Financed projects

Professor Simard’s team is leveraging advances in genomics technology to propose an innovative approach to more effectively prevent breast cancer and to screen for it earlier. This approach is based on a multifactorial assessment of individual risk, which is far more precise than using age as the sole criterion.  

With just a saliva sample, more than 300 breast cancer susceptibility genes identified by the research team can be analyzed and a polygenic risk score (PRS) established. By combining these data with other factors such as family history, breast density and lifestyle, women can be classified into three risk categories.  

This risk stratification makes it easier to recommend prevention and screening strategies tailored to each individual. This type of public health policy could help to avoid unnecessary exams in certain women, while more effectively identifying those who require closer monitoring. Ultimately, more effective risk reduction could lead to fewer cases of breast cancer. Earlier detection of the disease will improve survival and quality of life for the people affected.   

The PERSPECTIVE project also led to a substantial improvement in the BOADICEA risk- prediction algorithm, which is now used worldwide via the CanRisk web application, enabling over 1.5 million personalized risk assessments.  

The project is currently in its Integration and Implementation (I&I) phase, during which nearly 4,500 women in Quebec and Ontario are participating in the development of a reference framework for implementing personalized risk-based screening. 

The Foundation has provided financial support for the PERSPECTIVE project from the outset, which has been crucial to its progress.   

The Quebec Metastatic Breast Cancer Registry was launched in 2021 and has received financial support from the QBCF from the outset. This initiative is a platform dedicated to collecting and sharing information about cases of metastatic breast cancer in Quebec. Understanding today’s patient pathways is essential for improving care for the patients of tomorrow. 

This registry is a valuable tool for researchers, pharmaceutical companies and clinicians, offering them access to real data on treatments and their effects. The objective is to advance research and improve care. The number of patients on the Registry continues to grow with each passing week, due to the collaboration of approximately 10 partner establishments.

These establishments include McGill University Health Centre (MUHC), Centre hospitalier de l’Université de Montréal (CHUM), CHU de Québec-Université Laval (CHUQ), Hôpital Maisonneuve-Rosemont (HMR), Hôpital du Sacré-Cœur-de-Montréal, St. Mary’s Hospital Centre, Centre hospitalier régional de Lanaudière, Centre hospitalier universitaire de Sherbrooke (CHUS) and Hôpital de Chicoutimi. Other institutions will soon join, which will extend this essential database throughout the province of Quebec. 

NexPlasmaGen, a Quebec company, has developed cold plasma technology for treating breast cancer. This technology is injected directly into the surgical margins, targeting cancerous cells while preserving the healthy ones. NexPlasmaGen’s objective is to reduce subsequent treatments such as radiotherapy or a margin re-excision, and the associated side effects. Furthermore, the company is striving to reduce the risk of local recurrence after a lumpectomy. This method offers a number of other advantages such as its speed and tolerance and does not require general anesthesia or further planned interventions. Previous research has already shown the effectiveness of cold plasma in-vitro and in rodents. Clinical studies will now be conducted to assess its effectiveness and safety for patients, beginning soon at the CHUM. The QBCF funds this project, convinced of its potential to improve survival and quality of life for people with breast cancer. 

Cancerous cells must adapt their metabolism to meet the energetic and biosynthetic needs associated with the rapid growth of the primary tumour and the colonization of metastatic sites. They must manage the metabolic stress caused by the changing conditions in the primary tumour, the different steps in metastatic cascade and exposure to therapeutic agents. Previous research has shown that metabolic flexibility is a key concept that allows aggressive cancerous cells to overcome this stress by activating various metabolic programs. 

The objective of this research project is to study the signalling pathways and metabolic networks activated by cancerous cells in response to local changes in the primary tumour or in the metastatic microenvironments, to systemic changes such as obesity and to the stress induced by treatments. This research aims to uncover the molecular and cellular mechanisms that confer this metabolic flexibility, ultimately leading to aggressive cancerous phenotypes.  

This knowledge will be used to identify metabolic bottlenecks where vulnerabilities can be exploited to develop therapeutic strategies capable of overcoming the cancer’s metabolic flexibility. 

This research project spearheaded by professors Benoit Paquette and François-Michel Boisvert is focused on the early detection of triple-negative breast cancer recurrence. This particularly aggressive type of cancer does not respond to hormonal treatments or therapies targeting the Her2 protein. Approximately 30% of patients with this cancer will experience a recurrence of their disease within three years of initial treatment. 

Currently, patient monitoring consists in symptom observation, which means that the recurrence is often detected at an advanced stage, which lowers the chances of survival. The project aims to develop a simple, quick and accessible predictive test based on the detection of inflammatory markers in the blood of patients during radiation therapy. This test will make it possible to identify people who are at high risk of recurrence, to offer them closer monitoring and adapted early treatments. 

The project involves working closely with experts from the CIUSSS de l’Estrie – CHUS and includes a patient-partner, Catherine Wilhelmy, who provides valuable insight into the patient experience. This work promises to significantly improve care for triple-negative breast cancer patients, reducing the risks of recurrence and increasing the chances of survival. 

Adjuvant endocrine therapy is a drug therapy prescribed for women with hormone-receptive breast cancer, which represents approximately 75% of cases. This treatment helps to reduce the risks of recurrence and mortality. However, between 31% and 47% of women do not follow this treatment for the recommended five years. 

A program called PAcHA (Programme en Pharmacie pour l’Accompagnement des Femmes ayant de l’Hormonothérapie Adjuvante) was developed to solve this problem. This program aims to support women in taking their treatment through advice provided by specially trained pharmacists. 

The pilot study tested this program in 33 pharmacies to see if it actually helped women to better follow their treatment. The results of this study made it possible to improve the program and to plan a larger study to assess its effectiveness. The PAcHA program could fill a major gap in care for people with breast cancer and make it possible to maximize the benefits of endocrine therapy.  

Cancer Research Network (RRCancer) tissue and data bank – Dr. Anne-Marie Mes-Masson  

Breast cancer, a complex disease with tumours of varying characteristics, requires therapeutic options tailored to each patient. Researchers rely on high-quality data and tissue samples for a better understanding of breast cancer. The Cancer Research Network, directed by Dr. Anne-Marie Mes-Masson at the CHUM Research Centre, has established an essential infrastructure for collecting and preserving this biological material through various biobanks, including the one dedicated to breast cancer.  

Thanks to longstanding financial support from the QBCF, including a $500,000 grant in 2015, the biobank has been used in dozens of research projects. This valuable resource has made it possible to study thousands of tumour samples using advanced techniques such as tissue micro-arrays. This technology can be used to quickly and cost-efficiently analyze several biomarkers to identify those that can predict the effectiveness of conventional treatments or indicate the need for new therapeutic strategies.  

Learn more about biobanks in our blog article entitled Do you know what a Biobank is?

Breast cancer prevention: Optimizing surgical decision-making and prevention strategies in women at high risk of breast cancer – Dr. Stephanie Wong

Dr. Stephanie Wong is an assistant professor of surgery in the faculty of medicine at McGill University and breast surgical oncologist at the JGH Segal Cancer Centre in Montreal. Her clinical and research interests focus on surgical outcomes following neoadjuvant treatment and high-risk patient populations. She directs the High Risk Breast Clinic at the JGH Stroll Cancer Prevention Centre.

While the average Canadian woman has a 12% risk of developing breast cancer in her lifetime, some women are on a high-risk continuum that ranges from 20% to 85%. This is especially the case for women who received radiation to the chest wall. They use prevention and monitoring strategies to manage their breast cancer risk. Choosing prevention strategies is often complex and takes into consideration the estimated risk, the risk reduction offered by these strategies, their potential side effects as well as the perceived impact of a breast cancer diagnosis on quality of life.

Although endocrine prevention or prophylactic bilateral mastectomy considerably reduce the risk, they are not associated with a net improvement in overall survival. Dr. Wong seeks to better understand the characteristics of breast cancer subtypes that develop in women who previously received chest radiotherapy treatment, their response to treatment as well as their outcomes. Having this information could influence and facilitate decision making regarding which prevention, screening and care strategies to adopt for these high-risk subgroups. 

Profiling tumor-stromal interactions in metastatic breast cancer – Dr Mark Basik  

Dr. Mark Basik is a Senior Investigator at the Lady Davis Institute and Associate Professor in the Departments of Surgery and Oncology at McGill University since 2003. He is the Head of the Cancer Genomics and Translational Research Laboratory and the Medical Director of the Inter-disciplinary Breast Cancer Team at the Segal Cancer Centre at the Jewish General Hospital. Dr. Basik’s laboratory is part of the FRQS Réseau de Cancer axe cancer du sein/ovaire, and as such actively participates in province-wide breast tumour and plasma banking in breast cancer.   

Dr. Basik plans to examine the cells that surround the tumour when it propagates outside of the breast (in the liver, lungs, skin or brain) because in these cases, the cells form an environment around the tumour that protects it against treatments, rendering them ineffective. 

Targeting mRNA as a therapeutic strategy for breast cancer via eIF4E – Nahum Sonenberg

This research project is focused on how cells use genetic information to make proteins, which is a process essential to life. The scientist behind this project discovered a key element known as eIF4E, which plays a central role in regulating the production of proteins in our cells. This discovery made it possible to better understand how proteins are made and how this process is controlled, especially in conditions like cancer. 

In the context of breast cancer, it was discovered that certain signalling pathways in cells become hyperactive, which leads to an increase in eIF4E activity. This can favour the growth of tumours. The project explores how to target these pathways and the machinery that makes proteins to develop new treatments against breast cancer. In simple terms, the researchers are seeking to “deactivate” the signals that push cancerous cells to multiply, in the hopes of slowing or stopping the progression of the disease.  

Gene-modified mesenchymal stem cells for treating breast cancer – Nicoletta Eliopoulos

PTEN-Long is a tumour suppressor protein that is often deficient or absent in people with breast cancer. The primary goal of this research is to determine if mesenchymal stem cells (MSCs), a type of adult stem cells isolated from human adipose tissue can be modified to produce human PTEN-Long and used to fight breast cancer. The specific objectives are to: 

• Study the effects of human MSCs modified to produce PTEN-Long on cancerous breast cells in culture; 
• Determine if administering MSCs producing PTEN-Long causes anti-tumoral effects in rodents with breast cancer.  

This innovative study is the first to assess the delivery of PTEN-Long by stem cells for the treatment of breast cancer. It aims to advance research against the disease and improve patient survival.

The effect of cannabinoid receptors on breast cancer survival – Caroline Diorio

Breast cancer is the most common cancer and the second-leading cause of death in Canadian women. Although current therapies are effective, some breast tumours recur or resist these therapies. It is therefore important to find new treatments. Cannabinoids, the active components in marijuana, are on the radar as new treatments, as they seem to prevent cancerous cells from multiplying, migrating and invading other organs. Cannabinoids propagate their anti-cancerous activities by binding to CBR1 and CBR2 receptors. Researchers hypothesize that a higher concentration of these receptors in the breast tumour would be an indicator of poorer survival or of greater risk of recurrence in women with breast cancer. The goal of this project is to evaluate the link between the tumoral expression of CBR1 and CBR2 receptors, survival and recurrence in breast cancer patients. Tissue from women diagnosed with breast cancer who agreed to participate in a biobank and who are followed at the Centre des maladies du sein de Québec is used in the study. The expression of CBR1 and CBR2 is measured according to clinical standards. By measuring the expression of cannabinoid receptors at diagnosis, researchers believe they will be able to identify the women at risk of early death or recurrence. These receptors can then be exploited as therapeutic targets. 

Galectins are a class of proteins with immunosuppressive properties (that prevent the activation of the immune system) and that are expressed in abnormally elevated levels in tumoral cells associated with a number of cancers, including triple-negative breast cancer. Cells then evade the body’s defence system and develop. Dr. Saint-Pierre’s team is developing a toolkit aimed specifically at slowing the action of galectins, which will make it possible to develop targeted treatments in the future and offer more options to people with the disease. 

This contest aims to support programs for improving the quality of care, clinical application projects as well as educational initiatives intended to fill gaps in breast cancer care and services as well as educational disparities in the Quebec healthcare system. To ensure the highest quality in project selection, a peer review process was used to evaluate proposals. Here are the projects selected for the 2020 edition of the contest.  

Sentinel lymph node and targeted axillary dissection in patients with node-positive breast cancer and clinically negative axilla – Dr. Léamarie Meloche-Dumas

Although progress has been made, breast cancer treatments can still cause significant side effects. With improved drugs and radiotherapy, the need for surgery can now be reduced in some cases. For example, a study has shown that a sentinel lymph node biopsy is just as effective, but less invasive, than axillary dissection in patients whose lymph nodes are clinically normal even if one or two lymph nodes are positive. 

At the time of the study, a new recommendation was proposed to extend the use of sentinel lymph node biopsy, even if a lymph node is already confirmed positive by an ultrasound biopsy. However, this recommendation was based on expert opinions and had not yet been validated by studies.  

Targeted axillary dissection (TAD), which consists in precisely removing the positive lymph node using a guiding technique, proved to be much more accurate after pre-operative chemotherapy. The study aimed to evaluate two things: first, the feasibility and accuracy of sentinel lymph node biopsy in patients where a lymph node was confirmed positive by biopsy, and then if TAD can improve accuracy to avoid unnecessary surgeries in approximately one in seven women with breast cancer. 

Impact of virtual intervention promoting healthy eating and physical activity habits in women with breast cancer – Dr. Angelo Tremblay

Resources to promote healthy lifestyle habits to prevent certain diseases have often been insufficient in Quebec and elsewhere in Canada. This project proposed developing an innovative program to encourage physical activity and healthy eating habits in women in remission from breast cancer, via a virtual platform. 

The program recruited 80 women who were randomly divided into two groups for 12 weeks: one was supervised directly by a kinesiologist and a nutritionist in weekly meetings, while the other was supervised via an online platform with telephone support. 

Lifestyle habits, physical condition, perceived well-being as well as risk markers for metabolic syndrome were evaluated at the beginning and end of the program. Family medicine clinics in the Lanaudière and Quebec City regions participated in the study. 

To date, this project has made it possible to validate this innovative online intervention to promote healthy habits and create a database that strengthens collaboration between primary care settings and university institutions. 

Physical activity adapted for you: an intervention study for women diagnosed with breast cancer and reporting major emotional distress – Dr. Paquito Bernard

Between 10% and 35% of women diagnosed with breast cancer experience major emotional distress. Current treatments generally boil down to psychological monitoring, with or without taking antidepressants. Although physical activity is recognized for its potential to reduce the symptoms associated with depression and anxiety, this complementary therapy is not readily integrated into intervention plans. Dr. Paquito Bernard and his team have proposed evaluating the effects of an adapted physical activity intervention personalized based on anxiety-depressive symptoms and sleep in emotionally distressed breast cancer patients. This study was conducted in collaboration with Hôpital Maisonneuve-Rosemont and Hôpital Santa Cabrini. In the long term, it may make it possible to offer more treatment options to improve quality of life for women affected by breast cancer. 

Kinase-dead favours the progression of triple-negative breast cancer: defining the functions of PEAK1 protein complexes in tumour growth and metastasis – Dr. Jean-François Côté  

Many people with breast cancer are diagnosed with metastatic recurrence. Metastases are formed in a pathological process by which tumour cells from the breast leave the mammary gland and migrate to other organs to establish themselves there. It is these secondary tumour sites that threaten the life of patients with breast cancer.

The research project directed by Dr. Jean-François Côté at the Institut de recherches cliniques de Montréal (IRCM) is focused on the molecular mechanisms that facilitate the formation of metastases in breast cancer, particularly in triple-negative breast cancer, a particularly aggressive form that is difficult to treat. The research team identified a key protein, named PEAK1, that plays a crucial role in the growth and formation of metastases. By studying the mechanisms underlying PEAK1 involvement, researchers hope to develop targeted therapies to better treat triple-negative breast cancer. 

In parallel, the team is also exploring the phenomenon of cancer cell dormancy, where certain cells propagate to other organs, go dormant for months or years, then awaken to create metastases. Using functional gene approaches, researchers are looking to identify the regulators of this dormancy, with the long-term objective of translating these discoveries into clinical applications. This research promises a better understanding of metastatic breast cancer and the development of more precise treatments to prevent recurrence and improve patient care.

B7-H4 as a therapeutic target in poor-outcome triple-negative breast cancers – Dr. Morag Park

One in eight women will develop breast cancer in her lifetime. Triple-negative breast cancers represent between 15 and 20% of cancers diagnosed and are associated with poor outcomes. There is no targeted therapy for triple-negative breast cancer. A promising new therapeutic approach consists in using the patient’s immune system to destroy cancer cells. The infiltration of immune cells into the tumour is associated with better outcomes and increased sensitivity to standard therapies. Dr. Morag Park’s team has demonstrated the elevated expression of B7-H4, a negative regulator in immune cell activity and in tumour growth, in poor-outcome triple-negative breast cancers. Furthermore, the research team was able to identify potential B7-H4 regulators. The objective is to discover how B7-H4 alters anti-tumoral immunity and tumour progression. The ultimate goal is to develop strategies to inhibit its expression to increase immune responses and thereby offer new therapeutic approaches to treat triple-negative breast cancer.