Dr. Paul Grundy joined the Partnership as Expert Lead, Pediatric, Adolescent and Young Adult Oncology in 2016.
Dr. Grundy has been on the faculty of the Department of Pediatrics at the University of Alberta since 1988 and is currently a Professor of Pediatrics and Oncology.
Previously, Dr. Grundy was Senior Vice-President and Senior Medical Director with CancerControl Alberta, a division of Alberta Health Services. He has been a pediatric oncologist in Edmonton for over 20 years, and was Director of Pediatric Hematology and Oncology at the University of Alberta from 1999-2010. He was a founding member of C17, a national network of childhood cancer centres across Canada, and served as the first Director of the C17 Research Committee. He subsequently served as the network’s chair from 2006-2011.
Dr. Grundy’s research focus has been on Wilms' tumour of the kidney, a common childhood cancer,. His work on this type of cancer spans the spectrum from basic molecular biology to translational research and clinical trials. A legacy of his research program is the childhood renal tumours tissue bank which harbors a variety of specimens from over 6,000 patients and is available to researchers worldwide. He has served as the Chair of the National Wilms' Tumour Study Group and as Chair of the Children’s Oncology Group Renal Tumours Committee.
Dr. Grundy received his medical degree from the University of Alberta and did post-graduate training in Edmonton and New Zealand. He also completed a fellowship in pediatric hematology oncology at the Children’s Hospital of Philadelphia.
Areas of Expertise (8)
Adolescent and Young Adult Cancers
Cancer in Children
University of Alberta: MD, Medicine 1979
- Canadian Task Force for Adolescents and Young Adults with Cancer: Co Chair
- International Society of Pediatric Oncology: Member
- Children’s Oncology Group Renal Tumours Committee: Past Chair
- National Wilms' Tumour Study Group: Past Chair
- Canadian Association of Provincial Cancer Agencies: Past Chair
- C17 Council: Past Chair
Media Appearances (1)
Better survival rates from childhood leukemia reflect decades of progress
CBC News online
In Canada, the five-year survival rate for acute lymphoblastic leukemia (ALL) sits at 90.6 per cent.
The vast majority of children diagnosed with the disease will be cured because it rarely recurs, said Dr. Paul Grundy, the expert lead for pediatrics at the Canadian Partnership Against Cancer.
Grundy was not involved in the research but the partnership helped to fund the study, called CONCORD-2.
"In 1960, the survival was zero. There was no treatment. Children lived for a month or two after diagnosis and died," Grundy told CBC News. "In all of medicine, I think this is one of the top success stories: in just 50 years, to go from zero to 90 per cent survival."
For families, it still means one in 10 will lose their child after a devastating diagnosis, said Grundy, who is also a pediatric hematology oncologist in Edmonton.
He added that in North America, one area for improvement surrounds the long-term side-effects of treatment, which can pose a challenge to how children learn.
The treatment for ALL generally last between two-and-a-half to three years.
Wilms tumour (WT) is an embryonal kidney neoplasia for which very few driver genes have been identified. Here we identify DROSHA mutations in 12% of WT samples (26/222) using whole-exome sequencing and targeted sequencing of 10 microRNA (miRNA)-processing genes. A recurrent mutation (E1147K) affecting a metal-binding residue of the RNase IIIb domain is detected in 81% of the DROSHA-mutated tumours. In addition, we identify non-recurrent mutations in other genes of this pathway (DGCR8, DICER1, XPO5 and TARBP2). By assessing the miRNA expression pattern of the DROSHA-E1147K-mutated tumours and cell lines expressing this mutation, we determine that this variant leads to a predominant downregulation of a subset of miRNAs. We confirm that the downregulation occurs exclusively in mature miRNAs and not in primary miRNA transcripts, suggesting that the DROSHA E1147K mutation affects processing of primary miRNAs. Our data underscore the pivotal role of the miRNA biogenesis pathway in WT tumorigenesis, particularly the major miRNA-processing gene DROSHA.
Stage III designation in NWTS-5 (National Wilms Tumor Study–5) was determined by four pathologic criteria: positive lymph nodes (LNs), peritoneal implants, residual disease, and tumor rupture. The objective of this study was to determine the prognostic significance of each of the stage III criteria.
Childhood cancer is a major global health issue. Every year, almost 100 000 children die from cancer before the age of 15 years, more than 90% of them in resource-limited countries. Here, we review the key policy issues for the delivery of better care, research, and education of professionals and patients. We present a key list of time-limited proposals focusing on change to health systems and research and development. These include sector and system reforms to make care affordable to all, policies to promote growth of civil society around both cancer and Millennium Development Goals, major improvements to public health services (particularly the introduction of national cancer plans), improved career development, and increased remuneration of specialist health-care workers and government support for childhood cancer registries. Research and development proposals focus on sustainable funding, the establishment of more research networks, and clinical research specifically targeted at the needs of low-income and middle-income countries. Finally, we present proposals to address the need for clinical trial innovation, the complex dichotomy of regulations, and the threats to the availability of data for childhood cancers.
Wilms tumor is the most common childhood renal tumor. Although the majority of patients with favorable histology Wilms tumor (FHWT) have good outcomes, some patients still experience disease recurrence and death from disease. The goal of the current study was to determine whether tumor-specific chromosome 1q gain is associated with event-free survival (EFS) and overall survival (OS) in patients with FHWT.
Wilms tumor is the most common renal malignancy of childhood. To identify common variants that confer susceptibility to Wilms tumor, we conducted a genome-wide association study in 757 individuals with Wilms tumor (cases) and 1,879 controls. We evaluated ten SNPs in regions significantly associated at P < 5 × 10−5 in two independent replication series from the UK (769 cases and 2,814 controls) and the United States (719 cases and 1,037 controls). We identified clear significant associations at 2p24 (rs3755132, P = 1.03 × 10−14; rs807624, P = 1.32 × 10−14) and 11q14 (rs790356, P = 4.25 × 10−15). Both regions contain genes that are plausibly related to Wilms tumorigenesis. We also identified candidate association signals at 5q14, 22q12 and Xp22.
Metastatic lung disease in Wilms tumor (WT) patients was traditionally identified by chest radiograph (CXR). It is unclear whether patients with small lesions, detectable only by computed tomography (“CT-only” lesions), require the more intensive therapy, including doxorubicin and lung irradiation, given to patients with metastases detectable by CXR.
To determine if tumor-specific loss of heterozygosity (LOH) for chromosomes 1p or 16q is associated with a poorer prognosis for children with favorable-histology (FH) Wilms tumor entered on the fifth National Wilms Tumor Study (NWTS-5).