The Ori Rotstein Lecture in Translational Research
By: Rebecca Ruddy
The Institute of Medical Science’s (IMS) annual Ori Rotstein Lecture in Translational Research took place on October 23, 2015 and featured Dr. Paul O’Byrne as the keynote speaker.
The Ori Rotstein Lecture was founded in 2011 in honour of past IMS Director Dr. Ori Rotstein. Dr. Rotstein, Professor and Surgeon-in-Chief at St. Michael’s Hospital, was the Director of IMS between 2000 to 2011 and, under his leadership, the department grew to be the largest graduate unit in the Faculty of Medicine and the fifth largest unit at the University of Toronto. In addition to this expansion, Dr. Rotstein pioneered several important initiatives within IMS, including the introduction of additional professional programs, improvements in student policy, as well as continued development of curriculum, especially in the core departmental course. The Ori Rotstein Lecture was founded to highlight advancements and innovation in the field of surgery and translational research and features outstanding keynote speakers. This year was no exception.
Dr. Paul O’Byrne is a Distinguished Professor at McMaster University. He is an E.J. Moran Campbell Professor of Medicine and Chair of the Department of Medicine at the Michael G. DeGroote School of Medicine. Dr. O’Byrne is an accomplished researcher with over 400 peer-reviewed papers, 98 book chapters, and over 100 review articles, as well as the recipient of numerous awards and honours. Dr. O’Byrne’s research interests include “the mechanisms and treatment of asthma, with particular reference to the role of environmental allergens and the mechanisms by which these cause airway inflammation.”1 It was this research topic that was the focus of the keynote address entitled, “Developing New Treatments for Allergic Asthma.”
Dr. O’Byrne commenced the lecture by outlining the problems and obstacles encountered with new drug development in asthma; the number of asthma medications approved is decreasing while the cost per new drug approved is increasing. Therefore, this process needs to focus on more efficient and robust methods to identify drugs whose results in early phases are predictive of their success in later clinical trial phases. Although there are safe and effective drugs currently available for the treatment of asthma, there is still a fraction of patients that despite these medications still suffer from severe refractory asthma. This patient population is heterogeneous and often has co-morbidities and other issues that present challenges in the drug development and clinical trial process. Therefore, Dr. O’Byrne presented a potential solution to this obstacle in asthma drug development.
Dr. O’Byrne presented the idea of studying new drugs in patients with mild asthma by presenting them with an allergen to elicit a reaction (allergen challenge) and determining the effect and efficacy of new drugs at treating the asthmatic symptoms. The goal would be to use this as a predictive tool to determine drugs that will be effective in later clinical trial phases. Using this method, Dr. O’Byrne has identified true positive and negative controls that are respectively effective or ineffective in the treatment of allergen-induced asthma. However, there have been instances of false positives, with drugs that treat the allergy response, but are not effective in treating asthma, but there have been no false negatives.
This approach is currently being used in the Allergen NCE Clinical Investigator Collaborative study, a Canadian Phase II trial testing potential drug candidates for different types of asthma. Dr. O’Byrne presented data from different drugs that were tested using the allergen challenge approach and identified different drugs with some failing and some succeeding at attenuating the allergic reaction. These drugs therefore validated the allergen challenge model and allowed the allergen challenge to be a well-established clinical model to study new drugs. In addition, the reliability of this model will allow for smaller sample sizes. These results demonstrate that this model shows promise and will greatly improve current methods for the testing of drug candidates for asthma.
Following the remarkable keynote speech by Dr. Paul O’Byrne, Dr. Ori Rotstein moderated a panel discussion entitled, “Clinical Trials in a Canadian Context: What are we doing right? What could we be doing better?” The panellists included Dr. Paul O’Byrne, Dr. John Marshall (Professor, Department of Surgery, University of Toronto), Dr. Michael Tymianski (Senior Scientist, Toronto Western Research Institute), and Dr. Michael Farkouh (Associate Clinical Professor, Department of Medicine, University of Toronto and Director, Heart and Stroke/Richard Lewar Centres of Excellence). The panellists led a lively discussion regarding the current landscape of clinical trials in Canada, tackling such topics as investigator-initiated trials, the necessary skill-set for clinical trials in Canada, multicenter trials and collaborations, and funding challenges. The panel discussion provided audience members the opportunity to ask questions and provide input into the ongoing conversation, introducing the subjects of orphan drugs, funding drug research for uncommon diseases, and bringing a business aspect to drug discovery and clinical trials. Overall, the panel discussion successfully touched on important topics related to current clinical trial practices in Canada and offered insight into the existing challenges and potential solutions to improve the state of these trials.
The 5th annual Ori Rotstein Lecture in Translational Research has certainly continued to achieve what it intended when it was first founded and much more. Dr. Paul O’Byrne presented innovative approaches and data in translational research and demonstrated a new solution to the problem of inefficient methods in asthma drug discovery. Through his collaborative research, he presented promising results in validating a clinical model to study new drugs and therapies for asthma. In addition to the keynote speech, this year’s lecture also held an informative discussion on the current state of clinical trials in Canada, which gave the audience an opportunity to participate and ask questions. The panel discussion was insightful and offered varying opinions and viewpoints, which led to a successful well-rounded discussion. The Ori Rotstein Lecture in Translational Research succeeded in presenting innovative research in the field of surgery and translational research and demonstrated the excellence in research currently underway in Canada.