About the CHIR Project Grant Competition 

Each year, the Canadian Institute of Health Research (CIHR) invests a total of $1 billion in grants to innovative health research projects across the country. They allocate their funds among the four pillars of health research: biomedical, clinical, health services systems, and population health. 

For the CIHR Project Grants: Spring 2022 Competition, 407 grants were awarded, for a total investment of $325 million. Among the hundreds of grants awarded, several GCI research teams were named as recipients. 

The Gynecologic Cancer Initiative would like to congratulate Dr. Aline Talhouk, Dr. Deborah Money, Dr. Paul Yong, and their teams for receiving CIHR grants this year. We are pleased to share their amazing work on enhancing gynecologic cancer care and prevention: 

Recipient: Dr. Deborah Money, MD, FRCSC 

Project: The NOVA-HIV Study (A Study of Reduced Dosing of the Nonavalent HPV Vaccine in Women Living with HIV) 

Primary Investigator(s): Deborah Money, Arianne Alber, Isabelle Boucoiran, François Coutlée, Chelsea Elwood, Catherine Hankins, Marette Lee, Mona Loutfy, Valerie Martel-Laferrière, Elisabeth McClymont, Gina Ogilvie, Vanessa Poliquin, Manish Sadarangani, Joel Singer, Fiona Smaill, Marie-Louise Vachon, Sharon Walmsley, Mark Yudin 

Summary: There are very little data on human papillomavirus (HPV) vaccination among the 18 million women living with HIV (WLWH) globally, who constitute a population most vulnerable to HPV and the resultant cervical cancer. Particularly, there are no data to date on reduced-dose schedules of nonavalent HPV (9vHPV) vaccination in WLWH and there are very little data on the 9vHPV vaccine in this population overall. It is critical to examine the 9vHPV vaccine in WLWH now because the quadrivalent HPV (4vHPV) vaccine has been discontinued. Additionally, in order to reach the World Health Organization’s global goal of cervical cancer elimination, we must determine the role of various HPV prevention strategies in this important population including reduced vaccine dosing which can drastically increase the feasibility of HPV vaccination programs globally.  

This study, which builds upon our team’s prior work on HPV vaccination in WLWH, will determine whether two doses of 9vHPV vaccine can be used in WLWH instead of three, and will examine additional aspects of HPV vaccination in WLWH including the immune response to three doses, vaccine safety and efficacy, and attitudes towards self-collected HPV samples in this population. These data will inform global public health policy and programming and will inform the global strategy for cervical cancer elimination. 

Recipient: Dr. Aline Talhouk, PhD

Project: Digital self-tracking and self-testing for early detection of endometrial cancer 

Primary Investigator(s): Aline Talhouk, Michael Anglesio (Co-PI), Janet Hill (Co-PI), Deborah Money (Co-PI), Anna Tinker (Co-PI)

Summary: Endometrial cancer is the most common gynecological cancer in Canada and the developed world. Individuals with a uterus experience changes in bleeding as they age, which can be the first sign of endometrial cancer. Abnormal bleeding is common in those approaching menopause (1 in 3). To rule out cancer, a painful and invasive endometrial biopsy is needed. Given that less than 10% of women with abnormal bleeding have cancer, we need novel, less-invasive tools to distinguish symptoms of cancer from normal aging. In this project, we consider patterns in risk factors, biological, and digital app-collected data (menstrual, sleep, activity) to predict who is at higher risk of endometrial cancer. We want to understand whether digital tools, used in combination with biological information from at-home tests (DNA from tampons, microbial community from vaginal swabs, or hormones from saliva), can be used by individuals with elevated risk of cancer as a way to self-monitor. We will collect data from individuals referred to a gynecologist to undergo a biopsy for abnormal bleeding. Participants will complete a questionnaire on risk factors and complete an at-home sample collection. We will use this information to discern who is most likely to have cancer. A subset of participants who have DNA mutations associated with endometrial cancer will be selected to continue self-tracking for 6 months, providing weekly app-collected data, as well as self-testing via tampon, saliva, and vaginal swabs at a second time-point for comparison. We want to see what biological changes persist over time and may be cause for concern. If successful, self-testing and self-tracking apps could integrate with standard health care to increase awareness around what to expect with aging, to be proactive with respect to personal and medical choices, and provide a less-invasive alternative to endometrial biopsies to monitor changes for those without pathology, but with increased risk for endometrial cancer.

Recipient: Dr. Paul Yong, MD, PhD, FRCSC

Project: Clinical-biomarker predictors of outcome after endometriosis surgery

Primary Investigator(s): Paul Yong, Michael Anglesio (Co-PI), Amanda Howard (Co-PI), Ali Mohamed (Co-PI), Aline Talhouk (Co-PI)

Summary: Endometriosis affects ~1 million individuals in Canada. It is defined as tissue, which resembles tissue from inside the uterus (womb), growing outside of the uterus in other parts of the body. Endometriosis is associated with pelvic pain (including pain with sexual activity), infertility, and complications during pregnancy. It accounts for approximately $2 billion in annual costs to Canadian society, primarily due to impact on healthcare costs and work/productivity. Standard treatments for endometriosis are hormonal medication and surgery. However, up to half of patients will require a repeat surgery (re-operation) within 5 years of an initial surgery. Little is known about which patients respond well to surgery in the long-term, and which patients do not and experience persistent symptoms. In this proposal, we will examine which factors predict response after surgery for endometriosis. These include clinical and biomarker factors that measure aspects of the nervous system. We will then develop a tool to help patients and surgeons make a decision about whether to operate or not, and disseminate this tool via our website for endometriosis pain. This tool will improve the pre-operative counselling of patients with endometriosis about potential future outcomes. The goal is to avoid unnecessary surgeries and to provide precision surgical care for people with endometriosis.