Medical oncologist and clinical researcher Dr. Janessa Laskin has been at the forefront of BC Cancer’s Personalized OncoGenomics (POG) program since before it even began. She had her first glimpse of the power of genomics for cancer patient care when, in 2008, she worked closely with scientists the GSC to conduct whole genome and transcriptome analyses for one of her patients, enabling her to design a personalized therapeutic strategy. In 2010, their findings were published in the first study of its kind, demonstrating the use of whole genome and transcriptome analyses to inform therapeutic decisions.
“The publication led to a lot of interest in using as much information as possible to understand what is driving cancer, and to find individualized ways to block it,” says Dr. Laskin, “That ultimately led to the formation of the POG program itself, and it just grew from there.”
Dr. Laskin did her medical training at UBC and BC Cancer. Following a Fellowship at Vanderbilt University, she returned to Vancouver in 2003 where she is now a Clinical Associate Professor of Medicine in the Division of Medical Oncology through UBC and BC Cancer. In her role, Dr. Laskin is heavily engaged in clinical and translational research. As co-Founder and Clinical Lead of the POG program, she works with an interdisciplinary team of oncologists, pathologists, medical geneticists, interventional radiologists and surgeons to revolutionize our understanding of the use of genomics for cancer treatment planning.
“Genomics technologies have confirmed what we see clinically,” says Dr. Laskin, “While patients with similar cancers may look the same on the surface, their cancers often respond very differently to therapeutics.”
The initial stages of the POG program were focused on determining how to implement genomics into cancer management, and how scientists and clinicians would parse through whole genome and transcriptome analyses to inform patient care. Now, with over 1,000 patients having been enrolled in POG, Dr. Laskin is focused on therapeutically testing the clinical hypotheses that arise from these analyses.
“We now have the expertise, interest and proof-of-concept to demonstrate that whole genome and transcriptome sequencing is probably required for the vast majority of cancer cases,” says Dr. Laskin, “But we are so far ahead of the curve that it is challenging to create standard of care.”
Moving forward, Dr. Laskin envisions some version of the POG program being applicable to all cancer patients. She views the implementation of genomics into cancer care as being analogous to imaging technologies. Years ago, cancer imaging was done using x-rays. Now, with the development of more specialized imaging technologies including CT, PET-CT and MRI, clinicians utilize the most appropriate imaging technique for each individual patient. Similarly, patients currently might receive single gene or panel testing, but with the development of whole genome, transcriptome and epigenome sequencing technologies, it may be possible to customize and prioritize genomics testing for individual cancer patients.
As a clinician, Dr. Laskin has seen the direct impact of the POG program in the lives of cancer patients. For example, a study in which Dr. Laskin and the POG team used whole genome analyses to identify an important gene fusion in a small number of pancreatic cancer patients led to improved recommendations for standard care of advanced pancreatic cancer patients.
“We saw that a limited number of patients can actually change standard of care,” says Dr. Laskin, “I think that is very powerful on a clinical level.”
The POG program is collaborative by nature, and relies heavily on the multidisciplinary team of clinicians and scientists. Over the last seven and a half years, Dr. Laskin has fostered close collaborative relationships with Drs. Marco Marra and Steve Jones at the GSC, working together to make precision oncology a reality.
“They are a fabulous team to work with, individually and as a group,” says Dr. Laskin, “None of this work could have happened if it wasn’t for the respectful and collaborative environment at the GSC, and that starts at a leadership level and spreads down by example.”