Lymphoid cancers, which start in the immune system and include Hodgkin’s and non-Hodgkin’s lymphoma, myeloma, lymphocytic, and lymphoblastic leukemia, are the fifth-most-common cancers in both men and women and affect people of all ages. Every year in Canada, 16,000 people are diagnosed with a lymphoid cancer and 6,000 die from them. Death most often happens when disease relapses after an initially successful treatment, making treating and controlling the symptoms of relapsed disease the most pressing need for patients suffering from lymphoid cancers.
Because the causes of relapse are not known, and because relapsed cancer differs considerably from the initial cancer, there are no clinical tests to provide information on the prognosis for individual patients and likely treatment outcomes, or to provide guidance to physicians and patients on the use of alternative therapies, such as small molecule drugs or immunotherapy. Relapses and associated treatments cost the Canadian health-care system more than $315 million each year, about 10 per cent of the expected cancer drug budget in 2022, and the lack of clinical tests means many of these expensive treatments are applied without adequate guidance.
Drs. Christian Steidl, Marco Marra and David Scott of the BC Cancer Research Centre are developing genomics-based clinical tests to improve patient outcomes and quality of life, and working to integrate the tests in the health-care system. To do so, they will sequence relapsed tumours to identify novel biomarkers. They will undertake economic analyses to better understand the cost-effectiveness and health-system impact of genomics-informed management of relapsed disease. They will also develop an e-health application to assist patients with shared decision-making.
The results of this project will be novel clinical tests that will provide decision aids for physicians and patients, help policy makers in implementing personalized treatment approaches for relapsed lymphoid cancers and reduce the costs of treating relapsed lymphoid cancers.