Baby Steps and Sniper Attacks

The term ‘molecular oncology’ seems to go hand-in-hand with jetpacks and flying cars. It may sound futuristic, but it’s the leading edge of cancer treatment and it’s happening at The Ottawa Hospital.
Dr. Bryan Lo, Lead Scientist and Medical Director, Molecular Oncology Diagnostics Laboratory.
Dr. Bryan Lo, Lead Scientist and Medical Director, Molecular Oncology Diagnostics Laboratory. (photo credit: Mark Holleron)

Dr. Bryan Lo, lead scientist and medical director for The Ottawa Hospital’s Molecular Oncology Diagnostics Laboratory, opened the doors to Ottawa’s first lab devoted to treating and studying the genetics of cancer in 2014.

It was during his residency that Dr. Lo became interested in inherited cancers. A research fellowship at Yale eventually lead to a U.S firm called Genentech. Herceptin, a drug used to treat patients with metastatic breast cancer, was developed there.

“That was one of the most significant targeted therapies,” describes Dr. Lo. “It benefitted untold numbers of breast cancer patients.”

Targeted therapy is a growing part of modern cancer treatment. Imagine dropping a nuclear bomb on a city in order to take out one bad guy. The collateral damage would be immense. But what if you could employ a sniper to eliminate that same bad guy with pinpoint accuracy instead? Targeted therapy is the sniper — it is cancer treatment that precisely identifies and attacks cancer cells, usually while doing little damage to normal cells. 

Although Dr. Lo saw the development and launch of a number of targeted therapies during his time in the U.S. he had a desire to return to an academic hospital environment in Canada. 

“I wanted to participate with medical oncologists, in translational research, but also in the practical business of bringing these targeted therapies to Canadian cancer patients,” says Dr. Lo. “There was amazing amount of research that was going on in Ottawa, special research that really doesn’t happen in very many places.”

Dr. Lo describes molecular oncology as “the business of defining a cancer on molecular terms.” It’s about what works for an individual person on a molecular level. No two cancers are alike, and when technicians look at these cancers with the latest technologies, they can identify their complex molecular signatures.

“We don’t yet understand all of the details but it definitely tells us that perhaps the targeted therapies need to be matched to the cancer in a much more precise fashion,” says Dr. Lo. “The technologies have enabled us to really look at cancer in a new way. That has been a very significant advance.”

In layman’s terms, it means better-calibrated sniper attacks as well as more personalized treatment. Cancer treatment is already personalized to a degree, but TOH wants to get much better at it, with individualized treatment based upon information found on a molecular level. 

Technicians look for a particular mutation in a certain cancer gene, and then use that information to assess whether the patient will benefit from targeted therapy. Personalized medicine results in a better response in the patient and a lower incidence of side effects: side effects that can cause pain, suffering, and can even lead to hospitalization. 

One of the first things the Molecular Oncology lab did when it opened for business was put a dent in wait times for diagnostic testing.

“The first step was a baby step,” says Dr. Lo. “We repatriated a lot of tests that were being sent out to other laboratories and now we’re able to do these tests in Ottawa. We’re able to interpret these results in the context of the pathology – and the context of the clinical information – much better because we’re all right here.” 

Keeping tissue samples at TOH reduces wait times, paperwork and added costs, and improves efficiencies in the clinic. It also makes it easier for clinicians to re-examine samples for additional testing if needed.

The Ottawa Hospital has raised $2 of the $3 million needed for an expanded Molecular Oncology Diagnostics Lab. These funds will go towards the building of the laboratory and “next- generation” equipment. A new facility builds capacity for innovation, attracts leaders in the field and ultimately creates a stronger health-care system for a community. It’s also a magnet for new tech as well.

“We are small, but we are really not small, because the lab is part of the TOH community,” says Dr. Lo. 

This is the third of an ongoing series about The Ottawa Hospital. Look for the evolving archive on obj.ca.

Molecular Oncology

TOH BY THE NUMBERS

- 24,000 cancer patients were treated at The Ottawa Hospital Cancer Centre last year

- 9,000 people are diagnosed with cancer every year in our region

- 40% of Canadians are expected to develop cancer during their lifetimes