| DAY 1: WEDNESDAY, JUNE 21, 2023 |
Conference Day 1 Opening
- CCRAN works for and with patients to support their cancer care journeys. Through its advocacy, education, and research initiatives CCRAN strives to address challenges that impede optimal delivery of cancer care and patient outcomes in Canada. Timely access to biomarker testing results is one of these important challenges. This year's Biomarker Conference will convene clinical, research, policy and patient experts from across cancer types to provide a fulsome picture of the access issue in Canada.
Welcome from CCRAN's President
Precision medicines are guided by a tumor's biomarker status and represent a tremendous advancement in cancer treatment. They offer new hope, but systemic barriers to accessing biomarker testing and results need to be addressed. Care gaps identified by patients served as the impetus for this Conference:
- Patient-reported data captured from CCRAN's My CRC Consultant online tool reveal that many patients are not aware of their tumor's biomarker status or its relevance in their treatment, care and prognosis.
- Education on the role of advanced molecular testing and benefits of precision medicines is pertinent to improving patient care trajectories and outcomes.
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Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Ms. Filomena Servidio-Italiano, OCT, M.A.
President & CEO, CCRAN
Ms. Emma Langelier
Caregiver to metastatic colorectal cancer patient
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Why Timely Access to Molecular Testing Results is an Imperative Healthcare Issue in Canada
This session will build a case for establishing practice guidelines for biomarker testing across cancer types by:
- Describing the role of precision medicines in the fight against cancer and in improving patients' quality of life and overall survival.
- Highlighting clinical research advances that have unveiled extensive cancer tumor cell heterogenicity and the utility of biomarkers in predicting and monitoring response to therapy and in metastatic cancer diagnostic workup.
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Dr. Stephanie Snow
Medical Oncologist, QEII Health Sciences Centre
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Patient Access to Precision Medicines: Molecular Testing and Timely Biomarker Reporting (Patient Group Panel)
This Panel will bring together leads from patient groups across cancer types, including lung, gastric, colorectal, breast, ovarian, thyroid, pancreatic, melanoma, GIST, and blood cancers, to represent the views and experiences of cancer patients with respect to accessing biomarker testing and results in Canada. The discussion will serve to:
- Relay patient testimonials describing challenges patients face along the diagnostic care pathway and with respect to fully informed treatment decision making.
- Highlight commonalities among the challenges patients across different cancer types face with accessing biomarker testing and results.
- Identify key systemic barriers that are preventing cancer patients from accessing precision medicines.
- Champion awareness campaigns to support a dialogue across all stakeholder groups around the benefits of timely access to biomarker testing results.
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Moderator
Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Panel
Colorectal Cancer:
Ms. Filomena Servidio-Italiano
President & CEO, CCRAN
Lung Cancer:
Ms. Michele Wright
Lung Cancer Canada
Breast Cancer:
Ms. Kimberly Carson
CEO, Breast Cancer Canada
Ovarian Cancer:
Dr. Alicia Tone, Ph.D.
Scientific Advisor and OvCAN Project Manager, Ovarian Cancer Canada
GIST:
Dr. David Josephy, Ph.D.
GIST Sarcoma Life Raft Group Canada
Melanoma:
Ms. Kathleen Barnard
President, Save Your Skin Foundation
Pan-Canadian Tumor Perspective:
Ms. Lindsay Timm
Community Engagement Manager, Canadian Cancer Survivor Network
Pancreatic Cancer:
Ms. Stefanie Condon-Oldreive
President & CEO, Craig's Cause Pancreatic Cancer Society
Gastric Cancers:
Ms. Monica Yuen
Volunteer, My Gut Feeling, Stomach Cancer Foundation of Canada
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Break
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Ms. Brenda Clayton
Mother of young patient who succumbed to cholangiocarcinoma
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Facilitating Access to Precision Therapies for Colorectal Cancer, Lung Cancer, and Thyroid Cancer: Call for Timely Biomarker Reporting
Clinical experts will highlight precision therapies and biomarkers relevant for each respective tumor type, and will elaborate on the importance of having biomarker testing results available during a certain timeframe in order to inform treatment decisions involving precision medicines. Delays in molecular test reporting and variations in molecular testing processes will be addressed by tumor type to inform a discussion on systemic barriers to timely access as well as opportunities for improvement across tumour types.
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Moderator
Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Panel
Colorectal Cancer Perspective:
Dr. Sharlene Gill
GI Medical Oncologist, BC Cancer Agency
Lung Cancer Perspective:
Dr. Shaqil Kassam
Medical Oncologist, Southlake Stronach Regional Cancer Centre
Thyroid Cancer Perspective::
Dr. Nicole Chau
Medical Oncologist, BC Cancer Agency
Molecular Testing Perspective:
Dr. Brandon Sheffield
Pathologist, William Osler Health System
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Facilitating Access to Precision Therapies for Breast Cancer, Gastric Cancers, and GIST: Call for Timely Biomarker Reporting
Clinical experts will highlight precision therapies and biomarkers relevant for each respective tumor type, and will elaborate on the importance of having biomarker testing results available during a certain timeframe in order to inform treatment decisions involving precision medicines. Delays in molecular test reporting and variations in molecular testing processes will be addressed by tumor type to inform a discussion on systemic barriers to timely access as well as opportunities for improvement across tumour types.
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Moderator
Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Panel
Gastric Cancer Perspective:
Dr. Michael Raphael
GI Medical Oncologist, Odette Cancer Center at Sunnybrook Health Sciences Center
Breast Cancer Perspective:
Dr. Christine Brezden-Masley
Medical Oncologist, Mount Sinai Hospital
GIST Cancer Perspective:
Dr. Tim Asmis
Medical Oncologist, The Ottawa Hospital Cancer Centre
Molecular Testing Perspective:
Dr. Michael Carter
Pathologist, Faculty of Medicine, Dalhousie University
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Lunch Break
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Podcast with Lung Cancer Caregiver & Advocate, Filomena Servidio-Italiano, and Dr. Paul Wheatley-Price About Her Uncle's Inspiring Journey with Stage IV Disease
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Facilitating Access to Targeted Therapies for Melanoma, Gynecologic Cancer, and Pancreatic Cancer: Call for Timely Biomarker Reporting
Clinical experts will highlight precision therapies and biomarkers relevant for each respective tumor type, and will elaborate on the importance of having biomarker testing results available during a certain timeframe in order to inform treatment decisions involving precision medicines. Delays in molecular test reporting and variations in molecular testing processes will be addressed by tumor type to inform a discussion on systemic barriers to timely access as well as opportunities for improvement across tumour types.
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Moderator
Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Panel
Pancreatic Cancer Perspective:
Dr. Patricia Tang
Medical Oncologist, Tom Baker Cancer Centre
Melanoma Perspective:
Dr. Eve St-Hilaire
Medical Oncologist, Dr-Leon-Richard Oncology Centre, Vitalite Health Network
Gynecologic Cancer Perspective:
Dr. Neesha Dhani
Medical Oncologist, Princess Margaret Cancer Centre
Molecular Testing Perspective:
Dr. Aaron Pollett
Anatomic Pathologist, Division of Diagnostic Medical Genetics, Mount Sinai Hospital
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The Forgotten and Rare Cancers: A Call to Action
This session will address cancer types (e.g., hepatocellular carcinoma, cholangiocarcinoma, blood cancers, etc.) whose drug therapies are currently not guided by biomarker status. Research opportunities for identifying reliable molecular markers for several of these cancer types to predict prognosis and treatment response to precision medicines will be discussed.
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Moderator
Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Panel
Rare Cancer Perspective:
Dr. Michael Raphael
GI Medical Oncologist, Odette Cancer Center, Sunnybrook Health Sciences Center
Hepatobiliary Cancer Perspective:
Dr. Ravi Ramjeesingh
Medical Oncologist & Associate Professor, Nova Scotia Cancer Centre & Dalhousie University, Chair HPB Oncology Halifax
Hematology Perspective:
Dr. Shannon Jackson
Hematologist, West Coast Hematology, Value Based Health Care Physician Lead, Providence Health Care, St. Paul's Hospital
Molecular Testing Perspective:
Dr. Brandon Sheffield
Pathologist, William Osler Health System
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The role of liquid biopsy measuring circulating tumor DNA (ctDNA) in the management of cancer
This session will address the utility of ctDNA in the management of different cancer types in both the early stage and advanced stage setting. It will provide an update on the introduction and access to ctDNA testing in Canada, through the launch of Signatera, a partnership between LifeLabs and Natera. Panel members will discuss the readiness for ctDNA testing in Canadian healthcare and the implications of having this innovative and personalized approach to diagnostic testing available to Canadians.
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Moderator
Dr. Stephanie Snow
Medical Oncologist, QEII Health Sciences Centre
Panel
Cancer Patient Perspective:
Mr. Rob L.
Patient with lived CRC experience who accessed ctDNA testing
Clinical ctDNA Expert Perspective:
Dr. Elena Tsvetkova
Medical Oncologist, London Health Sciences Centre, Local Principal Investigator, COBRA Study
Industry Perspective:
Dr. Minetta Liu, MD
Chief Medical Officer, Natera
Dr. Vincent Funari, Ph.D.
Chief Scientific Officer, Imagia Canexia
Oncology Diagnostics Laboratory Perspective:
Dr. Dennis Dobrovolsky, Ph.D.
Product Manager, Oncology, LifeLabs
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Closing Remarks
Call to action on biomarker guidance document for every tumour type.
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Ms. Filomena Servidio-Italiano, OCT, M.A.
President & CEO, CCRAN
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| DAY 2: THURSDAY, JUNE 22, 2023 |
Conference Day 2 Opening & Welcome
Recap of Day 1 sessions:
- Take-aways from presentations and dialogue
- Reference to Conference objectives
- Call to action based on insights gained
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Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Ms. Filomena Servidio-Italiano, OCT, M.A.
President & CEO, CCRAN
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Health System Preparedness for Advanced Biomarker Testing: Implications for Timely Access to Results
This session will address key indicators of health system preparedness for advanced biomarker testing in Canada and will examine:
- Variations in preparedness across provinces.
- Infrastructural requirements for promoting timely access.
- System-level barriers to timely access to biomarker testing and reporting from policy, regulatory, reimbursement, and operational perspectives.
- Current opportunities for creating an infrastructure that would enable timely access.
- Impact of system preparedness on cancer care pathways.
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Moderator
Mr. Fred Horne
Health Policy Advisor, Former Alberta Health Minister
Panel Session
Mr. Don Husereau
Health Economist, School of Medicine, University of Ottawa
Dr. Harriet Feilotter, Ph.D.
Molecular Geneticist, Department of Pathology and Molecular Medicine, Queens University
Dr. Shantanu Banerji
Medical Oncologist, CancerCare Manitoba
Ms. Suzanne Wood
Patient with lived CRC experience whose care was guided by ctDNA
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Optimizing Patient Care Pathways through Timely Access to Biomarker Test Results
This session will use the value-based healthcare (VBHC) framework to examine:
- The importance of timely access to biomarker testing and reporting from the patient, healthcare provider, and health system perspective.
- How the value of timely access can be measured and incorporated into HTA review processes and policy decision making.
- How the patient voice can be harnessed for the generation of real world-evidence (RWE) based on the measurement of patient reported outcomes (PROs), and the utility of this RWE in lifecycle HTA.
- The alignment between the VBHC framework, Canada's Rare Disease Strategy and patient group advocacy initiatives, and the importance of collaboration for purposes of influencing system changes and improving equitable access to advanced molecular testing.
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Panel Session
Dr. Monika Slovinec D'Angelo, Ph.D., (Moderator)
VBHC Expert, Chief Research Officer, CCRAN
Dr. Durhane Wong-Rieger, Ph.D.
President & CEO, CORD
Dr. Shannon Jackson
Hematologist, West Coast Hematology, Value Based Health Care Physician Lead, Department of Hematology, Providence Health Care, St. Paul's Hospital
Dr. Ju-Yoon Yoon
Molecular pathologist, St. Michael's Hospital, Unity Health Toronto
Ms. Natalie Lipschultz
Patient with lived CRC experience
Ms. MJ DeCoteau
Founder & Executive Director, Rethink Breast Cancer
Dr. Samantha Pollard, PhD
Senior Methodologist, Cancer Control Research, BC Cancer
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Break
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Patient Video
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"My Colorectal Cancer Consultant" - A Novel Online Tool Promoting Patient Engagement & Informed Decision Making about Therapeutic Options
CCRAN's "My Colorectal Cancer Consultant" is a user-friendly, online tool that generates potential treatment options for the metastatic patient based on the user's tumour's biomarker status. The recommendations generated help to promote patient engagement and informed, joint decision making around the ideal treatment setting.
The tool captures patient-reported data both nationally and internationally and this presentation will describe the tool's objectives, utility and application to illustrate its:
- Reliability to provide high-quality information.
- Value for promoting a better understanding of personalized cancer diagnostic and therapeutic options, and joint decision-making about the ideal treatment setting.
- Utility as a patient-reported source of data on patient care, treatment needs and gaps.
Its scalability across other tumor types to benefit multiple advanced cancer patient populations will be highlighted (e.g., Lung Cancer, Breast Cancer and HCC).
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Presentation
Ms. Filomena Servidio-Italiano, OCT, M.A.
President & CEO, CCRAN
Dr. Mary De Vera, B.Sc., M.Sc., Ph.D.
Epidemiologist, Assistant Professor, University of British Columbia
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Lunch Break
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Clinician Video - Dr. Christopher Lieu, GI Medical Oncologist, University of Colorado Hospital
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The Utility and Value of Comprehensive Genomic Profiling (CGP) in Cancer Care
The number of actionable biomarkers or genes that can inform treatment decisions is currently limited for the vast number of advanced cancer patients. CGP testing presents an opportunity to facilitate integration of precision medicine within routine cancer care, but this is contingent on enablers across the health care continuum.
This session brings together clinical, research and systems experts to elaborate on the utility and value of CGP in cancer care, showcase the work of onco-genomics programs in Canada and the U.S,. and discuss some challenges with its practical application in clinical practice. Experts will address:
- The role of CGP in precision medicine and its clinical efficacy across tumour types;
- The value of CGP for patient care pathways, health outcomes and wellbeing;
- Research that is driving the evolution of CGP in clinical care;
- The work of BC's Personalized OncoGenomics Program (POG), a patient centric research initiative that has demonstrated impacts of therapy on cancer genomes and the potential for precision oncology to offer more effective therapeutic options for advanced cancer patients";
- The complexity of genomic data and the education and training required for its application in clinical practice, including management and communication of secondary findings, such as mutations that are not actionable.
- The advantages of digital decision support systems, such as CureMatch in the U.S., to facilitate its interpretation and guide treatment selection.
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Moderator
Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Panel
Cancer Patient Perspective:
Mr. Allen Chankowsky
Rare cancer patient with lived experience
Value-Based Healthcare Perspective:
Ms. Eva Villalba, MBA
VBHC Expert, Executive Director, Quebec Cancer Coalition
Canadian CGP Research & Program Perspective:
Dr. Howard Lim
Medical Oncologist, B.C. Cancer Agency
U.S. CGP Research & Program Perspective:
Dr. Razelle Kurzrock, MD
Professor of Medicine, Associate Director of Clinical Research; Linda T. And John A. Mellowes, Chair of Precision Oncology, MCW Cancer Center
& Center for Genomic Sciences and Precision Medicine; Founding Director, Michels Rare Cancers Research Laboratories, Froedtert and MCW
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What Will it Take to Adopt Comprehensive Genomic Profiling (CGP) as a Standard of Cancer Care in Canada?
Genomics is transforming cancer and the field of oncology. There are some considerations, however, regarding its incorporation into routine clinical practice and expanding its benefits to patients across the country. These include infrastructural requirements related to storage, security and privacy protection of the substantial amount of data generated by NGS tests, as well as implications of secondary findings and results that are not actionable.
This session brings together experts from different disciplines to discuss these issues, the value derived from CGP testing in oncology, and strategies for accelerating its uptake in Canadian healthcare. Speakers will address:
- Benefits and the added value of CGP over conventional molecular testing across different cancer types for all stakeholders;
- Infrastructural requirements for processing, managing, storing, protecting and translating the substantial amount of data generated by NGS tests;
- Cost-efficacy of NGS-based technologies and evidence gaps that would support its assessment in the context of health systems' budgetary allocations.
- Opportunities for broadening access to genomic testing programs for advanced cancer patients in Canada.
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Moderator
Mr. Don Husereau, BSc Pharm, MSc
Health Economist, School of Medicine, University of Ottawa
Panel
Clinical practice perspective on CGP in cancer care:
Dr. Cathy Eng
Medical Oncologist and Professor, Vanderbilt-Ingram Cancer Centre, Nashville, TN, U.S.
Patient Perspective:
Dr. Marko Yurkovich, MD
Primary care physician and stage 4 CRC patient in BC
NGS Technology Perspective:
Dr. Jeffrey M. Smith, Ph.D.
NGS Precision Medicine Director, Clinical Next-Generation Sequencing and Oncology Division, Thermo Fisher Scientific
CGP Access Perspective (U.S.):
Dr. John L. Fox, MD MHA
Senior Medical Director for the Americas, Market Access, Illumina
CGP Access Perspective (Canada):
Dr. Faisal M. Khan PhD, D(ABHI)
Director, Molecular Diagnostics, OncoHelix
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Closing Remarks
- Call to action on biomarker guidance document for every tumour type
- Comprehensive genomic profiling of all metastatic tumours to identify actionable targets to help improve patient outcomes
- Opportunities for collaboration to deliver on the vision of precision medicine in Canada.
- Ensure equitable access to and timely delivery of biomarker testing results across and within provinces
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Ms. Filomena Servidio-Italiano, OCT, M.A.
President & CEO, CCRAN
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