006 was unplanned and not a goal of the study. The study looked at whether there was a difference in the activity level of genes between tumours or patients that responded to chemotherapy and those that didn't.
“The goal was to personalize cancer treatment and base it on the person's genetics and the genetics of the tumour,” Parissenti said.
Tumour samples before treatment typically had high RNA quality. However, when samples were submitted from patients in the middle of therapy, he discovered considerable variation in the quality of the RNA, which can be measured and scored.
“The big surprise, and the very exciting one, was that patients with low (tumour) RNA quality mid-treatment responded well to chemotherapy and the tumour eventually disappeared completely. In contrast, those that had high RNA quality, throughout treatment, typically experienced progression of their disease and did not do well,” Parissenti said.
“The sad reality is that the vast majority of patients we treat do not receive a survival benefit from chemotherapy, but there was no way to differentiate between the minority of patients that receive a survival benefit and the majority that do not. We think this is the tool that will allow us to determine whether or not chemotherapy is working effectively.”
For those who do not respond well, other options are available such as radiation, other drugs (the study looked at two) or surgery to remove the tumour.
“We would never recommend denying treatment but we should make sure the treatments we are providing do work,” he said.
While it was clear the discovery was significant, Parissenti said it was also clear that the private sector had to be involved if the technology was to be developed for use on patients.
After drumming up interest through presentations, York Medtech Partners, a Toronto-based firm that specializes in incubating innovative med-tech companies, came on board about a year ago and formed Rna Diagnostics to commercialize the discovery.
“I strongly believe the approach to assess RNA quality will result in a better approach to chemotherapy,” Parissenti said.
One of the primary goals of the company is to help fund additional validation studies. There has only been one large clinical study to date and additional independent studies are required before the test can be widely applied. Subsequent studies will be conducted by credible clinical trial organizations associated with major cancer centres in North America and Europe.
“This is a significant breakthrough,” Parissenti said. “If this is what we hope it is, this could revolutionize cancer care because the need is there and we don't have anything like it right now. A tool like this would immediately be taken up widely across the world.”
Following validation studies, at least one central reference laboratory is planned to provide diagnostics services, possibly in Sudbury.
“There would have to be infrastructure in place for that, but right now, our official address is in Sudbury,” he said.
When the study was once referred to in a Toronto meeting and the audience was told samples were being sent to Sudbury for analysis, Parissenti said there was a murmur of “why” and “what” throughout the auditorium.
“Now when studies are based in Sudbury, no one bats an eye because we have established an excellent reputation for innovation,” he said. “I was the principal investigator of the study but it also involved researchers from quite a number of different locations. This experience shows that innovation in Sudbury can match any place anywhere, if you have highly credible partners.”
