2019-20 DMOH Annual Report

019-20 ANNUAL
REPORT

DIVISION OF MEDICAL

ONCOLOGY & HEMATOLOGY

Message from

Dr. Amit Oza

2019-20 was another great year for our division. Over
the past year we welcomed 10 medical oncologists
and malignant hematologists, one hematologist in the
Blood Disorders Program, two hospitalists and four
physician assistants. We also said goodbye to three
of our long-standing faculty, who retired. We saw
the further expansion of our cell therapy program,
managed an increasingly complex patient population
and continued to see our clinic volumes increase.
In June 2019 we held a strategic retreat where we
redefined our goals for the next five years. Sadly, the
COVID-19 pandemic spread to Canada near the end of
the fiscal year; impacting our patients, operations and
volumes. Thank you to all of our physicians, trainees,
allied health professionals and support staff for all of
their hard work and dedication to our patients.

Dr. Amit M. Oza
Professor of Medicine, University of Toronto
Head, Division of Medical Oncology and Hematology
Director, Cancer Clinical Research Unit
Director, Bras Drug Development Program

Table of

Contents

4 Divisional Overview
7 Blood Disorders Program
8 Solid Tumour
9 Malignant Hematology
10 Urgent Care
11 Quality
14 Research
20 Education
23 Notables

Divisional Overview

The Division of Medical Oncology and Hematology (DMOH) is comprised of four main service lines and 15 different
disease site groups at the Princess Margaret Cancer Centre, Toronto General Hospital and Sinai Health System
(SHS). It is the largest Division in the joint UHN/SHS Department of Medicine responsible for systemic therapy for
cancer, novel therapeutics, and immunotherapy.

ƒƒ Medical Oncology
ƒƒ Malignant Hematology
ƒƒ Hematology (Blood Disorders Program)
ƒƒ Medical Genetics

DMOH treats complex solid tumour cases and boasts the largest Malignant Hematology Programs in leukemia,
lymphoma and myeloma, as well as Blood and Marrow Transplantation Program within Canada.

Divisional Leadership

Executive

Amit Oza
Division Head

Lillian Siu Monika Richard Ward Jennifer Knox Eitan Amir Rajat Kumar Christine
Director, Special Krzyzanowska Director, Blood Director, Solid Tumour Director, Education Director, Malignant Brezden-Masley
Research Portfolios Director, Quality Disorders Program Director, Sinai Health
Oncology Program Program Hematology Systems Oncology
Program Program
Program

Quality Research Administration Education

Victoria Glinsky Melanie Berger James Austin Sarah Coyle Penny Bradbury
Alyssa Macedo Nishita Parekh Manager, Solid Tumour, Manager, Malignant & Blood Vikas Gupta
Jennifer Ryan Lindsay Philip
Quality & Education Disorders Program Santhosh Thyagu
4| Programs
Martha Cucullo Walaa Kheir
Michelle Williams Administrative Lianne Mulveney
Divisional Coordinator Supervisor
Coordinators

Mandy McDonald
Administrative
Coordinator

Site Leadership Malignant Hematology

Solid Tumour

Eitan Amir Warren Mason Monika Krzyzanowska Jonas Mattsson Christine Chen Karen Yee
Breast CNS Endocrine Allo BMT Auto BMT Leukemia

Eric Chen Aaron Hansen Stephanie Lheureux Anca Prica Donna Reece Armin Gerbitz
GI GU GYN Lymphoma Myeloma Orsino CPL

Anna Spreafico Lillian Siu Albiruni Razak
Head & Neck Phase I Sarcoma

Marcus Butler Natasha Leighl
Skin Thoracic

|5

2019-20 The Year in Numbers

Service Lines Malignant Solid Tumour Systemic Therapy Volume
Hematology
Blood Disorders  Breast 46000
Program  Allo Blood & Marrow  CNS 42000
Transplant  ENT / Head & Neck
 Apheresis  Endocrine 38000
 General Hematology  Leukemia  Gastrointestinal
 Maternal-Fetal  Lymphoma, Myeloma,  Genitourinary 34000
 Gyne
Hematology Auto Blood & Marrow  Lung 30000
 Red Blood Cell Transplant  Sarcoma 2013
 Thrombosis &  Skin & Melanoma
 Phase I 2014 2015 2016 2017 2018 2019
Hemostasis

Cancer Susceptibility/Genetics Outpatient Volume

105000

97500

90000

82500

101,067 34,497 44,685 489 75000 2014 2015 2016 2017 2018 2019
2013
outpatient inpatient courses of Blood & marrow
clinic visits# days* chemotherapy transplants performed
(stem cell; auto & allo)*
delivered*
*Fiscal & #calendar year
Inpatient Volume

35000

32500

Medical Oncologists & Hematologists 30000
Malignant Hematologists
11 27500
70
Medical Geneticists 25000 2014 2015 2016 2017 2018 2019
Hospitalists 2013
4
8 Team
DMOH Clinical Fellows
Clinical Associates
& Affiliate/Associate ~70

Physicians Physician Assistants

24 10

Practitioners, Nurses,
Allied Health, Trainees

150

6|

Blood Disorders Program

Richard Ward The Blood Disorders Program (BDP) is dedicated to managing complex, serious
Physician Lead diseases of the blood that do not require intensive chemotherapy. The BDP has an
interprofessional approach to patient care divided into six main areas described
below. The team consists of active and associate/affiliate staff at UHN/SHS, nurse
practitioners, a social worker, a transition navigator, a physician assistant, and fellows.
Registered nurses provide primary care on the outpatient treatment units. Fellows
specializing in hematology gain clinical and scholarly experience not obtainable
elsewhere in Canada.

2019-20 Snapshot

Outpatient Volume

13000

11750 11,214
10500

9250

8000 2014 2015 2016 2017 2018 2019 General Hematology
2013
3429

Clinic
Type

Thrombosis & Hemostasis

5758

Red Blood Cell Disorders

2027

*TGH ambulatory clinic visit statistics

|7

Solid Tumour

Jennifer Knox The Solid Tumour service is comprised of 11 site groups: Breast, Endocrine, Head &
Head of Solid Neck/ENT, Gyne, Gastrointestinal (GI), Genitourinary (GU), Lung, Melanoma, Neuro-
Tumour Oncology Oncology (Neuro), Sarcoma and Phase I. There are 36 active staff at UHN/SHS. We
are comprised of clinical and translational research-focused practices; implementing
innovative and complex patient trials for incurable cancers. Key highlights from 2019-
2020 included:

ƒƒ Implementation of bullet rounds and inpatient care guidelines
ƒƒ Approximately 8% growth in outpatient clinic visits vs. 2018

2019-20 Snapshot

Outpatient Volume

60000

55000

50000

57,372 45000

outpatient 40000 2014 2015 2016 2017 2018 2019
clinic visits# 2013

Inpatient Volume

10000

6,283 ~25 8000

inpatient average daily 6000
days* census

4000

*Fiscal & #calendar year (PM statistics)

2000 2014 2015 2016 2017 2018 2019
2013

8|

Malignant Hematology

The Malignant Hematology Service Outpatient Volume
consists of Allogeneic Blood and
Marrow Transplant (Allo BMT), 32500
Leukemia, and Lymphoma,
Myeloma and Autologous Blood 30250
and Marrow Transplant (LMT).
There are 34 active staff at UHN/ 28000
SHS. Key priorities in 2019-2020
Rajat Kumar included: 25750
Head of Malignant
ƒƒ Cell Processing Lab (CPL) 23500
Hematology Expansion: Clinical and 2013
Research
2014 2015 2016 2017 2018 2019
ƒƒ Development of Cellular
Therapy Immune Effector Inpatient Volume
Cell (IEC) Unit
30000

28500

27000

25500

24000 2015 2016 2017 2018 2019
2013 2014

2019-20 Snapshot Auto Stem Cell Transplant Volume

360 Total
270 Outpatient
180 Day-1 Transfer
Inpatient

32,481 28,214 90

outpatient inpatient 0
clinic visits# days* 2013 2014 2015 2016 2017 2018 2019

Allo Stem Cell Transplant Volume

200 Total
150 Related
Haplo
~80 489 Unrelated

average daily Blood & marrow 100
census transplants performed
(stem cell; auto & allo)* 50

*Fiscal & #calendar year (PM statistics) 0 2014 2015 2016 2017 2018 2019
2013

|9

Urgent Care 2019-20 Snapshot

The Al Hertz Urgent Care clinic (UCC) is a comprehensive acute 2,111 10
care management clinic for PM cancer patients. The clinic is
open from 9am-8pm Monday to Friday and houses 7 beds and 3 patient average daily
chairs. The UCC is a unique program within the global cancer care visits* census
landscape. As such, staff are continually sought after by provincial,
national, and international centres who are eager to duplicate this ~40% ~60%
highly innovative and patient-centred approach. Key goals of UCC
include: malignant solid tumours

ƒƒ Decant acutely ill patients from ambulatory clinics hematology *2018-19 data
ƒƒ Provide early intervention to minimize hospital
Discharged Home
admissions
ƒƒ Decrease emergency referrals and hospital 65%

admissions

Future goals of the UCC include:

ƒƒ Continuing to evaluate urgent care capacity needs
and challenges

ƒƒ Implementing a drop in model for patients calling in
from home

ƒƒ Exploring opportunities for innovation including
implementing quality improvement initiatives

ƒƒ Creating a resuscitation bay to best support our code
medical emergency patients

Patient Admitted to PM
Outcome
13%

Admitted to TGH ED

16%

Admitted to TGH GIM

6%

10 |

Quality

DMOH has a very active Quality Committee Mission
with 28 inter-professional members involved in
evaluation and improvement of the quality of ƒƒ To meet core UHN/PM Quality and safety priorities
care delivered by members of DMOH.
ƒƒ To promote a culture of quality and safety within the DMOH

ƒƒ To become an academic leader in quality improvement in
medical oncology and hematology

Performance Indicators

There are four priority performance metrics routinely tracked and reported by DMOH Quality. These have been selected in line with
key internal and external priorities. Below is an update on current state and developments over the last year. All performance metrics
were on target or close, except for Hepatitis B Screening.

Chemotherapy Consent Discharge Summary Note
Compliance Completion

99% 82%

of patients had evidence of of patients had a discharge
informed consent in EPR# summary note completed

(Goal: 100%) within 48 hours of dis-
charge* (Goal: 79%)

Cancer Care Ontario Referral Hepatitis B Screening *As of Q1 2020
to Consult Wait Times #As of June 2019
81%
82% | 11
of patients starting system-
of new consults were seen ic therapy were screened
by a DMOH physician with- for Hepatitis B*
in 14 days from receipt of (Goal: 100%)

referral* (Goal: 80%)

Quality Improvement

There are several quality improvement initiatives that have made great progress in the past year. Below is an update on current
state and developments over the last year.

DMOH Quality An important component of promoting a healthy safety culture is to share learnings from
of Care Rounds safety events broadly. DMOH has established a robust process for sharing learnings relevant to
DMOH clinicians in our Quality of Care Rounds. Last year we held a record breaking six Quality
of Care Rounds under the leadership of Rebecca Prince, with attendance of the majority of
staff. Major benefits of these rounds include the ability to translate learnings into practice and
collaboratively discuss recommendations to enhance the quality of patient care.

Ambulatory In 2019, DMOH Quality shifted gears from focusing on inpatient to ambulatory care provision.
Scoping Review With the goal of delivering high quality ambulatory care to improve both patient and staff
experiences, we completed 20 interviews with DMOH site leads. A comprehensive thematic
analysis was completed. There were six high-level themes developed:

ƒƒ Defining Who We Are
ƒƒ Broadening Engagement with Administration
ƒƒ Enhancing Partnerships with our Patients
ƒƒ Optimizing Physical Tools and Space
ƒƒ Improving Role Clarity
ƒƒ Advancing Work Processes

These themes align with the PM Strategy and will be actioned through Cancer Executive.

New Oncology A New Oncology Early Warning System (NOW) for Princess Margaret has been established by
Early Warning Tracy Murphy, Victoria Glinsky, Lisa Tinker and Maggie Dilling and supported by a wide
System (NOW) range of inter-professional members across the organization.

The initiative aims to provide clear guidance for when to escalate to the appropriate medical
professional, to ensure deteriorating patients on inpatient oncology units are identified and
treated in a timely fashion. The initiative has recently received excellent reception at the
UHN-level and as a result, has been funded over 500K internally for the next phase of digital
implementation of the NEWS2 scoring system.

12 |

Cancer Quality Adverse drug events are common in ambulatory oncology where care spans multiple providers
Lab (CQual) and medication documentation is often poor.

Ahead of accreditation in September 2019 and aligned with UHN’s Caring Safely initiative,
Monika Krzyzanowska and Celina Dara piloted and evaluated the use of an electronic
medical record-integrated tool (EMITT) to facilitate medication reconciliation for patients
initiating systemic therapy. During the pilot, 9.4% of all patients starting systemic therapy at
PM had a reconciled medication list in the electronic medical record system. Findings will be
presented at the ASCO Quality Care Symposium in September 2020.

What’s on the Horizon

The next year will bring many new opportunities and innovation as we enhance the models of care by exploring new ambulatory
approaches to care to improve the experience for both patients and staff, and implementing the inpatient standards with a
collaborative, systematic approach.

| 13

Research

DMOH has 53 clinician investigators, 12 clinician scientists, 18 clinician teachers/educators, 2 clinicians in quality and innovation, and
1 clinician administrator. Together, we are one of the most productive divisions in the Department of Medicine at the University of
Toronto.

Cellular Therapy Program 2019-20 Snapshot

What is Cellular Therapy? Clinical Trials

Cellular therapy involves the use of intact, live cells that are 10 total cell therapy
infused into patients as therapy. Chimeric antigen receptor trials currently open
(CAR) T-cell therapy is a break-through form of immune 4 CAR T-cell trials
effector cell (IEC) therapy that has shown impressive activity
across a wide array of cancers with potential for cure. Two 15 cellular therapy trials
products will be available at PM as standard of care: Kymri- pending
ah™ (ALL and DLBCL) and Yescarta (DLBCL).

Notable Highlights Patient Breakdown*

ƒƒ As of Januaray 2020, an inpatient cell therapy unit 14 CAR T-cell
(6 beds opened for all CAR-T and other cell therapy 25 engineered T-cell
patients (including those on study) cared for by an
interprofessional team with cell therapy experience 2 T-cell

ƒƒ Cell therapy clinic for new referrals was opened in *Patients treated from August 2018 to January 2020 at UHN
February 2020

ƒƒ Site Activation was finalized with Novartis and Kite Gilead
ƒƒ FACT accreditation was achieved for Allogeneic,

Autologous, Immune Effector Cell therapy and the
Manufacturing Laboratory

Patient Pathway

Triage Pre-Infusion Collection & Lymphodepleting Post-Infusion
Manufacturing Chemotherapy &
Cell Therapy Cell Therapy Acute: Auto Day
MDs Clinic Apheresis Infusion Unit

15B Inpatient Long term: Cell
Unit Therapy Clinic

14 |

Myeloproliferative Neoplasm Program

Vikas Gupta Since 2014, The Elizabeth and Tony Comper Myeloproliferative Neoplasm (MPN) Program is a national
Program Director resource for patients with myeloproliferative neoplasms and is the largest program of its kind in Canada.
Clinical care and research is seamlessly integrated. The program director is Vikas Gupta.

The MPN Program’s focus of expertise on rare blood disorders has attracted talented national and
international fellows. As part of their fellowship, fellows conduct MPN research and are a key driving force
behind the MPN Program. For example, fellows are key to the development and continuation of national
MPN rounds held by the MPN Program.

The MPN Program’s Clinical Research Fellowship is an intensive, highly competitive and comprehensive
program training the next generation of MPN experts. It is designed to train physicians as leaders in the
field of myeloid malignancies with a focus on MPN. Past fellows have gone on to become staff members
at Princess Margaret and other teaching hospitals and cancer centres internationally. Current fellows are
listed below.

Marta Davidson completed her PhD at the University of Toronto and residency at
the University of Calgary. Dr. Davidson’s research is focused on characterizing MPNs
more deeply, at a clinical and biological level, to gain a better understanding of disease
complications and outcomes. Specifically, she is studying the clinical and molecular
factors leading to the development of portal hypertension in MPN patients, which
causes significant morbidity and mortality. She is also investigating treatment outcomes
for MPN patients who develop secondary leukemias.

James England completed his Internal Medicine and Haematology training at the
University of British Columbia before joining the MPN program. Dr. England has a goal
to improve care for MPN patients in British Columbia and will aim to bring the skills and
experience from Dr. Gupta and the Princess Margaret MPN program back out west.
Dr. England has a research focus including the impact of genetic mutations on clinical
course and targeted therapy.

Karine Gauthier completed her training in Internal Medicine and Haematology at the
University of Ottawa before joining the MPN program. She decided to pursue further
training in MPN at Princess Margaret Cancer Centre to gain clinical and research
expertise in the largest program of its kind in Canada. Dr. Gauthier has a research
background in thrombosis, which is a leading driver of morbidity and mortality for
people with MPNs. Her research interests will focus on the prevention of thrombotic
events in patients with MPNs with the goal of improving the quality of care via a
multidisciplinary approach. Dr. Gauthier’s long-term goal will be to better understand,
prevent, and manage thrombosis in people living with MPN locally, and contribute to
national guidelines and strategies by collaborating with the Canadian MPN Network.

| 15

Bras Drug Development Program – Phase I

Lillian Siu Mission
Program Director
Conduct innovative, coordinated, efficient, regulatory-compliant and high impact
early phase clinical trials in experimental therapeutics evaluating immuno-oncology,
molecularly targeted and novel cytotoxic anticancer agents.

The Princess Margaret Cancer Centre Solid Tumors Phase and neck cancer, sarcoma, colorectal cancer, breast cancer and
I Program is one of the most active early phase drug melanoma. Also in 2019, Aaron Hansen has demonstrated
development programs in the world. It has been involved in the the feasibility of measuring patient-reported outcomes in
development of some of the most exciting immuno-oncology patients enrolled in phase I clinical trials, and further research
and molecularly targeted compounds, leveraging the expertise are ongoing using this type of patient-centric measures of their
in the Cancer Genomics Program and Tumor Immunotherapy symptoms in clinical trials.
Program at the Princess Margaret. The Phase I Program
consists of nearly 50 team members and is operationally The Phase I Drug Development Program Fellowship, directed
supported by the Correlative Science Program which handles, by Anna Spreafico, attracts early career oncologists from all
processes and ships biological samples collected in clinical over the world who spend two years at the Princess Margaret
trials. In 2019, the Phase I Program developed several Cancer Centre to learn about clinical trial planning and
subspecialized groups, one of which is the evaluation of implementation, as well as translational research in precision
oncolytic viruses which have become an attractive therapeutic medicine, cancer genomics and immunology. In 2019, our
in the immuno-oncology field. Albiruni Razak leads this group trainees successfully obtained recognition for their work
and coordinates the administration of these agents with the including American Society of Clinical Oncology (ASCO)’s Young
support of interventional radiology and the University Health Investigator Award and Merit Award, University of Toronto’s
Network Biosafety Committee. Hold ‘em for Life Fellowship, Novartis Oncology Young
Investigator Award, among others.
In 2019, the Phase I Program developed a novel electronic,
smart phone-enabled, password-restricted platform, called The Phase I Program is the preferred partner of excellence
Phase One Spot Tracker (POST), which functions as a research for many large pharmaceutical sponsors for first-in-human
engine to locate available trial spots, store trial-specific and combination trials. It holds memberships in many existent
information and track operational metrics. For example, research alliances with industry such as AstraZeneca’s
accrual data are readily available at our finger tips - in 2019, the Partner of Choice, Genentech/Roche’s imCORE network
top five tumor types enrolled by the Phase I Program are head and GlaxoSmithKline’s Oncology Clinical and Translational

16 |

Consortium. Drs. Philippe Bedard and Lillian Siu are the co- (NCI)’s Experimental Therapeutics Clinical Trials Network.
contact Principal Investigators of the North American Star
Consortium (NASC), which is a network of six comprehensive An annual phase I retreat is held by the Phase I Program
cancer centres to design and conduct adult cancer clinical to brainstorm about new ideas to improve efficiency and
trials. The Princess Margaret Cancer Centre is the only enhance research output from the team. This retreat is the
institution outside of the US to lead this 6-year multi-centre highlight event for the Program and is traditionally followed by
Phase I grant, supported by the US National Cancer Institution an evening of team building fun activities.

2019-20 Snapshot

Clinical Research

Fellows Dedicated Trial Nurses

Grants & Contracts Specialist 7 7

1 Pharmacokinetic Nurses

237 Financial Analyst Phase I 2 Physicians
Team
new patients 1 Investigational Drug Lillian Siu
enrolled Pharmacist Phillippe Bedard
Tissue Analyst for Aaron Hansen
23 Molecular Screening 1 Albiruni Razak
Anna Spreafico
new clinical trials 1 Program Managers
opened
Administrative 2
Support Staff
Clinical Study Assistant Program
3 Coordinators Managers

Regulatory Coordinators 13 2

2

Research Analyst

1

| 17

Bras Drug Development
Program – Phase II

Amit Oza 2019-20 Snapshot
Program Director
Coordinators Phase II Research Study Assistant
Drug Development Program Phase II – Canada’s Team
largest and premier early phase drug development 21 2
program and one of the top 10 worldwide. The PM
Phase II Consortium has been the first Canadian Research Students
centre to carry out National Cancer Institute (NCI)-
sponsored phase II clinical trials of new anti-cancer 2
drugs, and the only non-US based consortium. The
PM Phase II Consortium is part of the Bras Drug Managers
Development Program (DDP) at Princess Margaret
Cancer Centre, an umbrella program under which the 2
Consortium operates.
Start-Up
The Program in known to Lead a network of Coordinator
Cancer Centres across Canada and is focused on
managing multi-centred Investigator Initiated trials 1
and Intergroup trials. It collaborates with other
Consortiums across US and Internationally. On Physicians
average, 120-140 active trials across multiple disease
sites open at any one time Stephanie Lheureux
Neesha Dhani
The strength of the program is in its ability to Eric Chen
design study protocols investigating novel single or
combination therapies that patients in Canada would
not be able to access outside the clinical trials.

The department supports and enables Young
Investigators / Fellows engaging in variety of early
phase I and II activities including study protocol design
and writing, clinical trial participation, data analysis,
manuscript writing, as well as presentation of results
at national and international conferences such as the
annual ASCO meeting. As a result DDP II is part of
many publications and has leveraged to attract peer-
reviewed funding from sourced from CCO, CCSRI,
CPAC, NIH, OICR, TFRI, US DoD.

18 |

Wallace McCain Centre for Pancreatic Cancer

Jennifer Knox The Wallace McCain Centre for Pancreatic Cancer is a fully integrated clinical and research program led by
Head of Solid Co-Directors, Jennifer Knox and Steven Gallinger.
Tumour Oncology
Notable Highlights
Steven Gallinger
Surgical Oncologist ƒƒ The McCain Centre sees over 400 new patients every year, 85% of whom participate in some form of
research. The comprehensive care model including rapid diagnostics, multidisciplinary assessments
and a personalized approach has shown to improve survival for patients with pancreatic cancer which
is poised to be the 3rd leading cause of cancer deaths in 2020.

ƒƒ Building on results from the COMPASS Trial, NeoPancOne, also led by Jennifer Knox, is the first Canadian
clinical trial investigating a neoadjuvant approach for resectable pancreas cancer patients. Funded by
Pancreatic Cancer Canada, the study will open at 11 centres across Canada. “If we can reproduce the
chemotherapy efficacy by GATA6 status seen in the COMPASS trial in the NeoPancOne trial now in the
surgical setting, we could potentially separate patients based on a biomarker to treatment options in
which they could do better. We could give them different chemotherapy, or different regimens. We
could identify patients who could undergo standard chemotherapy and surgery with much better
outcomes than the average statistics. We could suggest different approaches to those not likely to
benefit from the standard approach and by avoiding non-effective therapy, improve quality of life. All
of this is very important for pancreatic cancer patients because the outcomes, in general, are still poor.
This is a way to improve that.”

| 19

Education 2019-20 Snapshot

The Division of Medical Oncology and Hematology is dedicated to Engaged Faculty
providing meaningful educational experiences to undergraduate
and graduate students, residents, fellows and visitors from ~45,000 h
around the world who wish to undertake training in medical
oncology and hematology (benign and malignant) disciplines. of clinical supervision
provided
DMOH fosters a culture of ongoing learning by developing courses
on emerging best practices, novel therapeutic approaches and ~1,800 h
models of care. The division highlights these innovations in
weekly oncology rounds and monthly general internal medicine of formal teaching
teaching sessions on a range of topics pertaining to our inter- provided
professional site group.

Leadership Diverse Learners Blood Disorders Program
Hematology
Eitan Amir Executive Director, DMOH Education Program 97 Malignant Hematology
Medical Oncology
Vikas Gupta Director, Malignant Hematology Fellowship 70 Other
Program total
67
Penny Bradbury Director, Solid Tumour Fellowship Program

Santhosh Thyagu Associate Director,Training and Education;
Assistant Program Coordinator, University of
Toronto Postgraduate Hematology Residency
Program PGY 1-5

Raymond Jang Program Director, University of Toronto
Postgraduate Medical Oncology Residency
Program 21

Elena Elimova Rotation Coordinator, University of Toronto
Postgraduate Medical Oncology Residency
Program PGY 4 & 5

Hassan Sibai Rotation Coordinator, University of Toronto 14--53EleUUcCtlooiiffvnieTTcRRRaleeeFsssiiieldddleeeonnntwttssss
Postgraduate Medical Oncology Residency
Program PGY 1-3

PGY
PGY

20 |

Clinical Fellowship Program

Our fellowship program attracts physicians from around the world. We offer exposure to a busy and challenging clinical practice in
addition to cutting edge research opportunities. At 65-70 fellows strong, we are one of the largest fellowship programs at the University
of Toronto. On Monday June 10, 2019, DMOH gathered to celebrate the physicians who left or were leaving our program in 2019.

Graduating FellowsAdult HeAmllooggleonbeiBnicorBepaMastTthieGsastroinGteesntiitnoaulrGOinynancreoyclooOglnoyLgceoiuclakolegOmyniLacuonloggy LymphomMaelanomMayelomaNeuro OnPchoalsoeg1y Chief Fellows

Wael Alanazi Omar Abduljalil and Ramy Saleh
Reem Alkharras
Ahmad Alotaibi Fellowship Awards
Zeyad Al-Shaibani
Kanan AlShammari Tannock Award Winners
John Aneke Marc Oliva, Ramy Saleh, Sharon Ben Barouch
Taleb Buhlaiaqh
Yu Cai Citizenship Award
Sunu Cyriac Winner: Georgina Daher-Reyes
Georgina Daher-Reyes Runners up: Ivan Pasic and Zachary Veitch
Sophie Feng
Cheryl Foster Paper of the Year
Michael Herman Winner: James Kennedy
Marco Iafolla Runners up: Marc Oliva and Zachary Veitch
Navya Kalidindi
Ana Lohmann
Habeeb Majeed
Brayan Merchan Ruiz
Ayman Mukhtar
Marc Bernal Oliva
Rosemarylin Or
Ivan Pasic
Kirstin Perdrizet
Shruti Prem
Kumar Rishikesh
Jamila RirOmar
Sam Saibil
Queralt Salas Gay
Hyra Sapru
Hadas Sorotsky
Zachary Veitch

| 21

2019-20 Origin Countries of Fellows

Australia 2 France 1 Israel 1 Nigeria 1 Russia 1 Switzerland 1
Honduras 1 Jordan 2 Oman 2 Saudi Arabia 11
Brazil 3 India 7 Korea 2 Pakistan 1 Singapore 1 United Kingdom 3
Ireland 4 Mexico 2 Philippines 1 Spain 2
Canada 17

Colombia 2

22 |

Notables

Leadership Appointments

Eitan Amir – DMOH Breast Disease Site Lead
Eitan Amir assumed the role of Breast Disease Site Lead, DMOH on September 1, 2019. A very special
acknowledgment to David Warr for his notable leadership within the Breast site over the past 4 years.

Michael Crump – CPAC Board Member
Michael Crump joined the Canadian Partnership Against Cancer’s (CPAC) Board of Directors in 2019.

Neesha Dhani – Solid Tumour Medical Oncology Inpatient Ward Chief
Neesha Dhani was appointed as the Solid Tumour Medical Oncology Inpatient Ward Chief in 2019.

David Hogg – UHN Oncology REB Chair
David Hogg was appointed as Chair of the Oncology Research Ethics Board at UHN, effective September 1,
2019.

Monika Krzyzanowska – Medical Lead & Co-Chair of PM Quality Committee
On July 1, 2019, Monika Krzyzanowska replaced Ralph Gilbert as the Medical Lead and Co-Chair of the Princess
Margaret Quality Committee.

Aaron Schimmer – PM Research Director
On February 15, 2019, Aaron Schimmer was appointed the Research Director at the Princess Margaret Cancer
Centre.

Service 5 Years 15 Years 20 Years 25 Years 35 Years
Milestones Bibi Ali John Bryson Christine Chen Nancy Vukovic David Warr
Raymond Jang Aaron Schimmer
Santhosh Thyagu David Barth Lillian Siu

| 23

New Faculty Members Maria Jiang joined the Solid Tumour
Oncology Program in the GU site group in
Zeyad Al-Shaibani joined the Hans November 2019.
Messner Allogeneic Transplant Program on
May 22, 2019. Zachary Liederman joined the Blood
Disorders Program in October 2019.
Sita Bhella joined the LMT group in October
2019. Grainne O’Kane joined the Solid Tumour
Oncology Program on September 18, 2019.
Christine Brezden-Masley was appointed
Medical Director, Cancer Program for Sinai Ivan Pasic joined the Hans Messner
Health and Director of the Marvelle Koffler Allogeneic Transplant Program in November
Breast Centre on July 2, 2019. 2019.

Ada Dominguez joined the DMOH Samuel Saibil joined the Solid Tumour
Hospitalist Program from Lakeridge Health in Oncology Program in the melanoma site
October 2019. group in April 2019.

Nazanin Fallah-Rad joined the Solid
Tumour Oncology Program on October 1,
2019.

Armin Gerbitz joined the Hans Messner
Allogeneic Transplant Program on November
06, 2019.

24 |

Retirements, Departures & New Arrivals William Brien retired from the Blood
Disorders Program in June 2019 after a
Pamela Goodwin retired from her clinical distinguished career at UHN.
practice in July 2019 after a renowned career
at Sinai Health Systems & UHN. Pamela
remains on faculty as an active clinical
and translational researcher within the
Lunenfield-Tanenbaum Research Institute.

Chantale Blattler resigned from her role as Manager to pursue a new opportunity with a pharmaceutical company after 13
years with Drug Development Program (DDP).

Valerie Bowering joined DDP as Program Manager In October 2019.

David Hedley retired at the end of March 2020 after almost 30 years with DMOH. We will always remember him for his
commitment to research, his camaraderie and boundless optimism.

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DMOH Strategic Plan Retreat

In June 2019, DMOH held a retreat focused on establishing
our strategy for 2019-2022. Four main priorities emerged
from this event: (1) reimagine a role in an integrated
service delivery model; (2) re-design models of care and
research based care; (3) attract and retain top talent; and
(4) advance our research strength and streamline research
processes.

PARTNER TO REIMAGINE OUR ROLE IN AN INTEGRATED SERVICE DELIVERY SYSTEM

ƒƒ DMOH will set up a new dedicated cell therapy unit
ƒƒ DMOH at UHN will have a defined and funded capacity building and shared care role for the GTA and province that is endorsed by

Ontario Health and key partners

ƒƒ DMOH will play an active role supporting a consistent level of quality care across the GTA and province through the creation of shared

care models between PMH physicians and community oncologists

ƒƒ DMOH & its partners will be using clearly defined care pathways that enable patients to receive highest quality of care & support

close to home.

ƒƒ DMOH will work with local partners across UHN divisions to create solutions that improve service delivery and support our volumes

LEVERAGE THE INTERPROFESSIONAL TEAM & VIRTUAL CLINICS TO TRANSFORM CARE

ƒƒ DMOH will be using models of care and research that integrate best practices from around the world and fully leverage interprofessional

teams to maximize the best use of resources and meet patient needs and desired experience

ƒƒ Individual sites will use performance data to bring innovations in care and integrate new models of virtual care and consultation.
ƒƒ DMOH will expand use of virtual care and virtual clinics for 30% of patients at some point in their trajectory
ƒƒ DMOH will accelerate how best practices and clinical advances are adopted and integrated

ATTRACT & RETAIN TOP ONCOLOGY & HEMATOLOGY TALENT

ƒƒ The Division will attract and retain top talent with interest and expertise in quality, clinical care, research and teaching.
ƒƒ DMOH will be known as a great collegial environment to practice, teach, learn, research and build a career.
ƒƒ DMOH will be a preferred division with high provider satisfaction & where the members feel valued both in their academic & clinical

streams.

ƒƒ Fellowship programs will be aligned with the expectations of incoming fellows (i.e. time for research, clinical workload, etc.)
ƒƒ DMOH will ensure that fellows meet the criteria set by the Department of Medicine for appointment and actively recruit for the jobs

available in the division

ADVANCE RESEARCH STRENGTH & STREAMLINE RESEARCH PROCESSES

ƒƒ DMOH will streamline the process for initiation and maintenance of investigator initiated and non-pharma research studies to further

build on the base of research currently being done across PMH and UHN.

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Select Awards & Distinctions Notable Grants

ƒƒ Dave Cescon: 2020 Conquer Cancer-Breast Cancer ƒƒ Dave Cescon: Development of a novel mesothelin CAR-T
Research Foundation Advanced Clinical Research Award immunotherapy and pharmacologic combinations for
triple negative breast cancer (Co-PI with Naoto Hirano).
ƒƒ Georgina Daher-Reyes: American Society of CIHR Project Grant
Hematology Achievement Award (Supervisor: Dennis
Kim) ƒƒ Dennis Kim: Clonal stromapoiesis and BM
microenvironment in leukemias and HCT. CCS Innovation
ƒƒ Nazanin Fallah-Rad: 2020 University of Toronto Grant
Division of Medical Oncology Outstanding Teaching
Award; appointed as a DMOH Fellowship Teaching ƒƒ Robert Kridel: Translational Research Program Grant,
Program Coordinator Operating Grant, and New Idea Award. Leukemia &
Lymphoma Society of Canada
ƒƒ Armand Keating: Inaugural Fellow of the American
Society for Transplantation and Cellular Therapy ƒƒ Kevin Kuo: National Institutes of Health (NIH) R33 Grant
ƒƒ Natasha Leighl: Achieving VALUE in Cancer Diagnostics:
ƒƒ Natasha Leighl: 2019 American Society of Clinical
Oncology Excellence in Teaching Award blood versus tissue molecular profiling – a prospective
Canadian study. Guardant Health, California for
ƒƒ Kirstin Pedrizet: 2019 ASCO Conquer Cancer Investigator-Initiated Multicentre Trials
Foundation Merit Award and Novartis Young Canadian ƒƒ Geoffrey Liu: Breathomics as a non invasive, inexpensive,
Investigator Award (PI: Natasha Leighl) point of care predictive test for immune checkpoint
inhibitor efficacy. CCSRI Innovation Grant
ƒƒ Frances Shepherd: Honourary Doctor of Laws from the ƒƒ Geoffrey Liu: Lung cancer early detection and
University of Ottawa and 2019 Israel Cancer Research classification using methylome analysis of plasma cell
Fund Women of Action Award free DNA (Co-PI with Scott Bratman). CIHR Operation
Grant
ƒƒ Lillian Siu: 2020 European Society for Medical Oncology ƒƒ Geoffrey Liu: 2BLAST Data Science Catalyst Grant.
Targeted Anticancer Therapies Honourary Award Princess Margaret Data Science Program
ƒƒ Geoffrey Liu: CARMA-BROS – Canadian rare molecular
ƒƒ Santhosh Thyagu: 2019-20 University of Toronto alteration basket-umbrella real-world observational
Wightman-Berris Academy Award for Post Graduate study. Takeda
Education and 2019-20 UHN/SHS Leading Change in ƒƒ Adrian Sacher: Mucosal associated invariant T-cells as
Medical Education Award key mediators of anti-tumour immune responses and
the microbiome effect in non-small cell lung cancer. CIHR
Project Grant
ƒƒ Adrian Sacher: An exploratory evaluation of the
evolution of the tumor immune microenvironment in
hepatocellular carcinoma and non-amall cell lung cancer
with liver metastases treated with Atezolizumab and
Bevacizumab (INTEGRATE) (Co-PI with Jennifer Knox).
imCORE
ƒƒ Lillian Siu and Philippe Bedard: Renewal of Phase
I Grant. US National Cancer Institute Experimental
Therapeutics Clinical Trials Network

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Division of Medical Oncology & Hematology
Princess Margaret Cancer Centre
610 University Avenue
Toronto ON M5G 2M9 Canada

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