At the Lunenfeld, we’re taking findings from the lab to the patient’s bedside to change the lives of people with debilitating illnesses
SAMUEL LUNENFELD RESEARCH INSTITUTE Advances in research are transforming patients’ lives.
New medications based on genetic and genomic information, as well as insights into the appropriate use of available therapies, have already improved the prognosis for many people with leukemia, colon and breast cancer. These medications have also put previously unmanageable cases of rheumatoid arthritis into remission, and identified new strategies for treating diabetes.
With new genetic information about how common and complex illnesses develop, Mount Sinai Hospital researchers have made great strides in changing the lives of Canadians suffering from debilitating illnesses.
Dr. Kathy Siminovitch
“If treated early and with the best possible therapies, arthritis patients have a much greater chance of controlling their disease and even staying symptom free,” says Dr. Siminovitch. “Our research is uncovering the genes and molecular events underlying arthritis in specific sub-sets of patients. We can then diagnose patients earlier and more accurately, and intervene with more effective treatments tailored to the unique genetic makeup of each individual.” Dr. Siminovitch and her team are also developing a new method to predict if and how arthritis patients will respond to initial treatment. This will help patients receive effective treatment earlier and avoid unnecessary therapies, so they have the best possible opportunity to control the disease, prevent its progression and avoid permanent joint damage.
Drs. Daniel Drucker and Bernard Zinman
New therapies are helping to greatly improve blood sugar control and reduce complications for people with diabetes. The two most recently approved drug classes for the treatment of Type 2 diabetes, DPP-4 inhibitors and GLP-1R agonists, are based in part on the research of Dr. Daniel Drucker, a clinician-scientist at Mount Sinai.
“These new medications give us more treatment options and a better ability to select a drug with the features best suited to the individual patient,” says Dr. Drucker. DPP-4 inhibitors, for example, have a lower risk of hypoglycemia – an important feature for an older person with diabetes who could become dizzy, fall and possibly break a hip during a low blood sugar episode. Dr. Drucker also contributed to the clinical testing of a new once-weekly treatment regimen for Type 2 diabetes to replace the more common twicedaily injection. “Going from about 20 injections and 20 pin pricks to just one injection transforms a patient’s life. A simpler regimen also makes it easier to control their blood sugar and reduce complications like heart disease and kidney failure,” he says.
For more than 25 years, internationally renowned diabetes researcher and clinician Dr. Bernard Zinman has changed the face of diabetes treatment. He is helping lead the Diabetes Control and Complications Trial (DCCT), the largest and most comprehensive diabetes complications study ever conducted in Type 1 diabetes. The DCCT treatment approach has become the standard of care for Type 1 diabetes. Thousands of people with the illness in Canada and worldwide have immensely benefited.
Dr. Zinman and colleagues are now recruiting patients with Type 2 diabetes of less than eight years’ duration for a new study to find out if people with this kind of diabetes can go into long-term remission; an exciting possibility most commonly associated with cancer or arthritis. Patients in the study will be treated with intensive insulin therapy for one month to repair their beta cells (cells of the pancreas that produce insulin), with the goal to put their diabetes into remission. (Those interested in hearing more about this research can call the Diabetes Centre at 416-586-8775).
Dr. Pamela Goodwin
Mount Sinai breast cancer researcher and clinician Dr. Pamela Goodwin is examining the interaction between a patient’s lifestyle, their unique physiologic and genetic makeup, and specific type of breast cancer, to better predict outcome and response to therapy. Her groundbreaking research has shown that high levels of insulin arising from obesity encourage tumour growth and make breast cancer recurrence more likely.
Dr. Goodwin is leading an international clinical trial to find out whether the diabetes drug metformin can help increase survival rates for women with early stage breast cancer and determine who is most likely to benefit based on their genetic makeup. “Tumours don’t exist in isolation. Changing the patient’s physiology by lowering her natural insulin level may make her body more inhospitable to tumour growth and can potentially change the outcome of the cancer,” she says.