Randy Gascoyne, MD, FRCPC
Lymphoid cancers are the fourth most common cancer in British Columbia, where Dr. Gascoyne has spent the entirety of his professional career. He received his MD from the University of British Columbia where he also completed a residency in Hematopathology. He joined the staff of the BC Cancer Agency (BCCA) in 1987, where he is currently a Clinical Professor of Pathology and a Hematopathologist, as well as Co-Director of the Centre for Lymphoid Cancer (CLC). Dr. Gascoyne has also collaborated with LRF for several years, working on LRF funded projects in both mantle cell lymphoma (MCL) and follicular lymphoma (FL), as well as serving on the Scientific Advisory Board (SAB) and participating in the MCL Consortium.
Dr. Gascoyne's research focuses on the biology of lymphoid neoplasms, particularly the pathogenesis of FL, MCL and diffuse large B cell lymphoma (DLBCL). Over the past 2-3 years, the group in Vancouver has published seminal papers in the field of lymphoma genomics, including the first papers to use next-generation sequencing to describe EZH2 mutations in FL and DLBCL, as well as the mutational landscape of DLBCL and recurrent NOTCH1 mutations in MCL. Several pharmaceutical companies have made specific small molecule inhibitors to EZH2 and these have just begun testing in the clinic, having been given to lymphoma patients as the "first in man" studies as recently as June 2013. These exciting studies highlight the value of genomic medicine, whereby discoveries by the Vancouver group have translated in just 3 years time into specific, targeted therapies for lymphoma patients.
Over the last several months, Dr. Gascoyne and his colleagues at the BCCA have added texture to their previous work, publishing three significant studies on the genomics of B-cell lymphomas in the journal Blood. In a study published in Blood in April, Dr. Gascoyne and his colleagues identified recurrent & novel genetic mutations involving the UBR5 gene in MCL. In May, separate publications in Blood examined the genetics of DLBCL. They first identified recurrent mutations in the FOX01 gene that indicated decreased overall survival rates for DLBCL patients undergoing the current standard treatment, the combination chemotherapy R-CHOP. The second paper detailed the completion of the most comprehensive whole genome sequencing effort in DLBCL, revealing numerous novel & recurrent mutations in the disease. Each of these studies improves understanding of how lymphoma tumors develop and grow, allowing researchers to explore more effective treatment options.
"Through a marriage between cutting-edge genomic approaches and in-depth knowledge of lymphoma biology, the team is making record breaking discoveries at an unprecedented pace," Dr. Gascoyne says, "many of which are poised to significantly improve our fundamental understanding of how these cancers grow and are already providing clues to how we might better fight against these diseases." The CLC is looking to build on their accomplishments by partnering with the Michael Smith Genome Sciences Centre within the BC Cancer Agency to translate the genomic personalization of lymphoid cancer treatment from the research lab to day-to-day medical care, a concept which has been long anticipated but not yet put into practice. Dr. Gascoyne and his colleagues anticipate that this program will not only improve treatment options for Canadian lymphoma patients, but serve as a model for the use of genomic personalization in medical practices around the world.
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