The Hour is Blue

Dr. Marco Marra — From Mapping the Human Genome to the Future of Cancer Medicine

In this conversation, I speak with Dr. Marco Marra, University Killam Professor in the Department of Medical Genetics and Michael Smith Laboratories at the University of British Columbia, Distinguished Scientist at BC Cancer, and Terry Fox Leader in Cancer Genome Science. An Officer of the Order of Canada, Fellow of the Royal Society of Canada, and inductee into the Canadian Medical Hall of Fame, he is also a recipient of the National Killam Prize in Health Sciences and the Canadian Cancer Society's Lifetime Contribution Prize.

Marra's scientific career spans more than three decades, from his early contributions to the Human Genome Project at Washington University in St. Louis to pioneering advances in cancer genomics and personalized medicine. Recruited to Vancouver by Nobel laureate Michael Smith, he co-founded Canada's Michael Smith Genome Sciences Centre, which he directed for more than two decades. In 2003, he led the Vancouver effort that sequenced the SARS coronavirus genome. He also co-founded BC Cancer's Personalized OncoGenomics program, investigating how genomic information can guide cancer treatment.

Our conversation takes a retrospective look at his life's work and the extraordinary transformation of genomics that he has witnessed firsthand. We discuss the scientific discoveries and technological advances that have reshaped our understanding of the human genome, the challenges of translating genomic research into treatments for cancer patients, and the possibilities that emerging technologies may open for the future of medicine.

CiTR 101.9 FM / The Blue Hour

Recorded live in person on October 27, 2026, at the University of British Columbia, Vancouver.

Listen: CiTR | Apple Podcasts | Spotify | YouTube

The Blue Hour, hosted by Farha Guerrero, airs live every Tuesday at 2 p.m. PT on CiTR 101.9 FM at the University of British Columbia in Vancouver, Canada.

Transcript

Transcript lightly edited for clarity and readability while preserving the substance and natural rhythm of the conversation.

Farha: Marco, it's such a privilege to have you here.

Marco: It's a great privilege to be here. I look forward to our conversation.

Farha: That's quite the introduction. I didn't want to reduce it because I wanted to capture, right at the outset, what you've been doing all these years. And it's nice to even mention someone like Nobel laureate Michael Smith, who is obviously someone really important.

You've just come back from Toronto. There are some really exciting things I want to talk about, what happened there. But before we do that, let's get comfortable and talk about you a little bit.

Who is this man? Who is the scientist sitting in front of me who's clearly done so much? And the world is grateful, I'm sure, to you and your team and many of the other scientists you've worked with all these years.

But there's something else, I think, in that child that you once were, and maybe the curiosity that you had growing up in a rural setting. Am I right?

Marco: I did grow up in rural settings. I was born in northern Alberta, in Peace River Country, six decades ago.

And I followed my father's employment with railroads, predominantly BC Rail back in the day, and ended up moving from northern Alberta to Fort St. John, where I attended elementary school. And from there to Quesnel, British Columbia, almost smack in the centre of this beautiful province, where I graduated high school.

And a shout-out to all my friends in the Quesnel area.

Farha: Did that kind of upbringing influence, do you think, a little bit of this curiosity that brought you to studying what you ended up devoting your life to?

Marco: I think so. I was lucky to have an opportunity to experience, essentially, a hobby farm.

Dad was a railroader and Mom did her best to keep us all going forward, fed and clothed and all of that. A full-time job in and of itself.

But we had animals.

And the idea of animals and what made a superior cow or chicken often related to the lineage from which those animals came. And so you started to develop a sense of the importance of genetics fairly early on in that environment.

It wasn't a big operation. It was tiny. It fed us. But the idea of genetics, I think, was probably planted at that stage.

And then it extended into the garden. We had carrots, and we had these kinds of carrots and those kinds of carrots, and so on and so forth.

And so one got the idea that this concept of heredity was at play in just about everything that we ever did.

So I suspect, although I don't know, that that sort of laid the foundation for an interest in biology, which continues until this day.

Farha: But initially, if I'm not mistaken, you weren't thinking about going into medicine. That came later?

Marco: It came much later.

I was an undergraduate student at Simon Fraser University, and I thought, well, perhaps I should pursue veterinary medicine.

And so I applied to be interviewed. The interviewer kindly and graciously offered me the opportunity to explain myself.

And at the time, being young and foolish and not understanding anything about veterinary medicine, I had an emphasis on a large animal practice. I thought that's what I wanted to do.

And I think the interviewer was looking for a little more holistic appreciation for what veterinary medicine actually meant. And so that didn't pan out.

I distinctly remember, though, at the end of the interview, the guy says to me, "You seem to be ultra-rational. Maybe you should consider a career in research."

And I thought, well, what is this research business? And I didn't have the opportunity to find out until quite a bit later.

Farha: Which eventually, and this could be going a bit too far forward, you ended up at Washington University, and you were working on something called the Human Genome Project, right?

We may have heard this term, but for someone who's never heard what that even means, can you break it down?

Marco: I can. But I have to amplify a little bit of the story here to give a shout-out to my old PhD supervisor, Dr. David Baillie.

I was dutifully attending classes and learning the wonders of genetics and molecular biology and enjoying myself.

I found myself outside, sitting on the steps of the academic quadrangle one day, basking in the sunshine, wondering what it was that I was going to do with myself.

And along comes David and sits down beside me, and he says, "What are you going to do with yourself?"

And I said, "I don't know."

And he says, "Why don't you come and work in the lab for a bit?"

And I said, "Sure."

And I did.

David was a visionary. Now, he, in his lab, worked on a tiny soil nematode called Caenorhabditis elegans, which was emerging as a very important model organism for the study of muscle development and neural development.

And so we were engaged in this work, and David was trying to find genes.

He was doing this using classical genetics of the sort that had been done in fruit flies and the worm for many decades, using mutagens to induce mutations and then using genetic strategies to map the mutations.

And this would eventually assist in the cloning of genes of interest.

Along that trajectory, researchers in the UK and in St. Louis, Cambridge, UK, and St. Louis, Missouri, were collaborating to generate something called a physical map.

And this physical map was cloned segments of the C. elegans genome. They were assembling these to reconstruct the entire genome in experimentally tractable 30,000-base-pair fragments.

And these 30,000-base-pair fragments had various uses.

But one of the more important uses was when you made a mutation in an animal and you created an animal that couldn't move properly or had other defects, you could reintroduce into the gonad of this animal these long stretches of DNA.

And they would be incorporated into the progeny, the offspring of that animal.

And you would look for the animals that were born that had restored movement. And this was considered some element of proof that the function of the gene had been preserved in that cloned element.

And so you knew that the gene you were after must be on that cloned element.

This was very powerful.

And then you would do a DNA sequencing experiment to sequence that cloned fragment, and you would find your gene. So this revolutionized cloning.

And because they made these reagents available to the entire community, cloned by phone, you'd phone up these magnificent leaders and you'd say, "Can you send me this fragment or that fragment?"

And it would arrive, and you'd do the test, and then you'd report back whether it did indeed have the gene on it.

And so this gene business continued on for some time. And the map construction continued on for some time.

This was Sir John Sulston, who later received a Nobel Prize along with Sidney Brenner and Bob Horvitz for his work.

And John and his colleague Alan Coulson in Cambridge were doing this in collaboration with a fellow named Robert Waterston, who was in St. Louis.

And together they assembled this beautiful map of overlapping cloned fragments.

This was presented at Cold Spring Harbor at the Genome Meeting, the C. elegans Genome Meeting, every year.

And it was at one of these meetings that it became clear to a very influential attendee at the meeting, Jim Watson, that actually this map could serve as a substrate for genome sequencing.

And that's really how I see the foundation of how the human genome was sequenced, and later on my contributions to it.

And so this business of having overlapping cloned fragments led to the sequencing of C. elegans, and it led to the foundation on which we actually conducted the Human Genome Project, with these large cloned fragments and finding ways to arrange them next to each other and understand the order of them in the genome.

Farha: And this was in the 90s, is that right?

Marco: That's right.

So David and the environment he created at SFU led directly to this familiarity with all of this business. And then it became a natural fit for me to pursue a postdoctoral training opportunity with Dr. Waterston in St. Louis.

And he kindly took on this wannabe vet from the interior of BC.

Farha: So what you did at SFU was really important for you to get there?

Marco: A continuum of thought, that one thing led to another and so on and so forth.

Farha: That's nice. So much of what you've done has really been grown in this province, right?

Marco: Oh, yeah. I'm very definitely a Canadian. A BC man.

Farha: Because it's definitely British Columbia where you've been most of this time, right?

Marco: Absolutely right.

Farha: Can you give us a visual, if you could, even if it feels elementary, of what these maps actually were and what they would look like for someone who would never understand this?

Marco: So when you think about a genome, and most people don't, maybe we should start with that. What is a genome?

A genome is another term for all of the DNA that resides within the cell.

The nucleus of the cell is where the nuclear genome resides, and mitochondria, which are the energy factories of the cell, have their own genome, a much smaller version.

But the human genome is thought typically to, when people think about DNA, they think about these depictions of chromosomes.

And so these chromosomes live in the nucleus. That's the genome.

The idea for years and years and years has been to try and identify genetic alterations in the genome that might explain the etiology of disease.

And so when we see a particular alteration and we associate that alteration with disease, you can say, "Ah, the alteration and the disease, they're related in some way."

An example of this was the recognition that the Philadelphia chromosome, a fusion of chromosomes 9 and 22, led to a particular kind of leukemia, CML.

And that fusion of 9 and 22 could be recognized under the light microscope because it was such an enormous rearrangement by genome standards that you could see it using just a standard microscope.

But there were many more disease indications that could not be seen under the light microscope.

And so the approach to those really was to look in families where the disease was clearly inherited.

There would be individuals within a family that might have the disease, and others within the family, perhaps siblings, who did not.

And then the idea became, can we identify any differences in the DNA and the chromosomes between individuals within the family that had the disease versus those that did not?

And you could do such things if you had really good family information.

Did you have a pedigree? Did you have a good description of the disease within the family so that you knew you were talking about the same thing?

And this was, to cut what is a very long story, and I do go on, I apologize, but a very long story short, this was called positional cloning.

And this was expensive and it was slow.

And one of the main rationales then became, with the advent of technology and the realization that we couldn't work with chromosomes, they were just too big to be amenable to the tools of molecular biology, we had to break the chromosomes down into smaller fragments.

And so there were ways to do that.

But then we needed to capture those smaller fragments in the test tube. And we were creating many copies of the smaller fragments.

And they would lose their positional information when they were captured.

And so you would take the genome, you would bust it into a million little tiny fragments, you would capture those fragments, and you'd say, "Okay, well, where does this fragment come from?"

And we needed a way to be able to reconstruct the genome in these much smaller pieces.

And so that's the genome mapping approach that was pioneered by Sulston and Coulson and Waterston, and indeed Maynard Olson in yeast, and the technology upon which we borrowed very heavily for the Human Genome Project.

Farha: So there is this kind of genomic revolution and then a kind of technological revolution, which since the 90s, a lot has changed, right? And still is evolving.

So bring us to, give us an idea of what are the kinds of things that you've seen over the decades, when you think back to those days and now.

Marco: Well, I sort of arrived on the scientific scene before there was a genome sequence.

And we didn't know how to do it.

I've seen that firsthand as a PhD student, and indeed most of my PhD was spent sweating in the lab trying to recover a tiny little piece of the genome and sequence it.

And so that was a laborious and incredibly low-resolution way to go about things.

And now here we are, 35 or 40 years later, whatever it is, and ours is the first generation which is seeing entire genomes reproducibly sequenced at throughput, at scale, in laboratories around the world for a fraction of the cost of what it normally was.

I'm fond of saying, and I don't know that this is exactly accurate, but I suppose you could do the calculation, I'm fond of saying that we're about 10-million-fold more efficient in DNA sequencing now than we were then.

And so there are factors of cost and throughput and so on and so forth.

But where I am now, at the Michael Smith Labs, there's a very powerful machine that can sequence many genomes a week.

And this resides within the context of a university unit.

And then at Canada's Michael Smith Genome Sciences Centre, there are more of them.

And so this jurisdiction is capable of sequencing thousands of human genomes a year with equipment that you can buy.

You don't have to build it or create it. It's available.

And so that span of time, within the scientific lifetime of me, has gone through this.

And it's just been an amazing time to watch the trajectory of the technology and the science and the medical inferences that have come about as a consequence.

Farha: To me, that's quite exciting.

Just to be able to be witness to that, it's one thing to be, of course, in it, and it's hard to step outside of yourself.

But I can imagine if you were to think about you back then in the 90s and now, and how far this technology has come.

Do you think you would have, it's a hypothetical question, but do you think you would have imagined these kinds of things that you're seeing now?

Marco: Oh, no. The idea that you could do these things was science fiction.

It was just inconceivable.

Even at the time when the first draft publication of the human genome was being produced in the early 2000s, there was no way to think like this. None at all.

And it wasn't really until 2006, when we here in BC were fortunate enough to get our hands, and this was at the Genome Sciences Centre at BC Cancer, on an instrument that was the first iteration of the much fancier and more powerful instrument that we have now.

This was made by an outfit named Solexa.

And we were one of four labs around the world to be offered the opportunity to experiment with it.

At the time, Martin Hirst was working with me at BC Cancer, and he did a superb job of developing technology that would allow this instrument to be useful.

And it was revolutionary.

And you could see at that point, you started to say, "Okay, wait a minute, this is Gen 1, more like Gen 0.1."

And you could see where this was going to go.

And it was going to change everything.

So massive factories sequencing DNA with hundreds and hundreds of staff were going to be replaced by a single machine with a few people generating the data.

But what we didn't understand is that although the laboratory requirements for generating data at scale would be radically reduced, the need to have sophisticated informatics and IT solutions for the massive amounts of data was going to amplify.

And we couldn't have envisioned that either.

And so it's been one delightful surprise after the other.

And now really, the data science has become vitally important for getting anything at all out of these very powerful machines.

Farha: It brings me to someone, and I was teasing you a little bit about your name, if I could pronounce it in Italian, because I speak the language, Marco Marra, or Marco Antonio Marra, which maybe is not the way your name is commonly said.

But there is a man that I'm going to be interviewing in Italy in January, Telmo Pievani, and he did a lecture recently, or last year, called Imparo, Dunque, Evolvo, I Learn, Therefore I Evolve.

And at the end of the lecture, he talks about this idea that every year when he starts a semester, say at a university like here at UBC, he looks at his students and wonders what one of them or two of them or a few of them would invent that he wouldn't neither predict or imagine.

And it's just this beautiful idea that even a 20-year, 30-year cycle of learning can bring out something so novel, as you said, and I love how you said science fiction, that would have felt like science fiction but years later is actually in your hands.

But that's your lifetime where you're seeing that. So that has to feel special.

Marco: I feel incredibly privileged.

I was a farm kid from an immigrant dad who worked on the railroad, went to high school in a very small town in central BC.

And I had the opportunity to see that science fiction firsthand evolve over a period of time.

So it's been delightful.

And in terms of the individual you mentioned in Italy, I stand in front of classrooms from time to time and deliver a guest lecture or talk to audiences in different venues.

And the brilliance, and where young people are starting from today, you just know that we're on the cusp of some amazing developments.

And it'll be great fun to see what emerges over the next couple of decades.

And I'm filled with optimism.

These will be very positive things that will transform health and well-being for humans all around the world.

Farha: I can imagine you get asked that quite a bit, because people want to know, will my children grow up where we won't have to worry about something like cancer?

You must hear that from people, right?

Marco: Sure.

I was once asked, in a press conference where we were working with colleagues to talk about a discovery that we had made, an advance, why do you do these things?

And the question was really predicated on my disclosure that I was an insulin-dependent diabetic.

And so there I was, an insulin-dependent diabetic, but I'm working on cancer.

So why are you working on cancer?

And this led into a conversation of what do you hope for then?

And I thought about that.

And the nature of the press conference had to do with breast cancer.

And I was thinking about that, and my daughter had just been born.

And that was first and foremost in my mind. I was filled with the emotion of the moment.

And then we were talking about this, and I said, "I need this world to be a better place for my kids, and for your kids, and for all their children, too."

And this is my opportunity to contribute.

Farha: That's beautiful.

Although the other part of this discussion is, you have the research, and then you have all of the behind-the-scenes, and I want to talk about what happened in Toronto last week, because that's really exciting.

But first, there's also the tragedy of when we see people, even my mother died of cancer, two bouts of lymphoma.

And even the second lymphoma that she was diagnosed with six years later, surprised and puzzled the doctors because it was a very rare form again.

And then a friend of mine, a fellow writer, just died a few weeks ago of cancer after a long battle with ovarian cancer.

And one could argue probably most of us in Canada know someone who has been afflicted with the disease.

And so that's why having people like you are so important to speak with, because it does give us hope that there's a lot of work and investment, not just in terms of money, but it's that dedication to wanting to see people healthy.

Marco: You're right. Cancer is a huge thing.

And it's not cancer, it's cancers.

And when I step back and think, well, really, what has genome science brought to a fundamental new understanding of cancer?

I would have to say it has revealed the sheer heterogeneity of the diseases that we call collectively cancer.

And so I want to use an analogy here that might help explain what I mean.

We'll go back to the SARS genome, which we sequenced in 2003.

At the time, we didn't know what the agent was that caused SARS.

We knew that it was creating all kinds of issues, people were dying, there was panic. What are we dealing with here?

And so we weren't able to put a name to the thing.

And without a name to the thing, you couldn't find the thing. You couldn't think about treating the thing.

You knew it was an infectious agent of some sort because of its behaviour.

And public health told us about that behaviour, but we didn't have a name.

And I guess I'm a reductionist. I boil everything down to the nucleotide.

And so I remember I was here on campus, sitting in a lecture, supposed to be thinking about what the lecturer was saying.

And instead, I was thinking about, okay, what are we going to do about this? Because this is crazy.

We need to know.

And it was during that lecture that I decided that what we had to do was sequence the genome.

But in order to do that, we had to have a sample, which my colleague Dr. Caroline Astell, who was working with us at the time, was able to get for us.

And this was through the BCCDC, from the National Microbiology Laboratory in Winnipeg, where they had a sample from a patient who had passed away from SARS.

So we got a very tiny quantity of fluid, barely visible on the bottom of a tiny little receptacle.

And a very talented fellow working with me, Jaswinder Khattra, manufactured the reagents over a period of six days that eventually made their way onto what then was the latest sequencing technology.

And within a matter of hours, in the wee hours of the morning, we knew what we had.

We had a coronavirus.

And so we were able to put, by virtue of sequencing the letters of the viral genome, we were able to give it a name.

And as soon as we knew what it was, and we knew the sequence of it, we had a way to think about how we could detect it using PCR, polymerase chain reaction technology, which was commonly available everywhere around the world.

We had the formation of the SARS Accelerated Vaccine Initiative here in BC, funded by the BC government to create a vaccine quickly.

And so these things were precipitated by virtue of the knowledge of the thing.

And I feel the same way about how we've thought about tackling cancers with this genome sequencing approach.

And so now we survey the six billion letters of the human cancer genome, trying to find the broken pieces in the genetic code and trying to lay them all out.

So this is what we see in lymphomas or in breast cancer or whatever, the hundred-plus diseases that we think of as cancer.

And when we have that information, when we have a catalogue of the broken pieces of the genome and the proteins that these broken pieces inactivate or dysregulate, then we can start thinking about, okay, if that's the broken piece, how does it work?

And can we interfere with how it works to drive cancer using some sort of a therapeutic?

And that's where we are today.

And that's our hope, that we're going to be able to do this here across the country as part of the Marathon of Hope Cancer Centres Network.

We're going to be able to align patients to therapies, and we have some world-leading expertise right here in British Columbia doing that sort of thing.

And we're going to align the right person to the right treatment at the right time in their disease.

And we'll think about doing that iteratively as disease progresses if we can't get rid of it the first time.

And we're going to learn. We're going to learn a huge amount about how all that works.

Farha: And then it gets very interesting in this very recent study, some of your research.

You've looked at how cancer, and forgive me for using the word evolution, but I had Sally Otto on my show a few weeks ago, who's an evolutionary biologist.

But it is this idea that by looking at these cells, there is this interesting window now to interpret them and to see how they are reorganizing and almost exploiting themselves.

And you had some studies looking at children with leukemia, right, where you could see that even the cells, as time passed, were essentially going backwards or moving backwards in their development.

That's really interesting, and I don't know if it's completely connected to what you were saying, but just because we are going forward in time, that is a whole other kind of question mark probably in the back of your brain, no?

Marco: Oh, it is.

If we're going to interfere with cancer, we have to understand how it works.

And because it isn't a unit entity, there's an enormous amount that we have to learn and have learned.

And so, as we understand the biology of these diseases, we develop ways of being able to interfere with that biology for the benefit of the patient.

But what we know is that within a patient, for most cancers, there are collections of cells within that cancer that are distinct from other populations of cells within that cancer.

And these cancer cells, even within a single patient, can have very different properties.

We all hear about instances where a treatment is applied and the cancer goes away, and then the cancer comes back.

Well, what could possibly explain that?

One explanation is it's a new cancer, and those situations do occur.

But another explanation is that when we treated the patient with the therapy, the cancer cells that were susceptible to that therapy were killed and went away.

But because cancer, like infectious disease, to go back to that analogy, there are many cells, and these many cells have distinct properties.

And some of those cells, sometimes quite rare populations of those cells, can survive the therapy, and they can grow out.

And when they grow out, they are by definition resistant to the therapy that was applied.

And so that is selection at work.

It's a strong selection for certain types of cells, and other cells evade it, and they come about with new properties, and then they become very difficult to manage.

How do you deal with it now?

And we have learned, in some cases, that there are sequences that we can apply to help manage that disease.

Farha: So really, when the therapy doesn't work, that's not just a question of, okay, the therapy is not working.

There's something in that whole cellular process that's happening that's now raising a lot of questions about what is actually going on, right?

And that's, to me, really interesting, the changes in the cell state to understand the mechanisms of resistance.

Marco: And the AML situation, the pediatric AML situation that you're referring to, is an example of how you select for cells that are resistant to therapy, and they grow into the dominant form when cancer relapses.

And then you've got a whole new therapeutic challenge ahead of you that you have to understand if you are to help the patient.

Farha: Now, I did mention at the start this Personalized OncoGenomics program. Did I pronounce it right, oncogenomics?

Marco: You did.

Farha: Do you want to tell us a little bit about the beginnings of it? It's the Personalized OncoGenomics program at BC Cancer.

Marco: We call it the POG program.

And so this emerged from a collaboration between Dr. Janessa Laskin, who's a medical oncologist at BC Cancer, and one of the people that I've worked with most closely over, I don't know, 15 years or so.

And Dr. Laskin is an amazing individual with tremendous energy for innovation and a vision for what could be if only we were to integrate science and medicine.

So we're working together at BC Cancer in various contexts.

We started around 2006, 2008, something like that.

And then an opportunity arose. We were invited, I should say, to have a go at sequencing a cancer.

And we were compelled to do so.

This was one of Dr. Laskin's patients.

And so the charge was, explain what is wrong and explain what therapy we might bring to bear here.

And so we refer to this as patient one.

And so in patient one, and the individual has been disclosed, this has been talked about publicly by the family.

I won't use names because it makes me uncomfortable, but the information is out there. If anybody wants to follow up, they can do so.

The idea was that a cancer that was at a certain anatomic site, base of the tongue, had metastasized and spread throughout the body, and a node had found itself in the lung, actually several.

And so the question was, well, what's going on here?

Surgery wasn't curative. There was radiation involved. It didn't help.

And at the point the cancer reemerged in the lung, the question became, well, we don't know.

There is no sequence now. So there's no prescribed way forward.

And that was assessed by the patient as being completely inadequate.

And the patient, being a sophisticated person with knowledge of the research environment, knew about our genome centre at BC Cancer and said, "Well, those guys know how to deal with such things, and they should do this thing."

And we did.

And so what that revealed, and this was an amazing stroke of luck, phenomenally lucky, we did not know how to do this.

We were doing a million other things using the technology of the time, which was primitive by today's standards, even though this was, I don't know, 2010-ish by this time.

Put aside everything, and for six months we all beavered away, ignoring our other responsibilities, because this was a bit depressing, and we needed to get it done.

And what we found was strong evidence for a target of an experimental therapy that was in clinical trials for a completely different cancer.

And so we found a target.

The molecular information that we were able to collect through DNA sequencing of both the patient's tumour and normal, and we compare those two things to find the broken bits in the tumours, and we looked at all of that.

We found evidence that we considered evidence. We created a hypothesis.

And we said, our hypothesis is that's the driver.

And then a second hypothesis was, well, if we are able to interfere with the function of that driver alteration, it'll bring benefit to the patient.

The drug was obtained, was applied, and it was this amazing radiologic response.

And so under imaging, the tumour shrank, the patient felt better, and we were like, wow.

We had not anticipated we could ever be so lucky.

And that was the root of POG.

And so today, something like almost 3,000 patients have been enrolled.

They support our work through their participation, but also through their advocacy.

They're the reason why we do what we do.

And we are them, aren't we? We really are, all of us together in this community of people under threat of cancer.

And that's the face of cancer.

Farha: That's the face of cancer.

Marco: And so this is what we do.

We sequence their genomes, tumour and normal, and we try and find evidence within those genomes to rationalize the selection of drugs, trying to find the right drug for the right patient.

Farha: I think we now have to talk about what you were doing in Toronto recently, because it's a really big moment.

Why don't you tell us about this extraordinary act of philanthropy that the government matched with the Terry Fox Foundation?

And also maybe tell us about that lovely stop-motion animated video, which you are in?

Marco: So I'm told!

This concept of being able to do genomics and understand more and more about the cancer, and in some cases use the information directly to align patients to therapy, not in all patients, but in some, this idea has encircled the globe.

It's not unique to our environment.

But what is unique to our environment across this country is the formation of the Marathon of Hope Cancer Centres Network, where we unite Canadian cancer centres under the banner of Terry Fox.

And this program has been supported by various federal governments, most recently the Carney government.

Thank you very much, federal governments, for your support over all these many years.

So the network has been built, and we have representation from groups across the country, the leading cancer centres, and an ever-growing consortium.

There's now 57 institutions, more than 1,300 researchers, who aim to generate this kind of information, study what it means, and now, in this current phase, apply that information to bring precision oncology ever closer to the clinic.

Now, it's a research study. It's not a care study, but we anticipate and indeed will drive forward applications to the clinic from this program.

It's a data-sharing program.

And so the vision is, if I have an observation about a patient here in British Columbia, a colleague in St. John's will be able to look at that information, understand elements of the patient profile, the disease the patient was diagnosed with, what we may have done about it, and use that information locally so that the information doesn't create inequities in cancer centres across the country.

And so it's a mass effort to essentially bring precision oncology to Canada, not to Toronto or to Vancouver or to Montreal, but to all of it.

And so this is extraordinarily attractive to me, and the concept of data sharing I find incredibly powerful.

It's been the foundation of much of what we've done during our time as researchers. My contemporaries will tell you the same.

So here we are, and the idea behind the funding that we get from the federal government is it must be matched.

And so we've been very lucky here in BC to have the very strong support from the University of British Columbia, where we now sit, but also the BC Cancer Foundation has supported us and indeed other projects at BC Cancer that participate in the Marathon of Hope Cancer Centres Network.

We also have the support of Genome BC and the Provincial Health Services Authority and hospitals across the continuum, and now into the interior and into the north, involvement of Kelowna and Prince George.

And so this network of things, where we're extending across the country, trying to promote this idea that data sharing is foundational to progress, and that we can use these tools, which are now fairly well understood and very powerful, to do this kind of work and share information, is going to lead to advances that we couldn't have anticipated without this data-sharing business.

So that's the landscape of it all.

This Toronto visit that I just recently came back from was entirely centred around the Marathon of Hope Cancer Centres Network.

And so we were fortunate enough to be able to come together as a big extended group.

I was very privileged to be asked to emcee an event and announce an incredible gift from the Tanenbaum Family Foundation in Toronto, who stepped forward with $25 million.

And so Larry and Judy, thank you very much. And Julie, the president of the foundation, thank you very much for that amazing leadership.

This then leverages an additional $25 million in matching funds from the federal government.

So that's $50 million in impact.

And so having the opportunity to make that announcement and to participate in that event was really uplifting, I guess you could say.

So we did that.

We had an operational meeting where we heard reports from across the country and various research studies, including our amazing patient working group.

So these are patients who participate in the research and in the organization of it.

And then we went from there to another amazing event organized by the Terry Fox Foundation and supported by the Terry Fox Research Institute, of which I'm a part, where we were able to tell our stories and invite a patient and her husband to come forward and tell their story to the audience.

It's incredibly powerful, events which really consolidate our community and emphasize the fact that this is not about some researchers and not about some patients.

It's about us.

Farha: It's about us. It's emotional, I'm sure.

Marco: For me, it is.

Again, one of these kinds of things that you didn't know could ever exist until it did.

Farha: I want to give you one last minute.

What do you envision, even in the short future right now? What do you see? What do you hope for in the next few years?

Marco: That's a loaded question. I hope for so much.

And so the Fox family has, for 46 years, carried forward Terry's vision.

And I've been privileged to meet a number of members of the Fox family.

And I had the opportunity this time to meet Terry's nieces.

And so here's a shout-out to Terry's nieces.

They're amazing young women who are clearly stepping up and assuming leadership roles.

And so this, to me, gives me heart that the notion of Terry Fox and the involvement as a family will continue.

And I think that's vitally important.

The whole Fox family are heroes. Terry was the first, but they're all right there.

And so I love that.

And I want us to get to a point where we actually have this technology, any technology, to help us do better by cancer patients.

There are so many problems to work through in the healthcare system.

And this technology will do some things, but really, we need to advance.

We need to be more sophisticated, more compassionate. We need to be faster.

And we need to be more accurate.

We need to get there. And we need to do it quickly.

And I think with the people assembling around the network and beyond, and the unifying theme, the icon of Terry Fox, we have a long way to go, but we have a vehicle to get there.

Farha: And I will post a link to that lovely video.

Marco: It's the creation of the Terry Fox Foundation.

It starts off with Terry running alone and then aggregating people around him.

And then he slows.

And a crowd forms around him, and then disappears, and he's gone.

And then a researcher starts running.

And shout-out to Dr. Robin Urquhart in the Atlantic Cancer Consortium.

Robin is the one leading the way.

And then there are various scenes depicting the transfer of information.

We see Drs. Ian Watson and Lillian Siu, Quebec and Toronto respectively, exchanging information.

We see researchers swinging across these lines connecting big tall buildings, transfer of information, the internet, if you like, I suppose.

And all of it boils down to me on top of a van with my colleague from Alberta, Dr. Jen Chan.

And we're scooting along and we hop off the van and throw open the door.

And Darryl Sittler, one of Terry's heroes, who presented Terry with his NHL All-Star jersey during the run, he hops out and he skates away and busts through a wall.

And it all culminates with a spinning centrifuge and some scene shot in a laboratory.

So it goes from claymation, stop-motion, to a real-world lab setting.

It's incredibly powerful.

Farha: And very Canadian.

Marco: It is, as we are.

Farha: To remind everyone that my children, my younger one is almost out of high school now, but every year the Terry Fox Run is part of their school, and it's something really important in the fabric of this country.

When you think about that and seeing that little film, it is beautiful.

Marco: It is.

The concept is a beautiful thing.

And the run very concretely brings us together for an event every year.

And we think about what it means. Very powerful.

Farha: I think, Marco, we'll end there.

Thank you so much for joining me.

Marco: Huge pleasure. Thank you for having me.

Research and Further Reading

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