On April 12, 1980, 21-year-old cancer survivor Terry Fox dipped his prosthetic leg in the Atlantic Ocean near St. John’s to mark the beginning of an ambitious cross-country run to raise money for cancer research.
There was little fanfare when the Marathon of Hope began, but Terry’s odyssey began to generate media attention and, over weeks, months and years, his story gripped the nation, and the astonishing amount of money raised has left a mark on cancer research around the world through the numerous initiatives it has funded.
Thirty-nine years later, members of his family and the Terry Fox Foundation will return to the site of the first steps of the journey for a similarly low-key launch of what they hope will become another world-leading initiative.
The Marathon of Hope Cancer Networks is the name given to a grouping of leading cancer hospitals and research universities across Canada that will pool their resources to study and implement precision oncology. The networks will be overseen by the Terry Fox Research Institute, a group funded by the charitable foundation.
The project, which the foundation has had on the drawing board for years, just received a $150-million kick-start from the federal government – a single line in the March 19 federal budget that went largely unnoticed – and that will be matched dollar-for-dollar by the hospital partners.
Darrell Fox, Terry’s brother, said Terry’s dream was to see the work funded by the Marathon of Hope continue without him, and this is another great way to do so: “We are grateful to the millions of Canadians who have kept his dream alive and to the research and funding partners that are making this precision medicine network possible. You are bringing new hope to cancer patients.”
Precision oncology, simply stated, means customizing cancer treatments to individuals based on their genetic makeup and the molecular characteristics of their tumours. To do that, paradoxically, requires a lot of data from others: Patients’ genomes are decoded, their treatments are tracked and what is learned from the successes and failures goes back into refining treatments, a constant feedback loop that, theoretically, will result in much more precise and effective treatment.
“We’re committed to having the highest-quality data to ensure the highest-quality treatment for cancer patients,” Dr. Victor Ling, the president and scientific director of the Terry Fox Foundation, said in an interview.
The network’s researchers plan to decode the genomes of 15,000 cancer patients within the first five years, and 100,000 patients within a decade. The cancerous tumours of these patients would also undergo molecular profiling.
In addition, the network will gather, share and interpret data that have already been collected. “There’s a lot of useful information sitting in people’s laptops that needs to be shared more broadly,” Dr. Ling said.
He said one of the great advantages Canada has is a universal health-care system and specialized cancer-treatment centres, making it easy to track patients’ treatment from start to finish, and their outcomes over time. In the era of Big Data, that is crucial.
One of the key characteristics of the Marathon of Hope Cancer Networks is that it will be mandatory for researchers to collaborate across provincial borders. Five regional consortiums – B.C., Ontario, Quebec, the Prairies and Atlantic Canada – are expected to participate in the network once it’s fully operational.
Dr. Ling said the goal is to build the “Team Canada" of researchers that can play a prominent role on the international stage in this rapidly evolving field.
Although precision oncology is in its infancy, there are early, hopeful indications that knowing patient’s genetic variants can help avoid over- and underutilization of targeted cancer treatments. A typical example of this approach is the drug Herceptin, which is used to treat women with breast cancer, but only if they have a gene called HER2.
The data derived from genomic sequencing and molecular profiling should help identify other targets and help clinicians know, in advance, when and for whom specific treatments will or will not work.
The testing is getting increasingly affordable and available but projects such as this cost hundreds of millions of dollars because of the highly-trained individuals needed to do the analysis and interpretation that ultimately benefits patients.
“This network is about Big Data and artificial intelligence,” Dr. Ling said. “But, above all, it’s about investing in real intelligence to figure out what to with it.”