Accelerating precision health for ovarian cancers

Cheng-Han Lee

Cheng-Han Lee dedicated the first decade of his career to uncovering the genetic drivers for gynecological cancers—he even helped identify a new kind of cancer altogether. 

But he realized a significant, troubling problem with the work he was doing: identifying the cause of a certain type of cancer doesn’t mean there’s a treatment to help the person who has it.

“The oncologist would ask me, ‘What should we do?’ And it’s a hopeless feeling when you don’t know what to do,” says Lee, a consulting pathologist and associate professor of laboratory medicine and pathology. 

“It motivated me to be more creative, to think about different ways we can target these cancers and hopefully translate that to better treatments for patients.”

Lee is driven to help patients with aggressive, treatment-resistant cancers in his new role as the Sawin-Baldwin Chair in Ovarian Cancer, funded by the Alberta Women’s Health Foundation. Since arriving from the University of British Columbia in June 2021, Lee has been researching and creating better experimental models to test the effectiveness of potential ovarian cancer treatments.

Experimental models help clinicians and scientists like Lee recreate the conditions of cancer outside the human body to trial treatments in an efficient manner before bringing forth more promising novel treatments to clinical trials. Lee’s team can replicate realistic microanatomy of a patient’s cancer using surgery samples in the lab to create three-dimensional models. They can use these to test hundreds of potential drug compounds to treat the tumour within months after models are established. Clinicians can then evaluate the most promising therapies on patients in clinical trials.

"Two women who have been diagnosed with ovarian cancer can have two wildly different diseases."

When developing lab techniques that replicate the patient’s cancer in a petri dish, Lee says it’s important for the model to be as specific as the subtype of cancer itself. After all, no two tumours are truly identical. Two women who have been diagnosed with ovarian cancer can have two wildly different diseases, each with a molecular makeup as unique as a fingerprint. 

“Ovarian cancer is not just one type of disease—it represents a wide spectrum of different types of diseases,” Lee says. “It’s also very clear that different types of ovarian cancers respond to different types of existing treatments. And some just don’t respond very well at all to what we can offer today.”

In the past, scientists have typically tested potential treatments using more accessible and generic two-dimensional models. While these have been helpful, their use has not been as successful when compared to testing therapies with the new three-dimensional models. The newer models also are able to better represent a wider spectrum of cancer that affects patients. 

To address these gaps, Lee is at the forefront of developing models that are as accurate as possible—tailor-made for gynecological cancers. “That way, when you check sensitivities of the cancer to different drugs in the lab, the positive hit is more likely to predict a positive hit in clinical studies,” he says. 

Lee is particularly interested in developing the best experimental models for cancers that develop and spread quickly, those that are not well-represented by two-dimensional models. This includes high-grade serous ovarian cancers, the most common subset of aggressive ovarian cancers accounting for 70 per cent of cases. New targeted therapies have been able to help about half of the women diagnosed with this subset, but Lee’s eager to help develop treatments for those currently left out. 

It’s a task he feels a great sense of urgency around. After all, he says, he’s racing against a disease as evolved as humanity itself—and cancer never waits around for the nuances of science to catch up. 

“It’s a challenging endeavour but it is also highly worthwhile,” Lee says. “I appreciate the anxiety that a cancer diagnosis puts patients and their families through—I don’t think I need much more motivation than that.”

Cheng-Han Lee is supported by the Alberta Women’s Health Foundation through WCHRI.