"By increasing access to molecular testing, we hope to increase treatment options for people with this rare cancer," says Dr. Rebecca Auer, co-founder of C3, surgical oncologist and senior scientist at The Ottawa Hospital and professor at the University of Ottawa. People across Canada with biliary tract cancers (cholangiocarcinoma and gallbladder), now have access to molecular testing to help them find treatments and clinical trials that are more likely to work against their cancer. This national testing program is run and paid for by the Canadian Cholangiocarcinoma Collaborative (C3), based at The Ottawa Hospital, with OncoHelix Inc. and the University Health Network providing the testing.
Patients with biliary tract cancer have few treatment options and a very low survival rate. New therapies that target certain mutations are showing promise, but patients first need molecular testing to see if their cancer is a match.
"Molecular testing is standard of care for biliary tract cancers, but the cost isn't covered by most provinces and territories, and patients have had to pay thousands of dollars out of pocket, often to companies based in the U.S.," says Dr. Rebecca Auer, co-founder of C3, surgical oncologist and senior scientist at The Ottawa Hospital and professor at the University of Ottawa. "Quebec recently became the first province in Canada to fully cover the costs of testing. We wanted to fill this gap for the rest of the country and give all patients access to hope through targeted therapies and clinical trials."
C3 is a national research network that aims to change how patients with biliary tract cancer receive and access integrated research and care in Canada. It was awarded a network grant from the Canadian Cancer Society and the Canadian Institutes of Health Research in 2023. Part of this funding will cover the cost of molecular testing for patients outside of Quebec for as long as possible, with the hopes the provinces and territories will eventually cover the costs.
Patients eligible for testing through C3 are those with a viable biopsy sample whose cancer cannot be treated through surgery, has spread to other parts of the body, or whose cancer has returned after surgery. Most patients will be eligible, as biliary tract cancer is usually diagnosed when it has already spread to other parts of the body.
C3 expects that around 300 patients per year will be referred for testing by their oncologist. About 40 per cent of all biliary tract cancers will have one or more targetable mutations.
Molecular testing for Ontario patients will be done by the University Health Network Genome Diagnostics lab in Toronto. OncoHelix Inc., based in Calgary, will provide testing for the rest of Canada, excluding Quebec which has provincially-funded testing. Both the patient and their physician will receive the results. Providing molecular testing in Canada will eliminate the need for cross-border shipping, travel and data-sharing of sensitive health information.
The C3 network offers expert advice to physicians who are less familiar with this rare cancer or with interpreting molecular tests to help them make the best treatment decision.
With the patient's consent, C3 will add their results to a national C3 registry to better understand the molecular landscape of biliary tract cancer in Canada. They hope this information will convince more drug companies to open clinical trials in Canada, by showing how many participants could be recruited with specific tumour mutations.
"We have a chicken-and-egg scenario here," says Dr. Auer. "Canada does not have many funded targeted treatments or clinical trials for biliary tract cancer compared to the rest of the world, so why would someone get molecular testing? But if nobody gets tested, drug companies won't set up clinical trials here and patients can't get access to new treatments. By increasing access to molecular testing, we hope to increase treatment options for people with this rare cancer."
People with biliary tract cancer who want molecular testing of their tumour funded through C3 should visit C3’s website (www.cholangio.ca) for more information. It is always important for patients to talk to their oncologist to see if they are a suitable candidate. Patients and physicians can access the test requisition form at www.cholangio.ca/getmoleculartesting. Patients should note that getting a molecular test is not guaranteed to help them.
"Cancer researchers have spent the last 50 years unravelling the molecular underpinnings of cancer cells and exploiting those discoveries to make new therapies," says Dr. Auer. "Now we need to give patients universal access to molecular testing so they can benefit from this knowledge and these treatments."
The Canadian Cholangiocarcinoma Collaborative (C3) aims to grow hope in Canadians living with biliary tract cancers by integrating research with patient care. Our network has over 100 doctors, researchers, and patient partners. The C3 is funded by the Canadian Cancer Society and Canadian Institutes for Health Research. To learn more about the C3 and our patient support initiatives and research opportunities, visit cholangio.ca.
The Ottawa Hospital (TOH) is one of Canada’s top learning and research hospitals where we are guided by our vision to provide the world-class and compassionate care we would all want for our loved ones. Our multi-campus hospital, affiliated with the University of Ottawa, is home to the Regional Trauma Centre and Cancer Centre, and to discoveries that are adopted globally. Backed by generous support from the community, we are focused on reshaping the future of health care to improve the health of our diverse population of patients from Eastern Ontario, Western Quebec, and Nunavut. For more information, visit www.ohri.ca.
OncoHelix Inc. is a Calgary-based organization recognized in Canada and internationally as a leader in precision diagnostics. The OncoHelix team comprises molecular diagnostic specialists, clinical pathologists, medical oncologists, immunologists, and bioinformaticians with over 375 publications in leading scientific journals and multiple international awards. A cornerstone of OncoHelix’s mission is to work with health sector partners to increase access to cancer genomics and immune profiling for patients across Canada and worldwide. OncoHelix provides testing across Canada through its clinically accredited lab space located at the University of Calgary.
University Health Network (UHN) is Canada's #1 hospital, with more than 10 sites, including Toronto General Hospital, Toronto Western Hospital, the Princess Margaret Cancer Centre, Toronto Rehabilitation Institute, West Park Healthcare Centre, and the Michener Institute of Education. The scope of biomedical research and complexity of cases at UHN have made it a national and international source for discovery, education and patient care. UHN's Laboratory Medicine Program is the largest hospital diagnostic lab in Canada and one of the largest academic labs in the world. UHN has the largest hospital-based research program in Canada, with major research in neurosciences, cardiology, transplantation, oncology, surgical innovation, infectious diseases, genomic medicine and rehabilitation medicine. UHN is a research hospital affiliated with the University of Toronto. For more information: www.uhn.ca
The University of Ottawa is home to over 50,000 students, faculty and staff, who live, work and study in both French and English. Our campus is a crossroads of cultures and ideas, where bold minds come together to inspire game-changing ideas. We are one of Canada’s top 10 research universities—our professors and researchers explore new approaches to today’s challenges. One of a handful of Canadian universities ranked among the top 200 in the world, we attract exceptional thinkers and welcome diverse perspectives from across the globe. www.uottawa.ca
Media Contact
Jennifer Ganton
Director, Communications and Public Relations
Ottawa Hospital Research Institute
Cell: 613-614-5253
jganton@ohri.ca
