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Meeting of the Minds

Part 2 in a series on collaborations between researchers and clinicians

The Sarcoma Program at Mount Sinai

Mount Sinai Hospital’s Sarcoma Program (part of the Christopher Sharp Centre for Surgical Oncology) is the largest sarcoma specialty unit in Canada, has the highest patient volume and most complex cases, and is a world-renowned resource with a cure rate of 75% (including limb-sparing surgeries for most patients).

Patients receive treatment from the program’s talented, compassionate physicians and many have rebuilt their lives after recovering from the illness. The program at Mount Sinai is unique in that patients not only receive all of their cancer care needs, but also all of their associated medical, rehabilitation and psychosocial needs. 

The Sarcoma Program also performs clinical research that has resulted in significant advances in sarcoma care. For example, Dr. Irene Andrulis works to identify the genes involved in sarcoma. A major goal of her research is to apply cancer molecular genetics to clinical practice.

Through her work in assembling a tissue bank that provides information about the genetics of sarcoma, she is helping her clinical colleagues in Mount Sinai’s Sarcoma Program to translate laboratory findings via clinical trials to sarcoma patients in Canada.

Understanding the molecular biology and genetics underlying sarcoma is helping to advance therapy and improve patient outcomes.

Read Part 1 of the series »

Dr. Andrulis notes that her expertise in molecular biology, combined with Dr. Wunder’s clinical insights, allowed them to pose and examine challenging clinical questions in a holistic, systems-focused way.

“It’s become a mutually beneficial relationship because of our combined expertise,” agrees Dr. Wunder.

Additional expertise from epidemiologists and biostatisticians including Lunenfeld Senior Investigator Dr. Shelley Bull helped Drs. Wunder and Andrulis to understand the factors that distinguish patients who develop and survive sarcoma, versus those who do not. Dr. Bull’s work involves the use of powerful statistical and epidemiological tools that enable statistical theory and computational experiments to improve the reliability of genetic epidemiologic studies. In essence, statistics can help solve ‘genetic puzzles’ and identify the genetic factors that lead to increased susceptibility to disease recurrence.

“I first became involved in the sarcoma research at an early stage when the investigators were designing a study to test the importance of a candidate gene known as MDR in sarcoma outcome,” says Dr. Bull, noting that the use of statistical formulas was critical. “Later on, when microarray technology became available, we designed genome-wide investigations of gene expression in sarcoma tumours in which many genes from all across the genome were evaluated for their ability to distinguish between patients with good versus poor outcomes.”

In 1994, Dr. Wunder moved to New York to study at Memorial Sloan Kettering Cancer Center, one of the world’s preeminent cancer facilities. A few years prior, Dr. Robert Bell, a Harvard-trained orthopaedic surgeon, began working at Mount Sinai Hospital, and established its now world-famous sarcoma program into which Dr. Wunder was recruited when he returned to Toronto.

In working with Drs. Bell and Wunder, Dr. Andrulis established an extensive biospecimen repository (BSR) in 1996 to systematically collect and analyze tumour samples, and house them in a centralized location to further research into various human cancers.

Completed in 2009, a renewed BSR facility at 60 Murray Street provides Lunenfeld investigators and their clinical colleagues with tissue samples from breast, pancreatic, colon and sarcoma tumours, to assist them in their research. Patient clinical data associated with the samples is also stored under tight security.

“If you want to conduct meaningful human research, you need large-scale tissue repositories. We are extremely fortunate to have a robust collection of patient tumour samples,” says Dr. Wunder.

The BSR holds much promise for research, as the tissue samples are annotated with relevant clinical data over many years of follow-up. Few centres in North America have access to such a rich source of research data.

Through their success with the sarcoma tumour bank, an extensive clinical trial initiative and the sarcoma program’s astonishing cure rates of 75 per cent, Drs. Wunder and  Andrulis—and colleagues including orthopaedic surgeon Dr. Peter Ferguson and surgical oncologists Drs. Rebecca Gladdy and Carol Swallow—have garnered worldwide acclaim.  

Meeting of the Minds: Part 1

Meeting of the Minds: Part 3