Meeting of the minds: Advancing
sarcoma research and care
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.
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).
Dr. Wunder, Mount Sinai’s Surgeon-in-Chief, is also a scientist investigating the genetic causes of bone and soft tissue sarcomas. He 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.
Dr. Andrulis notes that her expertise in molecular biology, combined with Dr. Wunder’s clinical insights, allow 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.
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.
“Researchers and clinicians internationally speak about the expertise of our sarcoma tumour group,” says Dr. Andrulis, who returned several months ago from a research meeting in Paris at which scientists worldwide convened to present up-to-date research on sarcoma. “Here at Mount Sinai, we have specifically recruited research associates to collect and analyze patient tumours and data.” Through these multidisciplinary collaborations, Drs. Wunder and Andrulis also investigate biomedical and clinical questions in consultation with specialized pathologists, medical oncologists and radiation oncologists.
Dr. Andrulis notes that since Dr. Wunder first trained in her lab, several other surgical oncology fellows have studied molecular genetics with her team as well, so that they are skilled in both areas and understand the importance of translating their research findings to the clinic, for better patient outcomes.
The fellows and trainees—as well as colleagues at other hospitals in Toronto—all attend bi-monthly sarcoma rounds at which basic researchers and clinicians including Drs. Wunder, Ferguson, Gladdy and Swallow present their research and discuss clinical cases.
“I think it’s a really great model that other centres are hoping to replicate,” says Dr. Wunder. “It’s also an especially powerful paradigm for clinicians who want to conduct higher-end research, especially in the area of disease modeling. We can bring together our questions about the disease, and look at problems from several viewpoints.”
The partnership between Drs. Andrulis and Wunder also extends to their involvement in team grants such as those from the National Institutes of Health, as well as their involvement in large-scale sequencing projects. For example, a new project includes collaboration with researchers in British Columbia and internationally, and is designed to assess changes in the tumours of osteosarcoma patients and how these changes affect outcomes, as well as how more individualized therapies can be designed and targeted to unique tumour types.
About the Sarcoma Program
Mount Sinai Hospital’s Sarcoma Program (part of the Christopher Sharp Centre for Surgery & 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 per cent (including limb-sparing surgeries for most patients).
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.