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Meeting of the Minds

Drs. Jay Wunder and Irene Andrulis are advancing sarcoma research and care at Mount Sinai Hospital

The first in a 3-part series on collaborations between researchers and clinicians

Dr. Irene Andrulis
Dr. Irene Andrulis
Dr Jay Wunder
Dr. Jay Wunder

A dozen colleagues are gathered in the Hospital’s surgical skills room and wait for the ‘Sarcoma Rounds’ to begin. Scientists converse with medical oncologists, orthopaedic surgeons, residents and trainees. They discuss the results of a limb-sparing surgery for a particular sarcoma patient, and one of the scientists mentions key genes suspected to play a role in the patient’s tumour. The scenario is familiar grounds for Drs. Jay Wunder and Irene Andrulis, orthopaedic surgeon and molecular biologist at Mount Sinai Hospital. 

Increasingly in the Hospital’s evolution and in the field of biomedical research in general, scientists’ projects are intersecting with clinical teams, and collaborations such as that between Drs. Wunder and Andrulis are combining detailed clinical information with sophisticated science, helping to define new treatment strategies for improved patient outcomes.   

Co-head of the Fred A. Litwin Centre for Cancer Genetics and Senior Investigator at the Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Dr. Andrulis’ pioneering work in breast cancer genetics is world-renowned. As well, she and her colleagues are conducting studies to help find predictors that will identify risk, prognosis, treatment outcomes and recurrence of sarcoma (malignant tumours that arise from muscles, bones, nerves, fat, blood vessels or connective tissue). Each year, osteosarcoma—the type of cancer that afflicted Terry Fox—affects approximately 140 young Canadians, and approximately 900 soft tissue sarcomas are diagnosed among a somewhat older age group.

Dr. Wunder is Surgeon-in-Chief of Mount Sinai Hospital. An award-winning clinician, he is also a scientist investigating the genetic causes of bone and soft tissue sarcomas. Dr. Wunder has collaborated with Dr. Andrulis and other colleagues to develop Canada’s most extensive sarcoma tissue bank (which also houses protected clinical data), to help determine the relationship between genetic mutations in tumours and clinical outcomes.  

Their collaborations began in 1990, when Dr. Wunder completed graduate studies in Dr. Andrulis’ lab as part of his training in orthopaedic surgery.

“I had no previous training in cancer or genetics before working with Irene, so it was a happy accident that I had the opportunity to study in her lab,” says Dr. Wunder. 

“Jay was fantastic in the lab and extremely interested in the genetic aspects of cancer,” says Dr. Andrulis.

At the time, Dr. Andrulis was studying gene amplification (a process that occurs in some cancerous cells, in which DNA replication is flawed and many copies of a genetic region are produced instead of one). One of her research projects focused on the development of drug resistance, a challenge in the management of osteosarcoma.

“New molecular genetic technologies allowed us to ask important questions about osteosarcoma, to better understand why some patients become resistant to therapy or have poorer outcomes,” says Dr.  Andrulis.

In the early 90s, little was known about the molecular mechanisms underlying the development and progression of sarcoma, nor its unique ‘genetic signature’ (compared with other cancers such as colorectal or breast, in which researchers can more readily predict which genetic regions are associated with causality, risk and prognosis). 

“That was the start of my collaboration with Jay, because of our common interest in these questions.” Drs. Andrulis and Wunder began working to understand the genetic and molecular factors differentiating patients who have tumour recurrences versus those who do not, as well as the mechanisms underlying drug resistance.

“Genetics will provide the next big innovation in understanding why people get these diseases,” says Dr. Wunder. “Once we know that, we can develop new ways to prevent the disease and better ways to treat them.”

Meeting of the Minds: Part 2 »