The Detection of Early Cancer Evolution

Early cancer detection is critical to improving health outcomes and cancer survival.

About Our project

Liquid biopsy technologies have received substantial attention in recent years owing to the potential benefits for detecting tumors and informing treatment. Proof-of-principle studies have demonstrated the translational potential of circulating cell-free DNA (cfDNA) or circulating tumor cells (CTCs) for prognostication, molecular profiling and monitoring.  Besides CTCs and cfDNA, liquid biopsy analyses can also illuminate the genomic interrogation of hematopoietic cells. Recent evidence from our team and others shows that in a subset of individuals, age related clonal hematopoiesis (ARCH) leads to the generation of pre-leukemic hematopoietic stem cells (HSCs) and eventual leukemia development. Early detection of these events is key to improving health outcomes and patient survival.

The Detection of Early Cancer Evolution project aims to assess the sensitivity of early-detection genomic tools to enable early-cancer genomic research and support the development of preventative early-diagnostic tools. We focus on genomic characterization of early cancer progression by leveraging a number of major resources within the OICR, Ontario and the national cancer community. By exploiting Canada’s national longitudinal population cohort, the Canadian Partnership for Tomorrow Program (CPTP) which has access to biologics and administrative health and linkage data for over 315,000 Canadians, we can identify stored blood samples from incident cancer case participants at varying times and ages before diagnoses. We are developing with OICR’s Genomics Program deep-coverage targeted sequencing to capture genomic signatures of clonal hematopoiesis as well as developing ct/cfDNA tools. These resources will facilitate the study of early stage genomics and the development of pre-diagnostics that can detect cancer progression before a “traditional first diagnosis”. Working with clinical partners at Princess Margaret Hospital and the University Hospital Network, we will begin the necessary work to both cope with incidental findings and translate these developments into clinical early detection and intervention.



Our goal is to evaluate large population cohorts with advanced genetic analyses to identify risk factors and mechanisms of progression to disease, develop genomic tools, and implement analytical methods for prediction of risk for progression to disease in the clinical setting.

Collaborate with Us

We welcome collaborations with cancer researchers across Canada and internationally.

Our Team

Dr. John Dick

  • Co-Investigator, PMH

Dr. Daniel De Carvalho

  • Co-Investigator, PMH

Dr. Trevor Pugh

  • Co-Applicant, PMH

Dr. Jared Simpson

  • Co-Applicant, OICR

Dr. Mark Minden

  • Co-Applicant, PMH

Dr. Aaron Schimmer

  • Collaborator, PMH

Dr. Michael Farkouh

  • Collaborator, UHN

Dr. Nicole Mittmann

  • Collaborator, Sunnybrook Health Sciences Centre