Understand the characteristics of cancer, from tumor initiation to the metastatic process
CRC professors approach cancer research from different angles by looking at all the characteristics of oncogenic transformation. For example, cellular stress, signal transduction, genome integrity and regulation, as well as developmental biology and metabolism. Using different experimental models, ranging from yeast to the study of human subjects, we aim to characterize the different steps leading to oncogenic transformation and progression. The CRC also addresses the understanding and treatment of cancer through integrative and systems biology strategies, in particular by using large-scale strategies such as genomics, epigenomics, transcriptomics, proteomics, metabolomics, microbiome and computational biology. High-throughput phenotypic and pharmacological screens are also performed, in order to obtain information at the global level of the cell, tissue and organism. The results of this research allow the identification and functional characterization of new vulnerabilities that can be exploited by new innovative therapeutic strategies in order to prevent or delay cancer. These discoveries may also lead to improved prediction of cancer risk, progression and response to therapeutic interventions.
Identify the causes of cancer in order to develop new prevention strategies
Although therapeutic advances are needed, a much stronger focus on cancer prevention, early detection and early intervention are crucial to reducing the burden of cancer. For example, our teams are working to understand how our lifestyle habits (nutrition, physical activity, etc.) can influence the onset, development and treatment of cancers. This knowledge will make it possible to develop personalized strategies for the prevention and treatment of this cancer, including through diet or dietary supplements.
Our teams also identify the genetic factors that influence the susceptibility of developing cancer. This type of research is carried out in collaboration with international consortia such as BCAC, CIMBA, CONFLUENCE, OncoArray network, GURC cohort study and the project CPCGene/ICGC. Access to genetic tests for the prevention and treatment of cancers, particularly breast and ovarian cancer, is an important issue for our research members. In particular, they are working on a collaborative model in oncogenetics based on interprofessional and interinstitutional collaboration, and diversified and personalized genetic services in order to improve access to genetic counseling services and reduce delays in accessing genetic tests for patients. Finally, the psychosocial impacts related to breast cancer of hereditary and familial origin are an important research theme of our center. This work has highlighted the relevance of offering psychosocial support to women tested for a genetic predisposition to breast and ovarian cancer and demonstrated the importance of training first-line workers on hereditary cancers.
Detect and treat cancer with a personalized approach
Precision medicine is currently at the heart of a revolution in oncology care and for which several innovative discoveries have been brought to light thanks to the expertise of our group. Combined with the strategies developed in theme 1, this theme will allow the discovery of new targeted therapies, the identification of biomarkers and molecular signatures for the prevention, early detection, diagnosis, prognosis and treatment of cancer. The research also aims to optimize the therapeutic response while minimizing the risks of adverse effects associated with certain treatments. This research will make it possible to adapt the treatment of people with cancer by evaluating the characteristics of the patient as well as those of the tumor or other biological samples including adjacent non-tumor tissue and biological fluids. Thus, these biomarkers or signatures will allow early detection in populations at risk, to guide the choice of treatment and its dosage, and to direct treatment towards targeted therapies adapted to the individual with cancer. On the other hand, the CRC is also designing new prognostic and theranostic tests and tools to determine which cancers are most likely to come back or recur and to guide adjuvant therapy. This translational research obviously requires the establishment of biobanks that meet the highest standards in the field, supported by a wide range of clinical and demographic information. This theme promises to transform the care of cancer patients by offering more appropriate therapeutic approaches.
Develop innovative diagnostic, prognostic and therapeutic approaches
To offer patients more effective and personalized treatments, it is essential to detect and characterize cancer cells either by blood markers or by imaging. However, current methods do not have the required sensitivity. Our teams are working to develop new biomarkers, medical imaging tools to characterize, visualize or predict the response to treatment and thus better treat each patient. We also want to improve radiotherapy, brachytherapy and targeted internal therapy treatments by optimizing the dose and delivery of treatments for all medical procedures using ionizing radiation, including radiotherapy, diagnostic and interventional radiology and nuclear medicine. The achievement of this objective possible thanks to a research program combining the physics of radiation, photonic optics, digital optimization, signal and image processing, as well as high-performance computing. We also use theranostic approaches which use imaging to map cancer cells in order to treat them in a targeted manner.
Optimize the psychosocial functioning and quality of life of patients and their loved ones, throughout the care trajectory
One of our objectives is to optimize symptom management for both people with a diagnosis of advanced or non-advanced cancer. Thus, one of the objectives is to develop innovative interventions aimed at optimizing the care offered to people with cancer and at the end of life and to test their effectiveness and efficiency in different care settings. These studies are grouped according to 2 axes, namely clinical research, including research in psychosocial oncology and palliative care, and the organization of services and health care. Our studies have an important societal impact which has considerable advantages for the patient. For example, interventions have been developed and are now being implemented to address the fear of cancer recurrence in people diagnosed with cancer. Also, studies are underway to improve communication between patients, their loved ones and healthcare teams.
Improving health care delivery
This objective looks at accessibility, quality and efficiency. The judicious use of human and financial resources will be exacerbated in the coming years given the increasing precision due to the aging of the population. The CRC is working to increase the population’s accessibility to interventions, in particular by developing and testing intervention formats that can be more easily implemented in different settings (for example, better cost-effectiveness ratio, interventions that can be generalized in non-university and rural settings) . To cite just a few examples, our teams have demonstrated the positive impact, both on people with cancer and on the organization of care, of having recourse to pivot nurses. This is a promising project that was implemented at the CHU de Québec and is now the standard at the national level. Another example is the implementation at the provincial level of the distress screening tool, which has had a significant impact on the delivery of care and on improving the management of people with cancer. In addition, decision-making assistance will be an important element in ensuring accessibility and quality of care that will be offered in oncology. This decision-making could also be improved thanks to the innovative advances of themes 1 and 2.