This technology allows you to see much earlier than standard imaging
assessments, whether a tumour is responding
or not. Using this type of methodology, Quantitative Ultrasound can
indicate within 1 to 4 weeks' time whether there's actually a response to treatment or not.
Standard methodology, for instance, relying on CT scans
would have to be done many months after treatment is done.
And only then, can it effectively, only measure the size of a tumour.
And as you can see, early on, there are really are no changes in tumour size, yet,
one can detect by 1 to 4 weeks' time, that there's actually cell death,
and the chemotherapy is killing tumour cells.
What it is, is it's a specialized form of ultrasound which uses information that ultrasound machines
normally discard. However, we're able to take that information and
process it. And from it, extract, if you like, ultrasound biomarkers
which we've been able to demonstrate over the past 20 years are linked to cell
death. So, what we're actually looking at here, are some Quantitative Ultrasound
images. In the top row, are images of a tumour
from a patient who actually had a very good response. And you can see here, the
cell death area as being colour-coded yellow, and
you can see, definitely by Week 4, there is actually a response. In the
patient below, you can see that here, the tumour is not
responsive to the chemotherapy as measured by these Quantitative Ultrasound
techniques. The work has moved from experiments in test tubes and in
tumour model systems, to actually now, evaluations in patients, and
over the last 18 months, we have been able to recruit 100 patients
to a first in-human study that we've been conducting here in the Odette Cancer Centre
at Sunnybrook Health Sciences Centre, where we're tracking
whether or not, these patients' chemotherapy is having its intended
effect. Data are very encouraging. They show sensitivities and specificities of over
90 per cent each, in order to use this, if
you like, as a medical test, at 1 to 4 weeks' time, out of 4 to 6 months
of chemotherapy, to determine whether or not that
drug or that drug regimen that's being given - is actually working.
So, where are we going next? We actually anticipate that in January of 2015,
we'll be starting a clinical trial here
at Sunnybrook Health Sciences Centre, to actually randomize patients
to receive conventional therapy and, the
other arm of that study, will have a patient population where this type of technology
is used to guide personalized medicine. This will be the first time where this type of
Quantitative Ultrasound imaging is used - ever - to
deliver personalized medicine. The whole goal is that if someone is receiving
an ineffective drug, to switch it to one, that is effective,
or even to a different type of therapy that's going to be effective.
My name's Jill Robinson, and I'm from Dundas, Ontario -- well actually
Greensville. My journey started in ---
I found out about my breast cancer, this January, that just went by. I went through
the standard treatment for breast cancer
where there's two different phases that you go through.
The first phase was really good. You could visually and palpably see it getting smaller.
But it seemed like during the second phase (and this is at a different hospital, by the way,
where I live). The second stage - it
seemed like it was sort of stabilizing, and near the end of it, it almost felt
like it was getting a little bit bigger. What happened was,
they caught it on an MRI, that it was getting so big
that they were concerned about doing the surgery, and it wasn't really in my
best interest. So, that's when I got referred from the hospital
- the other hospital in Toronto - to here, to Sunnybrook, because they said they had
this treatment, where you do radiation and chemo together.
When you were telling me about your study, I thought, 'That's brilliant!', because, before I even
start treatment here, I can see, on the screen - it's just -- I can't even
tell you - the first time, that I saw the second
the first time I saw this one week of treatment - -just the psychological
- I don't even know how to explain it -
just to SEE the difference, you know. There's something in that, that
just made me feel more hopeful. It made me feel
more part of my journey. Knowledge is power.
Right? And when you're going through something as difficult as this,
just having that extra piece---
that feeling like you've got more information.
My whole perception of my wellness curve and what's really happening with me has gone up astronomically.