Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan
Associate Member Saskatchewan Cancer Agency
Medical Director - Advanced Diagnostic Research Laboratory (ADRL)
Co-Leader - Translational Cancer Research (TCR) Cluster
Dr. John DeCoteau, MD, FRCP(C) is a Professor of Pathology and Laboratory Medicine at the University of Saskatchewan and holds an associate membership at the Saskatchewan Cancer Agency. He received his MD at the University of Saskatchewan and specialty certification in Hematopathology at the University of Toronto. Following that, he pursued post-doctoral research studies at Harvard, MIT, and the University of Toronto. Dr. DeCoteau’s expertise includes the molecular biology of leukemia, cancer diagnosis, classification and monitoring by Next Generation Sequencing, and minimal residual leukemia detection using high resolution flow cytometry. Dr. DeCoteau is the Medical Director of the Advanced Diagnostic Research Laboratory (ADRL) and is a co-leader of the Translational Cancer Research (TCR) Cluster at the University of Saskatchewan.
The field of oncology has been at the forefront of translating research discovery into improved diagnostics and targeted therapies. Consequently, the use of leading edge technologies, to support the diagnosis and monitoring of cancer patients, is now an essential element of clinical care. The Advanced Diagnostics Research Laboratory (ADRL) serves to develop and validate state-of-the-art diagnostic and monitoring tests for Saskatchewan cancer patients using new technology platforms such as 10-color flow cytometry and next generation sequencing (NGS). The information emerging from these tests can now be used to improve the diagnosis and classification of cancers, and to identify those cancer patients most likely to benefit from targeted therapies. New monitoring tests, having vastly increased sensitivity compared to standard approaches, are revolutionizing cancer care by allowing clinicians to safely reduce, or cease, potentially toxic therapies in those patients achieving 'deep' remissions, and by detecting early recurrence of cancer so that treatment approaches can be modified before unsalvageable disease progression occurs. ADRL holds a medical laboratory licence and performs validated assays to meet the oncology testing needs of clinical trial groups and the pharmaceutical industry. ADRL is also integrated with the Saskatchewan Therapeutic Antibody Resource (STAR) and the Centre for Biological Imaging Research and Development (C-BIRD) in the creation of a synthetic antibody discovery and validation pipeline. These entities use protein engineering and synthetic antibody technology to develop proprietary reagents and assays to improve the diagnosis and monitoring of cancer patients.
Current work undertaken by the ADRL includes assessing synthetic Fabs and antibodies generated against leukemia-associated surface proteins recently discovered by mass spectrometry based profiling of B-ALL cases. This work focuses on determining the diagnostic and therapeutic potential of these agents for improving the management of pediatric B-ALL. Another recently initiated project focuses on improving the monitoring of Non-Hodgkin Lymphoma (NHL) patients. Recent advances in NGS technology now permit tumor specific immunoglobulin gene clonotypes, and the mutational status of key genes implicated in lymphoma pathogenesis, to be efficiently determined in diagnostic biopsy material from individual NHL patients. This genetic information can be used to create predictive biomarkers, and to develop highly sensitive monitoring tools. Custom NGS based assays will be created to efficiently detect lymphoma clones in cell free DNA (cfDNA) present in plasma samples. This approach will be applied to serial plasma samples collected from NHL patients to test if noninvasive monitoring can identify evidence of molecular disease prior to clinical relapse and predict disease outcome after chemotherapy, transplantation or treatment with novel agents.