Early Cancer Detection and Interception for Molecular Residual Disease (MRD) in Solid Tumours

Abstract Canada network map

Finding the hidden seeds of cancer recurrence

Even after a seemingly successful treatment to remove a primary tumour, cancer sometimes reappears in other parts of the body. This is known as recurrence.  

In recent years, researchers have discovered that recurrence happens because certain cancer cells manage to evade initial treatment and go into a stealth-like mode that allows them to avoid detection through conventional methods such as medical imaging or serum tumour markers. These cells remain hidden in the body until they eventually seed the growth of new tumours, either in the same site as the original cancer or in a new location. 

In this context, finding better ways to detect these cells before they help form new tumours would constitute a significant step towards improving outcomes for cancer patients by allowing researchers and clinicians to know who is at a higher risk of recurrence and begin creating interventions that specifically target these cells before it occurs. 

“At the forefront of this paradigm shift is detection of Molecular Residual Disease (MRD),” explains Dr. Philippe Bedard, a clinician investigator at the Princess Margaret Cancer Centre. “This cutting-edge approach uses next generation sequencing to detect clinically occult fragments of tumour DNA in the bloodstream.” 

To support the development of better strategies for MRD detection, the Marathon of Hope Cancer Centres Network (MOHCCN) will support a pan-Canadian team of researchers and clinicians to establish the world's first and largest comprehensively characterized MRD cohort. With funding from a new MOHCCN Pan-Canadian Project award, this ambitious team made up of researchers and clinicians from Ontario, Quebec, British Columbia and New Brunswick will create a cohort that brings together samples from patients enrolled in trials across Canada that will be used to research new ways to identify and eliminate MRD before clinical relapse, offering newfound optimism for patients who would otherwise face recurrence and a grim outcome. 

“MRD detection represents an emerging opportunity for the development of interception strategies that target cancers at an early stage before recurrence or metastasis,” explains Dr. Bedard, who will lead the team. “This funding doesn’t only support the sequencing of samples but also brings experts and patients from across Canada to work towards this goal, which is necessary if we want to improve MRD detection throughout the country.” 

In addition to supporting the aims of the research team, the genomic and clinical data collected through this study will be contributed to the MOHCCN Gold Cohort, which seeks to be the largest and most complete cancer case resource in Canada.