Innovation for optimized detection and analysis of circulating tumor-derived DNA (ctDNA). I previously co-developed a comprehensive strategy for isolating circulating DNA from blood and detecting rare cancer-associated mutations. The method, called CAPP-Seq, for Cancer Personalized Profiling by deep Sequencing, was able to accurately quantify the amount of tumor in the body of patients with lung cancer (Nature Medicine, 2014). My lab is now building upon the technology of CAPP-Seq to make ctDNA detection and analysis clinically useful.
Personalized cancer medicine for head and neck cancer (HNC). Since establishing my independent research program at University of Toronto and the Princess Margaret Cancer Centre in 2014, my research has focused on improving outcomes for patients with HNC. As a radiation oncologist who treats patients with HNC, I am fortunate to have synergy between my clinical activities and research pursuits. Many HNC patients endure poor outcomes despite treatment regimens that cause significant toxicities. Thus, novel therapeutic strategies and innovative biomarkers are needed to improve our approach to this disease. One area of particular promise is the use of ctDNA to inform treatment decisions (Expert Rev Mol Diagn, 2015). Through innovative clinical trials, the use of model systems, and in vitro studies, my lab is working to turn ctDNA and other biomarkers into clinically useful tools for HNC patients.
Practical genomic biomarkers with clinical utility. There have been many significant roadblocks to clinical implementation of cancer biomarkers. A focus of my work has been on building practical tools that could have a major impact on clinical care. For example, in prior work I co-developed an RNA-based molecular prognostic index (MPI) for early-stage lung cancer that identifies high-risk patients who could benefit from adjuvant chemotherapy (J Natl Cancer Inst, 2015). The MPI has the potential to dramatically influence clinical practice by distinguishing lung cancer patients that could benefit from treatment intensification from those that could be cured with less toxic therapy. Moreover, the MPI would be easily implemented in clinical labs because of its use of standard quantitative PCR technologies. Ongoing work in the lab is focusing on practical genomic biomarkers with clinical utility for HNC, such as genotyping human papillomavirus for risk stratification (JAMA Oncol, 2016).