The ability to predict how a tumour will behave is a critical part of planning treatment. The grade of a tumour—a category assigned based on how aggressive the cancer is expected to be—can help. However, sometimes these categories do not reliably capture the behaviour of a tumour, which can make predicting patient outcomes and planning appropriate treatment a challenge.
Clinicians have long faced these issues when grading meningiomas, tumours that come from the membranes that surround the brain and spinal cord (called the meninges). In a new study from UHN’s Princess Margaret Cancer Centre (PM), researchers may have found a way to resolve this issue and make grading meningiomas significantly more reliable. The team, led by Drs. Gelareh Zadeh and Farshad Nassiri, an Affiliate Scientist and Scientist, respectively, at PM, found that meningiomas with certain chromosomal changes called copy number alterations (CNAs)—in particular a 1p loss (a loss of the first half of chromosome 1) or 1q gain (a copy gain in the latter half of chromosome 1)— behave more aggressively than their grade would predict. As a result, these tumours may not be receiving the best treatment, negatively impacting patient outcomes.
“Improving care for patients begins with ensuring that we accurately evaluate their tumour and predict how it will behave,” remarks Dr. Nassiri. “We’ve been studying genetic changes in meningiomas and how they impact tumour biology for years,” notes Dr. Alexander Landry, one of the first authors of the study, “but translating these discoveries has proved to be a challenge thus far.” “Our work offers a way to improve meningioma grading in clinical practice today without requiring tests that are impractical in most cancer care settings because they’re prohibitively expensive or need specialized technology and staff not available everywhere,” adds Dr. Zadeh.
This work highlights the critical need to improve the WHO grading system for CNS tumours like meningiomas, such as by incorporating genetic features like CNAs into grading criteria. Because meningiomas are one of the most common types of brain cancer in adults, rectifying the inconsistency in the current system could significantly improve care for a large population of patients with a challenging diagnosis and offer more patients a better chance at life after meningioma.
Drs. Alexander Landry and Justin Wang, the first authors on this study, are Graduate Researchers at the Princess Margaret Cancer Centre (PM), as well as Doctor of Philosophy candidates and neurosurgery residents at the University of Toronto.
Drs. Gelareh Zadeh and Farshad Nassiri are the senior authors on this study. Dr. Zadeh is an Affiliate Scientist at PM, a neurosurgeon at UHN’s Toronto Western Hospital (TWH), a Professor in the Faculty of Medicine at the University of Toronto, and the Chair of Neurosurgery at the Mayo Clinic. Dr. Nassiri is a Scientist at PM, a neurosurgeon at UHN in the Sprott Department of Surgery and a neurosurgeon at TWH, and an Assistant Professor in the Faculty of Medicine at the University of Toronto.
This work was supported by the International Consortium of Meningiomas, Brain Tumour Charity UK, CCS, Canadian Institutes of Health Research, and the Princess Margaret Cancer Foundation.
Landry AP‡, Wang JZ‡, Patil V, Liu J, Gui C, Ellenbogen Y, Ajisebutu A, Yefet L, Wei Q, Singh O, Sosa J, Mansouri S, Cohen-Gadol AA, Tabatabai G, Tatagiba M, Behling F, Barnholtz-Sloan JS, Sloan AE, Chotai S, Chambless LB, Mansouri A, Makarenko S, Yip S, Ehret F, Capper D, Tsang DS, Moliterno J, Gunel M, Wesseling P, Sahm F, Aldape K, Gao A, Zadeh G#, Nassiri F#. Chromosome 1p Loss and 1q Gain for Grading Meningioma. JAMA Oncol. 2025 April 3. doi: 10.1001/jamaoncol.2025.0329.
‡Contributed equally as first authors.
#Contributed equally as senior authors.
Artificial intelligence (AI) is transforming health care, offering new ways to enhance patient care and streamline clinical workflows. However, many health care professionals (HCPs) lack adequate training to effectively integrate these tools into their practice. A recent study from The Institute for Education Research at UHN explored gaps in AI education and proposed key strategies for improvement.
To better understand these challenges, researchers conducted 17 in-depth interviews with educators and learners in AI programs designed for HCPs. The findings highlighted three key areas needing improvement:
First, educators emphasized the need for ongoing AI education to help HCPs build knowledge and adapt to this rapidly evolving field. Second, HCPs preferred active learning approaches that allowed them to apply their learning to real-world scenarios through case studies, group-based learning, and discussions. And third, educators noted that curriculum design should be multidisciplinary and include diverse groups of learners and educators to ensure training aligns with industry demands and HCP needs.
Based on these insights, the researchers proposed several recommendations for health care leaders and medical education experts to guide the integration of AI into existing education:
● Implementing a structured, staged approach to AI education, starting with foundational knowledge and lifelong learning.
● Prioritizing interprofessional training to foster a collaborative, team-based approach to providing optimal care.
● Integrating equity, diversity, and inclusion principles to ensure the safe and responsible use of AI tools while preventing biases in care.
● Using clinical data to continuously assess learning needs and improve practice.
● Establishing organizational policies to support the ethical use of AI-related data for training, ensuring learners gain exposure to real-life scenarios.
As AI becomes more embedded in health care, ensuring HCPs are well-equipped is crucial. Rethinking AI education can foster a workforce that confidently and responsibly integrates AI, improving patient outcomes and advancing the future of medicine.
Tharshini Jeyakumar is the first author of the study and a PhD student at the University of Toronto.
Dr. David Wiljer is the senior author of the study, an Educational Investigator at The Institute for Education Research at UHN, and a Scientist at the Wilson Centre. Dr. Wiljer is also a Professor in the Department of Psychiatry in the Temerty Faculty of Medicine and the Institute of Health Policy Management and Evaluation at the University of Toronto.
This work was supported by UHN Foundation, the Future Skills Centre, and the Vector Institute.
Jeyakumar T, Balakumar S, Younus S, Clare M, Charow R, Al-Mouaswas D, Dhalla A, Gillan C, Jardine J, Akinli Kocak S, Mattson J, Salhia M, Tavares W, Zhang M, Wiljer D. Learning to Teach AI: Understanding the Needs of Healthcare Professionals. Stud Health Technol Inform. 2025 Feb 18. doi: 10.3233/SHTI250013.
Welcome to the latest issue of the Research Spotlight.
As Canada’s largest research hospital, UHN is a national and international source for discovery, education, and patient care. This newsletter highlights top research advancements from over 5000 members of TeamUHN—a diverse group of trainees, staff, and principal investigators who conduct research at UHN.
Stories in this month’s issue:
Read these stories and more online here. To read previous issues, see the newsletter archive.
Excessive bleeding is a common complication of cardiac surgery that can increase the risk of mortality. In a recent clinical trial, researchers at the Toronto General Hospital Research Institute (TGHRI) found that a drug called prothrombin complex concentrate (PCC, which goes by the brand name Octaplex®/Balfaxar®) is more effective at treating this complication than current treatments.
One important contributor to excessive bleeding after cardiac surgery is the depletion of enzymes that help blood clot. The standard treatment for this complication is the transfusion of frozen plasma (FP)—the liquid part of blood that contains clotting factors and is frozen for later use.
However, data on FP's effectiveness is limited, and it can cause life-threatening complications such as serious allergic reactions, transfusion-related acute lung injury, and transfusion-associated circulatory overload.
Recent preliminary data suggests that PCC, which is derived from large plasma pools and contains blood clotting factors and other proteins, may be a safer alternative to FP. A recent pilot study by a research team, led by Dr. Keyvan Karkouti, Senior Scientist at TGHRI, found that PCC may be more effective than FP in treating bleeding without increasing risk.
To confirm these results and determine PCC’s safety and efficacy in a larger, randomized trial, Dr. Karkouti’s team studied 420 adult cardiac surgery patients who required clotting factor replacement due to excessive bleeding after their procedure. They found that PCC was better than FP at stopping bleeding (77.9% versus 60.4% effectiveness). Serious adverse events were also less common (36.2% versus 47.3%), as was acute kidney injury (10.3% versus 18.8%).
“These findings indicate that PCC is a potential new treatment for managing bleeding in cardiac surgery. PCC benefits both patients and the health care system by reducing bleeding and the need for transfusions,” says Dr. Karkouti, co-lead of the study. "However, the clinical and financial impacts of this change need to be assessed in future studies.”
Dr. Keyvan Karkouti, Senior Scientist at the Toronto General Hospital Research Institute (TGHRI) and Professor in the Department of Anesthesiology and Pain Medicine at the University of Toronto (U of T), is the corresponding and co-first author of the study.
Dr. Jeannie L. Callum, Professor in the Department of Pathology and Molecular Medicine at Queen’s University and Associate Scientist at Sunnybrook Health Sciences Centre, is a co-first author of the study.
Authorship for this study also includes the FARES-II study group.
This work was supported by Octapharma AG, the Canadian Institutes of Health Research, the Department of Anesthesiology and Pain Medicine at the University of Toronto, and UHN Foundation.
The trial was conducted jointly by Octapharma AG (the sponsor), the Department of Anesthesia and Pain Management Clinical Trials Unit (ACTU) at UHN, and Ozmosis Research Inc.
Karkouti K, Callum JL, Bartoszko J, Tanaka KA, Knaub S, Brar S, Ghadimi K, Rochon A, Mullane D, Couture EJ, Lin Y, Harle C, Zeller M, Tran DTT, Solomon C, Rao V, Law M, Butt AL, Chen EP, Martins MR, Saha T, Shih AW, Vézina MC, Moussa F, Pereira Cezar Zamper R, Syed S, Buyukdere H, Werner S, Grewal D, Wong D, Vandyck KB, Tanzola R, Hughes B, Royer O, Wong S, Levy JH; FARES-II Study Group. Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery: The FARES-II Multicenter Randomized Clinical Trial. JAMA. 2025 Mar 29. doi: 10.1001/jama.2025.3501.
In a recent clinical trial, researchers from Princess Margaret Cancer Centre (PM) investigated the drug rucarparib in comparison to standard chemotherapy for treating patients with relapsed ovarian cancer caused by BRCA gene mutations.
Most patients with advanced high-grade ovarian cancer respond to initial treatment but eventually relapse. This recurrent disease is generally incurable. Rucaparib has demonstrated efficacy in patients with a specific type of recurrent ovarian cancer. It inhibits poly(ADP-ribose) polymerase (PARP), an enzyme involved in DNA repair.
To expand on previous evidence, including phase II clinical trials, Dr. Amit Oza’s group at PM led a randomized, controlled phase III trial, called ARIEL4. ARIEL4 compared rucaparib with the current standard-of-care chemotherapy in patients with relapsed ovarian cancer with BRCA mutations.
The trial involved 349 women from 12 countries who had previously undergone at least two chemotherapy treatments. They were randomly assigned to receive either rucaparib, taken as a daily pill, or chemotherapy. This cohort differed from previous studies because it included individuals with varying sensitivity to platinum-based chemotherapy, the standard first-line treatment for ovarian cancer.
The final report of this clinical trial examined overall survival, defined as the duration a patient lives following treatment. Overall survival was longer in patients assigned to chemotherapy (25.4 months) than those assigned to rucaparib (19.4 months). The research team suggested this could be attributed to one chemotherapy subgroup exhibiting greater resistance to treatment. In addition, no new or unexpected side effects were found in patients taking rucaparib.
However, the study did find that progression-free survival—the amount of time it takes for the disease to progress or get worse —was significantly longer with rucaparib than chemotherapy. These results were reported in a previous publication for the ARIEL4 study. Although the study was not designed to identify statistical differences between chemotherapy subgroups, this report found that patients in the rucaparib group had similar or longer progression-free survival versus patients in the chemotherapy group across all subgroups.
Researchers emphasize the need for further studies to optimize the use of PARP inhibitors, such as rucaparib, in combination with chemotherapy for advanced ovarian cancer treatment. Understanding the optimal treatment strategy could significantly impact patient outcomes.
The senior author of this study is Dr. Amit Oza, Senior Scientist at Princess Margaret Cancer Centre and Professor of Medicine at the University of Toronto.
This work was supported by Clovis Oncology and The Princess Margaret Cancer Foundation.
Dr. Amit Oza reports institutional research grants from AstraZeneca; has served on an advisory board (uncompensated) for GlaxoSmithKline; has served on advisory boards and steering committees (uncompensated) for Clovis Oncology and AstraZeneca; and as a principal investigator on investigator-initiated trials for Clovis Oncology, AstraZeneca, and GlaxoSmithKline.
For a full list of competing interests, see the manuscript.
Oza AM, Lisyanskaya A, Fedenko A, de Melo AC, Shparyk Y, Rakhmatullina I, Bondarenko I, Colombo N, Svintsitskiy V, Biela L, Nechaeva M, Lorusso D, Scambia G, Cibula D, Póka R, Oaknin A, Safra T, Mackowiak-Matejczyk B, Ma L, Thomas D, Lin KK, McLachlan K, Goble S, Kristeleit R. Rucaparib versus chemotherapy for treatment of relapsed ovarian cancer with deleterious BRCA1 or BRCA2 mutation (ARIEL4): final results of an international, open-label, randomised, phase 3 trial. Lancet Oncol. 2025 Feb;26(2):249-264. doi: 10.1016/S1470-2045(24)00674-0.
This past week, UHN hosted its inaugural Mission Excellence Awards, celebrating individuals and teams making outstanding contributions to help UHN realize its vision of A Healthier World. These awards combine the previous Local Impact Awards, Inventor of the Year, and Global Impact Awards, presenting them together in one program to elevate recognition and celebration.
During the ceremony, several members of the UHN research community were recognized for their hard work, commitment to excellence, and contribution to realizing UHN’s mission and vision.
UHN Global Impact Award
This award, which recognizes a current member or alumnus of TeamUHN, honours outstanding contributions to improving health and health care here and around the world. The UHN Global Impact Award has honoured giants in the field of medical research since its inception in 2004.
This year the award was given to Drs. Dafna Gladman, Emerita Scientist from Schroeder Arthritis Institute, and Daniel Cattran, Emeritus Scientist from the Toronto General Hospital Research Institute, to honour their outstanding contributions to health care, research, and education in rheumatology and kidney disease, respectively.
UHN President’s Patient Partner Award
As part of our strategic direction of Alignment for Impact, UHN bestows this award upon the UHN Patient Partners who play a vital and active role in co-creating care models, advancing person-centred care, and contributing to health system transformation.
The 2025 UHN President’s Patient Partner Award was given to UHN’s KITE Patient Engagement in Research (PiPER) Toolkit Co-Design Team to recognize the incredible impact that co-developing the Pride in Patient Engagement in Research toolkit has had on engaging patients, and their families and caregivers in research at UHN.
UHN Inventor of the Year Award
This award recognizes outstanding achievements that enable, and lead commercialization and partnerships related to UHN innovations and help create A Healthier World.
This year’s awardees were Drs. John Dick, Senior Scientist at the Princess Margaret Cancer Centre (PM), Jean Wang, Clinician Scientist at PM, and Jayne Danska, Senior Scientist at the Hospital for Sick Children. The UHN Inventor of the Year Award recognizes their innovative work in cancer immunotherapy in identifying a novel way that cancer cells evade discovery.
Congratulations to all the awardees recognized on this momentous night. Your continued dedication to your work and to bettering health and health care for the UHN community and beyond is central to making UHN what it is.
Read the story with a full list of awards and awardees originally posted by UHN here.
Congratulations to Drs. Jean Wang and John Dick of the Princess Margaret Cancer Centre, along with Dr. Jayne Danska of SickKids Research Institute, on winning UHN’s 2024 Inventor of the Year Award.
Drs. Wang, Dick, and Danska are recognized for their innovative work in cancer immunotherapy, identifying a novel mechanism by which cancer cells evade destruction. A discovery made decades ago at UHN and The Hospital for Sick Children led to a multibillion-dollar pharmaceutical deal, shaping new cancer treatments.
At the heart of their discovery lies the immune system’s ability to detect and destroy cancer cells. Cancer cells use a deceptive signal, nicknamed the ‘Don’t Eat Me’ signal, to evade immune attacks. The researchers developed a novel molecule, TTI-621, that targets a key molecule on cancer cells, CD47, blocking the transmission of the 'Dont Eat Me' signal and allowing the immune system to recognize and eliminate cancer cells more effectively.
This discovery laid the foundation for UHN start up, Trillium Therapeutics, launched in 2004 to commercialize this technology. In 2022, Pfizer Inc. acquired Trillium Therapeutics in a US$2.22 billion deal to further develop TTI-621, renaming the drug Maplirpacept. As of February 2025, Maplirpacept remains in global Phase II clinical trials for the treatment of a variety of blood cancers.
The award was presented to Drs. Wang, Dick, and Danska at UHN’s inaugural Mission Excellence Awards, which celebrate individuals and teams making outstanding contributions toward UHN’s vision of A Healthier World. See the full list of Mission Excellence Awards winners here and learn more about the discovery and commercialization of TTI-621 here.
The Inventor of the Year award is sponsored by Commercialization at UHN and recognizes an individual or team whose invention has made a substantial commercialization impact, contributing to UHN’s mission of ‘A Healthier World’. Read the full announcement here.
Research conducted at UHN's research institutes spans the full spectrum of diseases and disciplines, including cancer, cardiovascular sciences, transplantation, neural and sensory sciences, musculoskeletal health, rehabilitation sciences, and community and population health.
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