Structural changes or mutations in cancer genes have been identified as one of the causes of cancer. Common examples include gene amplification of the ERBB2 gene in 30% of breast cancers, EGFR gene mutations in 10% of North American lung cancer cases, and KIT mutations in occurring in over 70% of cases of a particular sarcoma subtype known as gastrointestinal stromal cancer. These mutations are particularly significant because they have led to the development of 'targeted' therapies, where a drug is designed to stop the growth of cancer cells with the specific gene abnormality, while sparing normal cells. This leads to therapy that not only prolongs survival, but reduces the toxicity of therapy.
The goal of my laboratory is to identify new gene targets in cancer using next generation DNA sequencing technology. We aim to characterize the rates of specific cancer associated mutations in the Manitoba population using resources like breast and lung cancer from the Manitoba Tumour Bank. We also analyze cancer tissue obtained from patients being treated at CancerCare Manitoba to try and identify targeted therapies that may be more effective for their cancer treatment. This is essential as we move towards more personalized therapy for all patients with cancer.
Julian Kim is a radiation oncologist at CancerCare Manitoba, and an Assistant Professor of Radiology in the Rady Faculty of Health Sciences at the University of Manitoba.
Dr. Kim is leading a study assessing a technique to diagnose non-small cell lung cancer using blood samples in order to speed up the diagnosis and treatment of non-small cell lung cancer. The diagnostic tests currently used to identify specific types of lung cancer from tumour biopsies can often take a month or longer. Since lung cancer often presents at a late stage and can grow quickly, timely diagnosis is imperative in order to initiate treatment prior to the disease spreading in the body. Dr. Kim is using an artificial intelligence technique called machine learning to analyze blood samples from Manitoba lung cancer patients to search for metabolomic signatures or patterns that identify lung cancer, which would speed up diagnosis and allow treatment to begin sooner. This study is funded by the Canadian Institutes for Health Research and the CancerCare Manitoba Foundation.
Dr. Kim is also leading a Phase II randomized clinical trial (The PREMIUM Trial) testing a common diabetes medication (Metformin) that has the potential to reduce unwanted side effects experienced by men with prostate cancer who are treated with androgen deprivation therapy (ADT) and radiotherapy. ADT causes many prostate cancer patients to gain weight, which can lead to elevated blood pressure, blood sugar, and cholesterol. Metabolic syndrome occurs when all of these conditions occur together. Metabolic syndrome increases the risk of heart disease, stroke, and diabetes, so this study has the potential to reduce these other health risks for men with prostate cancer. This study is funded by the CancerCare Manitoba Foundation and the Alberta Cancer Foundation.
Dr. Kim is also a co-principal investigator of a joint clinical study with the Mayo Clinic (The GENRE Study) which is examining the impact of a new genetic test that predicts a women’s risk of developing breast cancer. The study’s goal is to determine if women who learn they are at high risk of breast cancer are subsequently more inclined to take Tamoxifen and other drugs that reduce their risk of getting breast cancer.
1) Julian Kim, Charles Butts, Wilson Roa et al. Dose-escalated Hypofractionated Intensity-Modulated Radiation Therapy With Concurrent Chemotherapy For Inoperable or Unresectable Non-Small Cell Lung Cancer. American Journal of Clinical Oncology. Vol 40(3), June 2017.
2) Julian Kim, Faith Davis, Charles Butts, Marcy Winget. Waiting Time Intervals for Non-Small Cell Lung Cancer Diagnosis and Treatment in Alberta: Quantification of Intervals and Identification of Risk Factors Associated with Delays. Clinical Oncology. Vol 28 (16), Dec 2016.
3) Rene Razzak, Eric Bedard, Julian Kim, et al. MicroRNA expression profiling of sputum for the detection of early and locally advanced non-small cell lung cancer: a prospective case-control study. Current Oncology, Vol 23, No 2, April 2016.
4) Julian Kim, Sayf Gazala, Eric Bedard et al. Non-Small Cell Lung Cancer Detection Using MicroRNA Expression Profiling of Bronchoalveolar Lavage Fluids and Sputum. Anticancer Research. Vol 35, No 4, April 2015
5) Julian Kim, Roy Ma, et al. Long-Term Outcomes of Fractionated Stereotactic Radiotherapy (FSRT) For Pituitary Adenomas at the BC Cancer Agency (BCCA). International Journal of Radiation, Biology, Physics, Vol 87, No 3, Nov 2013.