Industry, Supercluster invest CA$17.8M to better diagnose cancer recurrence and relapse

Canada’s federally-funded Digital Technology Supercluster is joining with industry to invest CA$17.8 million (US$13.9 million) in an artificial intelligence (AI)-powered technologies program to advance personalized treatment for patients with cancer. Led by Vancouver, British Columbia-based Imagia Canexia Health Inc., the Candetect project is developing precision oncology software that Imagia CMO David Huntsman said will help monitor resistance to cancer therapy and treatment relapse in individual cancer survivors.

“There’s been a huge international effort to personalize cancer care decisions using information from a patient’s tumor and doing sequencing or analysis to say `This is the way your cancer should be treated,’” Huntsman told BioWorld. “The problem for most patients is precision oncology stops at this point. The Candetect project allows us to use some very sophisticated genomic tools, AI and cloud-based informatics to bring precision approaches into post management care.”

Treatment relapse and resistance to therapy place enormous strain on patients recovering from cancer and on Canada’s notoriously long cancer care wait lists. Huntsman said many patients benefit from precision oncology decision making “that is fantastic, there’s massive progress being made. But longer term follow up of patients becomes very generic after that.”

What’s needed is closer monitoring of treatment response in patients who may relapse or resist treatment post therapy, Huntsman said. As part of the Candetect project his technology will enable clinicians to perform real-time assessment of tumor status, detect earlier signs of patient relapse and recommend alternative treatment options.

The starting points for this work are the traditional “wet lab” procedures at Imagia’s Vancouver location and “dry lab” analytics, i.e., sophisticated, cloud-based informatics with elements of machine learning “where de-identified data is uploaded and analyzed and only the clinically relevant findings come down to populate a patient report. This can then be used to inform care,” said Huntsman.

By “informed care” Huntsman also means more localized care. Medical institutions typically operate very pragmatic schedules that direct patients to return for follow-up care, he explained, “but these schedules aren’t optimized to individual patients,” said Huntsman. That’s particularly so for patients living at remote distances, he noted.

“We believe there’s a great benefit in removing geographic access barriers and just making it easier for patients to get their care by simply making a simple blood test at their local clinic. In effect, the goal “is to make survivorship a precise decision-making process,” Huntsman said. Patients will be monitored “to determine has their cancer stayed away and if it’s come back how has it changed and what treatment decisions should be made next.”

Going deeper
Imagia’s assays rely on AI-driven machine learning to identify cellular mutation in DNA sequences from plasma samples. But what is missing generally across health care, Huntsman said, is “the big clinical decision support space everybody had been anticipating” with the advent of AI.

Here, having enough data derived from AI for a health care system to meaningfully contribute to understanding disease is only one challenge. “The bigger challenge is how to safely share data to treat patients who are already in the system,” said Huntsman. This becomes particularly salient addressing relapse and patient resistance to treatment.

“Candetect is not focused on determining if a healthy person has suddenly got cancer, but to identify features of relapse which can lead to a change in treatment,” said Huntsman. “When you set up a system like this you need what’s called `orthogonal’ data, i.e., data from another source against which you measure your progress.”

Here, that source is represented by many other patients with cancer who have been previously tested. “As more and more data gets processed using AI and machine learning the fidelity of the system and accuracy improves with time,” said Huntsman. Eventually new technology like Imagia’s testing software will outstrip any existing gold standard in analytics validation.

“In other words, the test system is better than the validation system and you have to get cleverer and cleverer in terms of how you get the orthogonal data to validate your findings,” said Huntsman.

What is also required is enormous learning of the human variety, notably the vast amount of data derived from human genome technology. Genomic readouts provide a very broad “almost impressionist view of what’s going on in a solid tumor cancer,” Huntsman explained. You then combine this “with a very high- fidelity view of the particular mutations which you can treat. This is the way forward.”

That way forward is underwritten by CA$12.5 million (US$9.75 million) from Imagia, Toronto-based Dnastack Inc., Microsoft Inc., and CA$5.3 million (US$4.1 million) co-invested through Ottawa’s Supercluster’s Technology Leadership program. Those contributing in-kind resources are BC Cancer Research, Toronto-based Dnastack, Microsoft, Queen’s University and Toronto’s University Health Network.

The project’s immediate goal is to introduce diagnostic tools like precision oncology software at the clinic level “that are at least as good or better than what we would consider the standard of care for monitoring patients,” said Huntsman.

The longer-term efficacy and optimal frequency of the technology’s use “will require prospective clinical studies done with our assays and others to really understand how best to use this technology and positively impact patient care.”

Pilot of new cancer test in Canada shows promise as faster alternative to conventional biopsies

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Genomeweb – Canexia Health Sees Canadian Liquid Biopsy Initiative as Springboard to Wider Adoption

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Canexia Health To Offer Cancer Testing and Treatment During COVID-19

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Canadian Consortium Backs Liquid Biopsy Solution to Increase Cancer Testing Access During the Pandemic

VANCOUVER, BRITISH COLUMBIA, July 15, 2020 – A consortium led by Vancouver-based Canexia Health (formerly Contextual Genomics) will enable access to critical testing and treatment options for Canadian cancer patients during the COVID-19 pandemic. Supported by the Digital Technology Supercluster, the CAD $2,590,000 initiative, named Project ACTT – Access to Cancer Testing & Treatment, will deploy and enhance a liquid biopsy solution that requires only a simple blood draw for cancer treatment selection, thereby eliminating the need for many patients to travel to hospital for surgical biopsies.

The consortium’s goal is to limit patient exposure to COVID-19 while increasing health system capacity initially for patients with recurrent or metastatic lung, breast, or colon cancer. The digital liquid biopsy solution uses advanced software technology including machine learning to identify circulating tumour DNA (ctDNA) in plasma and matches patients with targeted treatments shown to improve outcomes. In addition to Canexia Health, the consortium includes AstraZeneca CanadaQueen’s Universitythe Eastern Ontario Regional Laboratory AssociationGenolifeemtelligentNovateurSemaphore Solutions, Xtract AI, and Illumina.

Cancer patients have an estimated two-fold increased risk of contracting COVID-19 and a three-fold risk of dying compared to the general population. A comprehensive approach is required to address the needs of this high-risk group to limit their exposure and minimize hospital visits. Since early March, COVID-19 has delayed or postponed at least 100,000 surgeries in Canada including cancer tissue biopsies.

“Tackling the backlog of medical procedures and treatments due to COVID-19 is a challenge across Canada. The Canexia Health project team has an innovative and pragmatic solution to protecting cancer patients while providing much-needed treatment quickly and effectively,” stated Bill Tam, COO of the Digital Technology Supercluster.

“The precision oncology solution offered and further developed with our project partners will both increase patient safety and remove geographic barriers that can impede cancer care,” said Michael Ball, CEO of Canexia Health. “We are fortunate to have access to this cross-disciplinary group of project partners who, together, will bring these goals to fruition with the support of the Digital Technology Supercluster.”

“The early identification of biomarkers, including gene mutations, is critical to helping ensure patients with cancer have quick access to the most effective treatments available for their disease,” said Gaby Bourbara, VP-Oncology at AstraZeneca Canada. “As a key partner in this COVID-19 initiative, we hope to not only improve health outcomes for Canadian cancer patients during the pandemic, but to contribute to a lasting solution that will further strengthen health care capabilities in the area of early cancer screening and diagnoses.”

Canexia Health and AstraZeneca Canada will support testing and oncologist education, while Queen’s University, EORLA, Genolife, and LifeLabs will extend patient access initially in British Columbia, Ontario, Quebec, and Saskatchewan – with the longer-term objective of increasing access across Canada. Canexia Health will use emtelligent’s Natural Language Processing (NLP) technology to broaden the population of cancer patients who could benefit to those with all solid tumour types. Semaphore Solutions will work on laboratory process management and remote access to test results. Xtract AI will develop, train, and deploy NLP models to assist in the management, understanding, and integration of semi-structured information from a mutation and cancer-type database. Sequencing will be conducted on Illumina platforms. Novateur will partner on a health economics study to further establish the cost-effectiveness of liquid biopsy. Canexia Health also will lead technical transfer for hospitals and labs to run liquid biopsy testing in-house, bringing greater resilience to the Canadian health system.

“We’re excited to participate in this project on several levels, including as a proof of concept for technology transfer. We hope to provide the necessary evidence to accelerate provincial laboratory evaluation and adoption of ctDNA testing, which would ultimately benefit patients and oncologists across Canada,” said Dr. Harriet Feilotter, Queen’s University.

About Canexia Health

Canexia Health (formerly Contextual Genomics) makes high-quality cancer genomic information accessible and affordable with our clinically-validated assays, informatics, and support. Our suite of genomics-based cancer tests is clinically actionable and cost-effective, designed to improve cancer prevention, treatment, and monitoring. With our extensive scientific experience, specialized genomics-based tests, and support from pharmaceutical and diagnostic partners, we are leading the shift towards precision oncology.

About Digital Technology Supercluster

The Digital Technology Supercluster solves some of industry’s and society’s biggest problems through Canadian-made technologies. We bring together private and public sector organizations of all sizes to address challenges facing Canada’s economic sectors including healthcare, natural resources, manufacturing, and transportation. Through this ‘collaborative innovation’ the Supercluster helps to drive solutions better than any single organization could on its own. The Digital Technology Supercluster is led by industry leaders such as D-WaveLifeLabsLlamaZOOLululemonMDAMicrosoftMosaic Forest ManagementSanctuary AITeck Resources LimitedTELUSTerramera, and 1Qbit. Together, we work to position Canada as a global hub for digital innovation. A full list of Members can be found here.

About the COVID-19 Program

The COVID-19 Program aims to improve the health and safety of Canadians and support Canada’s ability to address issues created by the COVID-19 outbreak. In addition, the program will build expertise and capacity to anticipate and address issues that may arise in future health crises, from healthcare to a return to work and community. More information can be found here.

Media Contacts
Jennifer Temple
Canexia Health
jtemple@imagiacanexiahealth.com
858-705-9873

Elysa Darling
Switchboard PR for Digital Technology Supercluster
elysa@switchboardpr.com
587-890-9833

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