On December 5th, 2018, Ontario Genomics hosted Genomics at the Tipping Point: Partnering to Accelerate Market Uptake & Impact, a captivating symposium focused on closing the gap between genomics innovations and market impact.

A packed auditorium heard from innovators using genomics to advance the mining, agriculture and agri-food, bioengineering, natural resources and health sectors.  In addition to providing insights into critical elements for success and effectively dealing with red tape, regulatory burdens and other hurdles, presenters and panelists discussed the power of partnership between researchers and end-users to drive success in the uptake and application of genomics-based solutions across all sectors of the economy. As Ontario Genomics’ President and CEO Dr. Bettina Hamelin explained, “Such partnerships are an essential fuel for Ontario’s bio-economic growth engine and one of Ontario’s most crucial competitive advantages.”

Bettina explained that the symposium was organized to cross-pollinate between sectors and disciplines, to foster highly functioning collaborations and to open up new partnership opportunities. We have such a strong community and we know that it is at the intersection of disciplines and sectors that disruptive innovation happens.

“By leveraging our advantages and collaborating on outcomes-focused solutions with all of our stakeholders – researchers, industry, policy-makers and funders – we can create new businesses and jobs, attract greater international investment and help our industries to be more productive, sustainable and competitive globally.”  Dr. Bettina Hamelin, President and CEO, Ontario Genomics

The conference included many highlights, starting with a keynote address by Elyse Allan, former CEO GE Canada. As a member of the Advisory Council on Economic Growth to the Government of Canada, Elyse shared her insights regarding policy recommendations for strong and sustained economic growth in Canada.  Chief among them was that innovation drives growth because innovative economies are more productive, more resilient, more adaptable to change and better able to support higher living standards. [1]

Elyse explained the three bottlenecks to innovation the Advisory Council had identified:
“a gap between invention and revenue-generating commercialization, a struggle to scale up successful start-ups and small and medium-sized enterprises (SMEs) and no burning platform for corporate adoption of innovation.”

Elyse is nonetheless encouraged by Canada’s position in the global economy and emphasized that “we need to partner, find solutions and bring those solutions to market.”  We must ensure transparency and trust to foster successful partnerships, and ensure partnerships are focused on meeting the needs of companies, not pushing out technologies that don’t fit. We need to take advantage of diversity: innovation often happens at the fringes and it requires a variety and diversity of partners and ideas for success.

“It is up to each of us to be the champions of innovation, build our networks and foster buy-in of innovation to drive economic growth.” M. Elyse Allan

Elyse concluded with some key ingredients she has experienced that have led to successful partnerships:  developing deep relationships that acknowledge conflicting priorities to build trust, networks, defining governance and processes at the start and allowing for diversity to bear fruit.

It was interesting to hear these themes coming back throughout the day:

Our first session Critical Elements & Lessons Learned in Agriculture & Agri-Food, Bioprocessing, Mining and Natural Resources, began with three talks from paired academic/industry representatives.

Dr. Lesley Warren (University of Toronto) and Shirley Neault (HudBay Minerals) talked about the remarkable speed at which the mining industry came to recognize, and then collectively act upon, the importance of genomics in mining. Mineral extraction takes vast amounts of water, and naturally forming bacteria in the waste slurry called “tailings” can create problems leading to negative environmental impacts if not controlled. Lesley and team showed how genomics can give insight into the black box of the nature of these bacterial communities. A large consortium of the mining industry companies and stakeholders, many of whom are competitors, came together to work with Lesley and her team to better understand and prevent problems caused by these bacteria.

Dr. Peter Pauls (University of Guelph), Dr. Mohammed Oufattole (Benson Hill) and Dr. Lomas Tulsieram (Saturn Agrosciences) described their partnership to enhance seed production in canola, one of Canada’s most important agricultural crops, by changing genes in canola that control photosynthesis and metabolism. This is a strong three-way partnership, with complementary expertise and experiences to move the project from the laboratory to field evaluation and commercialization. The synergistic team and the infrastructure and facilities at the University of Guelph were key to cementing the partnership, along with the funding from Genome Canada/Ontario Genomics and exceptional networks in Ontario for partnering in the Agriculture and Agri-food space. Plants will be tested in the field as early as next year.

Humans have been making cheese for thousands of years; now genomics is being used to improve the processes to make cheddar cheese better. Dr. Gisele LaPointe (University of Guelph) and Dr. Anand Singh (Parmalat Canada, makers of Balderson cheeses), spoke about how they are using ‘omic and chemical characterization of the stages of cheese ripening to develop a new efficient and reliable process for cheese production. The team has found that close coordination between the research and production teams and the trust that this fostered has helped to solve problems and ensure that the team could easily adapt to project and timeline changes.

This session’s final talk from Dr. Sean Caffrey, Director of the Biozone Centre for Applied Biosciences and Bioengineering (University of Toronto) gave a broad perspective on factors for success for academic-industry partnerships. Biozone has fostered many such relationships through its role as a platform service linking industry with academic bioengineering innovation at the University of Toronto. Keys to partnership success include: (1) establish common clear and discrete research objectives; (2) foster strong communication so that the strategic context and constraints are understood; and (3) set clear expectations, gates, milestones and timelines. “In building strong partnerships, you need the right expertise and the best skill sets together early in the process”, concluded Sean.

Moderated by Nezar Rghei, Ontario Genomics’ new Vice-President Strategic Partnerships & Resource Development, the ensuing panel discussion with the above speakers emphasized that relationships drive success. Networking and connections bring partners together and leads them to apply for joint funding opportunities. It was emphasized that matchmaking helps bring the right skills to the table. The panel also agreed that communication outward to the community is essential to help the public appreciate that innovation can help make their lives better.

Bridging the agriculture and health sectors, Samira Mubareka (Sunnybrook Health Sciences Centre) provided insights into the need to connect human health professionals with veterinary and animal health professionals to enable enhanced surveillance for influenza virus in swine and avian reservoirs. These reservoirs can be the source of human pandemics.  We need to do surveillance in non-pandemic times – akin to putting away food in times of plenty.  Appropriately educating the public about the need for this work can avoid fear and advance further research.

Lunch was bookended by comments from two of our event sponsors. Alejandra de Almeida (Natural Sciences and Engineering Research Council of Canada) alluded to changes coming to NSERC; indeed the next day saw the announcement of further information regarding NSERC’s revised Research Partnerships Programs. Alex Robertson (Illumina) offered an invitation to Canada to work with Illumina to build a “Learning Health System” in which aggregated health data is used to drive better care. Time and money are put towards lengthy diagnostic pathways that timely genome sequencing could accelerate. The UK example shows that political leadership and advocacy is key to coordinate this new approach across the province.

As we saw over the morning’s session, the ultimate motivation for wanting to improve Canada’s innovation performance is simple: to improve our overall standards of living. Adoption of the technologies we heard about over the morning session will help create jobs, improve the environment and foster economic growth for a more productive, resilient and adaptable economy. Partnerships early in the process, connecting the right expertise and best skill sets with good communication are essential to adoption and will help build our innovation economy.

Our second session, Advancing Health Innovations Through Partnerships Between Academia & Industry, reinforced many of the same themes raised during the previous session.

Dr. Leah Cowen (University of Toronto) and Dr. Dominic Jaikaran (Bright Angel Therapeutics) described their partnership in forming Bright Angel Therapeutics with the goal of finding new treatments for fungal infections – an emerging threat to both human health and agriculture due to resistance to existing anti-fungal drugs. This promising new company has a unique understanding of fungal biology, and their work is further supported by an equity partnership with Schrödinger, a world leader in computational chemistry, to help drive drug discovery.

The next two academic-industry teams talked about their approaches to mining the microbiome – the collection of microbes that colonize the body – for new disease treatments. Biotagenics is a Toronto-based company founded by New York-based serial entrepreneur, Dr. Thomas Cirrito. Based on technologies developed by Dr. David Mack (Children’s Hospital of Eastern Ontario) and Dr. Alain Stintzi (University of Ottawa), Biotagenics uses multi-omic approaches to diagnose, monitor and treat diseases like Inflammatory Bowel Disease and Crohn’s Disease – common chronic diseases for which there is no cure.  They are developing simple and quick tests to determine optimal personalized treatment plans for patients.  Working with Ontario Genomics, this team was able to secure funding twice through Genome Canada’s Large-Scale Applied Research Project (LSARP) program, a program they credited as being essential to their success. The company’s microbiome technology is being developed as a platform to create value for pharma partners at every stage of drug discovery, development and commercialization.

Dr. Andrew Haigh (Adapsyn Bioscience) and Dr. Michael Surette (McMaster University) talked about how they are disrupting the traditional natural product drug discovery process. Adapasyn has a proprietary platform whereby it applies patented algorithms, proprietary artificial intelligence and machine learning to genomic and metabolomic data from microbes to identify and characterize novel natural products that can then be developed as new therapeutics. With the expertise of Surette’s team, they are working together to systematically mine the human microbiome for microbiome-produced compounds that can be used to treat human disease. Public funding from Genome Canada/Ontario Genomics for this type of exploratory work was essential, enabling Adapsyn to develop a competitive advantage and to leverage this funding against venture capital investment for faster company growth. One area to improve public funding would be to reduce the application process burden, which is difficult to manage for a start-up with limited resources and time constraints.

Leading into the panel discussion with the above teams, Kevin Perry, Assistant Deputy Minister of Red Tape & Regulatory Burden Reduction, spoke about the cabinet-approved regulatory burden reduction plan to make it easier to do business in Ontario. He introduced four components of the plan:

1. The “red tape” team will compile semi-annual packages of suggestions. The next package is expected to go out in the spring and will include health-related items.
2. The team has been “journey mapping” to understand what government processes and regulations look like to businesses.
3. The team is open to hearing about red tape issues – you are encouraged to contact them! Solutions may involve legislation or may be dealt with by working with ministry staff.
4. The team is also working to harmonize regulations between the various levels of government, such as the regulations for over-the-counter drugs and others.

Regulations are an important and necessary part of good governance, but not all regulations deliver on their intended purpose. What are the regulatory barriers to the innovation economy? The government is open to suggestions!

The ensuing panel discussion moderated by Bettina Hamelin and Kevin Perry was a lively conversation about the serendipity of partnerships. Partnerships may happen by chance encounters, but knowing a good opportunity when you see one is key.  Paraphrasing Louis Pasteur, chance prefers the prepared mind. Also listed as important contributors to success were: good science, science clusters such as MaRS to facilitate interactions and translational public funding programs such as the Genome Canada LSARP and Genomics Application Partnership Program (GAPP) programs. Networking is key to finding people with the appropriate skills – scientific skills as well as entrepreneurs with A-Z experience in taking a company from start to finish, or taking a drug from discovery, through clinical testing and into the market. Executive relocation packages would help bring this expertise to Ontario. Two important areas for regulatory reform were suggested: (1) the problem of having to deal with multiple ethics review boards and (2) equally burdensome is the need to individually negotiate contracts for each clinical trial site. Fortunately, Clinical Trials Ontario is working on these issues, with significant progress made to harmonize research ethics review processes. However, this solves the problem only within Ontario; multi-jurisdiction clinical trials can be severely delayed by these barriers.

The final series of talks and panel discussion focused on Advancing Health Innovations Through Partnerships Between Academia & Health Agencies (the ultimate gatekeepers of access to new treatments).

Dr. David Malkin (The Hospital for Sick Children) spoke about The Terry Fox PROFYLE (Precision Oncology For Young People) project which harnesses genomic sequencing and next generation molecular tools to identify biomarkers for treatment selection for children and young adults with cancer. This pan-Canadian project involves 20 health institutions; so far 56% of the patients that have been sequenced have at least one actionable finding.

Dr. John Bartlett (Ontario Institute for Cancer Research) highlighted a multinational initiative across multiple cancer types. The International Cancer Genome Consortium has collected over 30,000 whole cancer genomes and other ‘omic data from 39 primary cancer types from across the world. The ‘omic characterization of these tumours teaches us that cancers are far more complex and diverse than we thought, with hundreds of mutations. These can be different not only between individuals with the “same” kind of cancer, but both within a single patient’s cancer and over time. A multi-omic approach will be needed to find the best treatments for cancers such as pancreatic, breast and prostate cancer. John has partnered with ThermoFisher to develop a rapid RNAseq and DNAseq process on an FDA-approved platform for rapid clinical tumour diagnosis.

Dr. Wendy Ungar (The Hospital for Sick Children) presented the processes and unique challenges that genomic technologies present to agencies such as Health Quality Ontario (HQO), which is charged with conducting assessments to guide decisions on whether a health technology should be funded or not. In addition to her role as researcher at The Hospital for Sick Children, Wendy is Chair of the Ontario Genetic Advisory Committee, a standing subcommittee of HQO tasked with advising on which genetic and genomic services and devices should be publicly funded. The remarkable power of genomics technologies spans predicting risk, to prevention, to diagnosis and to prognosis – presenting challenges for the traditional assessment processes. The expectation is that the committee will develop and apply, in a public and transparent manner, new health technology assessment processes suitable to genomic technologies.

Dr. Rae Yeung (The Hospital for Sick Children) is using ‘omics to identify patients that can benefit from treatment with costly but life-altering biologics early in the appearance of childhood rheumatoid arthritis. The problem now is that patients must fail a standardized series of less expensive treatments before the pricey biologics can be considered, during which the disease can progress and become more difficult to treat. But there is evidence from Europe that early treatment with biologics can not only halt the disease, but can be safely discontinued once remission is reached. Rae is using a 16-biomarker test, coupled with patient-reported disease activity, to identify appropriate patients for this early treatment to convince Ministries of Health across Canada to allow early treatment with biologics – which will reduce healthcare costs and improve patient outcomes. Rae explained that hospitals in Canada are slow to integrate patient-reported data into their electronic medical records. She challenges our hospitals to adapt to such change more quickly.

Dr. Nicole Mittman (Cancer Care Ontario) prefaced the final panel discussion with a plan in development to improve the uptake of innovative genomic technologies with a focus on cancer. This is driven by both patients and physicians who want access to innovative technologies faster. The problem is that innovative cancer technologies are not easily implemented in the Ontario healthcare system. According to Nicole, cancer technologies such as genetic tests, companion diagnostic or algorithms associated with precision medicine tools and companion diagnostics are not typically amenable to existing health technology evaluation frameworks. While a better pathway to innovation is still in development, the principles for this include a nimble framework with a bias to being permissive, transparency, discontinuation of funded technologies if no longer justified, establishing a learning health system model to enable feedback loops between research and health care and broad application.

The final panel, moderated by Nicole, brought Rae, Wendy and David back to discuss how to best foster collaborations between academia and health agencies. The importance of these collaborations was underscored by David’s experience: while discoveries originated in Canada, Canadian patients have been unable to participate in some international clinical trials when it took too long to initiate these trials here due to bureaucratic delays.  Wendy pointed out that early involvement of the health receptor in the research has significant advantages, but that the health receptor needs to set clear expectations. She pointed out that there are in fact several potential partnerships that need to be developed that may include, for example, the Laboratories and Genetics Branch for accreditation, Health Quality Ontario for assessment of the evidence and the Ministry of Health and Long-Term Care for the final reimbursement decision. For Rae, the e-health tools being developed as part of her project are part of her plan for health agency engagement, providing more comprehensive health information to enable reimbursement decisions. Ontario can make it easier to succeed here by addressing the outsourcing of many genetic tests, which is not sustainable and is a missed opportunity to support both Ontario bio-industries and Ontario patients. Wendy pointed out the importance of “implementation science” to really understand the process. Even after funding is approved, integrating a new technology into the health care system is an overlooked challenge that is a significant contributor to the years-long delays in true system uptake. Both Rae and David mentioned the regulatory barriers that block access to drugs. Rae gave the example of different tests needed to gain access to the same drug in patients with different presentations of the same disease. Despite advancements, there are still many opportunities to improve the uptake of new technologies into Ontario’s healthcare system.

In Elyse Allen’s inspirational talk to start the day, she called upon each of us to drive innovation to market by building and using our connections, to be mindful of Thomas Edison’s famous quote to “not invent anything that won’t sell,” and to be true champions of the power of innovation to drive growth.

The day brought a range of sectors together – linked by the power of genomics and a common learning that success comes from strong partnerships fueled by deep and transparent relationships between people with the right expertise and the best skill sets to leverage each other’s strengths. This requires networking, connections and matchmaking. Partnerships can happen through serendipity, but as Tom Cirrito said, “serendipity doesn\’t mean by accident or by luck.”

The day was also an opportunity to collect ideas for improvements to enhance doing business in Ontario. We heard about the need to augment funding programs and to improve them by providing ground up support and less top-down oversight; streamlining research ethics review and clinical trial contracting processes; simplifying access to drugs and re-thinking a risk-averse approach enabling access to health innovations; helping the public understand how genomics can help provide improved health and economic growth; assistance in bringing the right expertise to Ontario; and advocating for federal tax and regulatory changes to assist start-up companies. It was great to hear from Kevin Perry that Ontario’s new government is open to these ideas – a great opportunity for all of us to speak up.

As Bettina noted in her concluding remarks, we all have an opportunity to up our game when it comes to effective collaborations so that together we can achieve a productive, resilient, adaptive Ontario through innovation – with the ultimate goal of higher living standards.[1] Ontario Genomics wants to facilitate these important partnerships – by connecting people, ideas and organizations to strengthen our collective networks through events like this and by being out there in the community. “This is how we can pursue Ontario Genomics’ ambitious Vision: Healthy Lives, a Healthy Economy, a Healthy Planet through Genomics Innovations.”

“We all need to work together because it is only through multidisciplinary dialogues across all sectors and at all levels - through collaboration and meaningful partnerships - that we can confidently and successfully champion for an innovation-rich Ontario going forward. Reach out to us and let’s keep the conversation going.”  Dr. Bettina Hamelin

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[1] Advisory Council on Economic Growth (2017) Unlocking Innovation to Drive Scale and Growth. Available at: https://www.budget.gc.ca/aceg-ccce/pdf/innovation-2-eng.pdf