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Peter Dirks and the Stand-up to Cancer Program

“Stand-up to Cancer Program” (http://www.standup2cancer.org/), a unique source of funding from the entertainment industry foundation, has awarded Peter Dirks and his team a $10 million grant. “The driving force behind this program is the corporate executives, marketing and business people in the U.S. entertainment industry. Katie Couric, a widely respected television commentator and anchor, was one of the drivers for the initiation and continuation of this program. She lost her young husband to colon cancer, leaving her with three children to rise. The theme of the fund is ‘there is too much competition in cancer research, let’s bring them together into collaborating dream teams instead of competitors.’ The program has now funded 10-15 teams since 2008 with very strong clinical trajectory. The goal is to bring interventions, primarily drugs, to clinical trials, using excellent data which is shared and then moved toward clinical trials. There is very strong spirit and energy in the program and the ‘crème de la crème’ of scientific investigators. CIHR, Genome Canada, and the Ontario Institute for Cancer Research joined the program 2 years ago and there is a close association of the program with the American Association for Cancer Research.

Peter Dirks and James Rutka
Peter Dirks and James Rutka

“We did a collaborative application with Vancouver, Calgary and Montreal as a team to work on gliomas (glioblastoma mutiforme and ependymoma). Our research focus is the molecular network of stem cells that drive cancer growth. There are subsets of stem cells that drive cancer growth and we have identified and isolated these cells. We can now study the network and study drugs that affect it. We hope to trial a drug that affects ependymomas. Michael Taylor in 2014 found an epedymoma in the cerebellum that has an aberrant wrap of the DNA, an epigenetic focus for exploration. We are starting with DNA methylation here as the stepping stone, even though it has long been studied. The co-leader of this study is Sam Weiss from Calgary, a Gairdner laureate 7 years ago, who found stem cells in the mammalian brain in the 1992. We (Dirk’s group) then found stem cells in brain cancer. We now work together and are bringing others to study the epigenetic and proteomic aspects of cancer growth, principally Toronto and Montreal investigators.”

Q: What is exciting?

A: We will use open access to good data, rapidly disseminating what is important, that would be the legacy of this 4 year project. The Chair of Stand-up asked us: “How open is open?”. This is an interesting issue and there are some ethical aspects to consider, because there is normal DNA of the patient’s genome in the cancer DNA we are studying. Through Katie Couric I met Vice –President Joe Biden in the White House to talk about Stand-up to Cancer. Biden’s son (Beau Biden) died of a glioblastoma. The Vice-President asked about the silos of science problem, which we are directly working to counter. There is a structural genomics project at the University of Toronto headed by Alan Edwards and Sheryl Arrowsmith. Importantly, it brings pharmaceutical executives into the project, a new and important model.

Q: What is the most fun in this program?

A: The mix of the new creative team is a group of world leaders, and the data so far is exciting. We are proposing one clinical trial and anticipate that 3 or 4 more will be coming toward the end of the project.

Q: How do you meet?

A: Two face-to-face meetings per year plus regular WebX conferences, plus monthly meetings of the lab team. It’s a living project. We use scientific social media - the “Stack. com” program - to announce data within the group. We share new papers, collateral discoveries and have a wikipage for the project to link us with younger scientists and bioinformatics people. We are constantly learning from them. This is the most work and the most fun I have ever had. I do something on the project every day, I go to see people often and there are multiple layers of communication. As the group leader, I go to Montreal, and will soon go to Vancouver. Sam Weiss is here in Toronto from Calgary every month. Our first review will be held in July. The review committee is chaired by Phil Sharpe, a Nobel laureate. This is a very large responsibility for me, and I have never seen such enthusiasm in a scientific project. The data is the legacy and the patients are the winners.

Q: How is the REB functioning to oversee this work?

A: REB ideas are somewhat outdated since genetic information does need protection, and REB patient advocacy for privacy is very strong. Patients in fact wouldn’t mind being asked for their tissue for post-mortem exams or for resampling of their tumors at recurrence. This has been helpful in leukemia where resampling only requires a bone marrow aspiration. It’s more complicated when brain tumor patients relapse.

Q: Can the University of Toronto institutions work together in teams?

A: Institutions are very protectionist. They tend to work in silos to protect their patients. Individual hospitals, though proud to be members, are nevertheless somewhat siloed. Elizabeth Peter will be contacted to help solve some of these problems at the University level. We could protect all the patients with the Standard Protection Protocol. It is certainly an issue that the genetic information is all on the internet, and tumor DNA contains normal DNA from the patient’s genome. We could use a person like Timothy Caulfield as an ethics consultant.

Q: Tell us a little bit about your own work apart from the Stand-up Project.

A: I am in a great job with wonderful patients at a great institution. Our group has three papers coming out his year in Cancer Cell, the top journal in our field. Our goal is to publish quality research. I worry about young people in Surgery. Mike Taylor is an exemplar of the next generation, but there are not any candidates at the next level in the generation after Mike. There is very significant pressure, primarily from the Ministry toward care rather than research. In 1998, it was easy to get a grant and the Alternate Funding Plan gave me the time to do research. New people today are pushed very hard toward care as their primary activity. Jim Rutka was my mentor and I was his first student. At that time, $50,000 and grit and fortunate timing and a group practice that respected what you do was the secret of success. They never doubted me. I have always done the clinical work, of course, as we are surgeons first, but the environment was essential. Ori Rotstein was a key player in the evolution of the Surgeon-Scientist Program for us.

The Stand-up to Cancer people are very engaged forceful significant people. America could do so much in this field because of its wealth. Canada needs the philanthropic drivers and should step up to support young scientists. We don’t have a Howard Hughes Foundation of $2 billion for science, but there are billionaires in Canada who could make a significant contribution. The government gave $30 million for cancer research when we needed $500 million. We need this kind of investment to hold our young scientists here, or they will go to the United States, or the United Kingdom. We need more institutions like the Ontario Institute for Cancer Research. Sean Parker, founder of Napster, recently put up $200 million for immunotherapy of cancer. In addition to big programs like that, we also need small grass roots funding like I had when I started.

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