Sask. researchers make history in cancer detection
By Ashleigh Mattern, The StarPhoenix
In an unassuming office building in Innovation Place at the University of Saskatchewan, some world-class discoveries are being made.
Phenomenome Discoveries Inc. (PDI), has a lot of what you would expect – lab technicians in long, white coats examining test tubes. But Alix Hayden, director of operations, says a lot of science now comes from guys in jeans and a geeky T-shirts sitting computers – running statistics while drinking a Slurpee.
PDI is the research company behind Cologic, a new blood test that can detect whether a person is at risk for colon cancer – before the cancer has even had a chance to develop. Sean Richie is the researcher who made the discovery behind the colon cancer test.
“The test is unique in the world,” said Dr. James McHattie, head of gastroenterology for the Regina Qu’Appelle Health Region and lead clinical investigator for the Cologic trial. “How they discovered this, and their diligence, is fantastic.”
John Hyshka and Dayan Goodenowe founded the company in 2000. Cologic is the first product they’re rolling out based on PDI’s original research and patented technology. In the first few years, the business did more contract work to pay the bills and to avoid relying too heavily on investors. Around 2002-03, PDI started to spend more time researching its own projects, including Cologic.
Other similar tests are coming. In fact, there are so many new products on the horizon it’s “an embarrassment of riches,” Hayden says.
“The technology platform we have is so great, so efficient at providing us discoveries, that we end up with a pipeline full of potential discoveries and new tests, then we have to find the resources and prioritize those for development,” she said.
After Cologic, the company wants to develop similar tests for ovarian cancer and pancreatic cancer, as well tests for Alzheimer’s disease and multiple sclerosis. Researchers are also working with partners to create a therapy based on the same science behind Cologic.
“There’s a therapeutic molecule we’re developing that we believe can prevent a number of people from getting Alzheimer’s,” said Hyshka. “You’ll be able to take the molecule that’s disappearing in your system; our idea is to replenish it.” He compares the process to taking vitamin C to ward off scurvy.
Scott Livingstone, CEO of the Saskatchewan Cancer Agency, says he’s especially excited about tests for other cancers like ovarian cancer – which has so few symptoms, they call it the silent cancer.
“The science is really neat,” said Livingstone. “I’m not a PhD in biochemistry” (he’s a pharmacist by training) “but it’s really exciting to see how they’ve applied some of their basic scientific research to move forward with the entire early detection side.”
The cancer agency provides treatment, screening and prevention for patients, but it also has its own researchers who work with the team at PDI on various projects.
The screening tests focus on small chemicals found in the blood called metabolites. They are measured with a special mass spectrometer, then compared to a sample from a healthy person. If there are differences between the two, they know something is wrong.
“In pop culture, we see (mass spectrometers) on shows like CSI,” Hayden explained. “They take a little sample of a chemical or sample of something they find, and pop it in the little machine, and two seconds later out comes a picture or a peak that says, this chemical is red lipstick number seven or whatever. It can find the weight of tiny things like single molecules in a sample, and it’s used in all kinds of science.”
The technology PDI invented and patented is a Fourier Transform Ion Cyclotron Resonance mass spectrometer (FTMS). This version has a “big, huge magnet,” bigger than the kind you might find on an MRI machine. The magnet makes the FTMS much more sensitive than other mass spectrometers.
Hayden says metabolites are “the front line of biology.” You might know you have the potential to get cancer because someone else in your family has it, but environmental impacts like what you eat, or smoking can have a more immediate influence.
“Instead of saying you have a risk genetically for breast cancer or colon caner, we can say, today in your blood we can see something that is linked to colon cancer, so you should go and have a colonoscopy,” said Hayden. “It’s a real time measure of biology and health.”
For the trial, PDI and its colleagues looked at 5,000 patients undergoing colonoscopies in the Regina Qu’Appelle Health Region. They had their blood taken, which was sent to PDI for analysis. The results were compared to the results of the colonoscopy. The study was recently published in the International Journal of Cancer.
The clinical trials wrapped up about two years ago. Cologic hit the market in Ontario in October last year, and will be rolling out across Canada over the next six months.
LOOKING FOR CLUES
In Saskatchewan, more than 600 people are diagnosed with colon cancer every year. Many of those people who are diagnosed are in advanced stages of the disease.
“If we can find cancer at the most early stages, that’s where we have the most impact,” said Livingstone.
If your doctor thinks you’re at risk for developing colon cancer, the current standard is to have a fecal occult blood test – and you’ll have to gather the sample yourself.
It may be no surprise to learn that most people don’t like collecting a stool sample.
“A lot of patients can’t be bothered,” said McHattie. “It’s more difficult to get the specimen collected and sent in.”
With a blood test like Cologic, more people are likely to get the test, and it’s more accurate than a stool sample. The stool sample is good at looking for blood in the stool, or some other evidence that a tumour has already formed. The blood test, on the other hand, can detect cancer at very early stages, or even before a tumour has formed.
McHattie also says it’s sometimes hard to determine when a patient with a family history of colon cancer should begin regular colonoscopies. In general, it’s 10 years before the time of diagnosis of the youngest family member with bowel cancer, but Cologic could give a much more specific answer to that question.
As much as collecting a stool sample turns people off, it still has a place in medicine – Livingstone points out that the traditional test can find Crohn’s disease or inflammatory bowel disease where Cologic is tuned specifically for cancer. They’re also not looking to replace a colonoscopy because that procedure is still the gold standard for diagnosing cancer and other problems with the intestine.
But once tests like Cologic are widely used, patients will have a better chance of surviving, and there will be less stress on the health care system as fewer people will be dealing with cancer at late stages.
CML Health Care has the rights to sell Cologic everywhere in Canada except Saskatchewan.
“When we licensed the rights to the test to CML Health Care, making it available in Ontario, we excluded Saskatchewan so no one else can charge our province for something that we developed,” said Hayden.
They’ve been working with the government and with the SCA to determine the best way to offer the test in Saskatchewan, and they expect the test will be available in its home province later this year.
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