Dr. Philippe Lefrancois is an Assistant Professor in the Department of Medicine, Division of Experimental Medicine, at McGill University. His laboratory focuses on enhancing understanding of skin cancers, particularly Basal Cell Carcinoma (BCC), which is the most prevalent of all human cancers. The aim is to enable patients to benefit from new targeted therapies and management options. The research involves defining the cellular and molecular phenotypes of aggressive BCC tumors. Computational biology, genomics, and molecular biology approaches are employed using various sample types, including data from cancer consortia, patient-derived tumors, publicly-available sequencing data from other patient cohorts, and primary cancer cell lines. The emphasis is on identifying novel signaling pathways and actionable targets for BCC, as well as characterizing the BCC tumor microenvironment with a focus on clinically-relevant features.

1. Who has influenced your choice of research field the most? And how?
For translational cancer research my Ph.D. advisor at Yale Mike Snyder (now at Stanford). Mike is a pioneer in personalized medicine and genomics technology development, with numerous successful spinoffs and startups. He always encouraged functional, practical, and clinical applications for our more basic science projects. He taught me to be fearless and not to care about existing dogmas. He advised me to be more involved in computational biology by auditing classes as a 5th year graduate student – now it’s a major part of what I do.
For dermatology my colleague Vincent Quoc-Huy Trinh (now PI at IRIC-UdeM). When I was in clerkship, I was going towards residency in pathology. He was doing a rotation as a PGY1 in dermatology and told me I would probably like it. A month before CaRMS, I did one rotation in dermatology at the CHUM, I was excited about skin cancers and the clinic-pathological correlation in derm, and the rest is history…

2. What are the greatest challenges you have faced or are facing in your research area?
A common challenge is the misconception about non-melanoma skin cancer like BCC and SCC amongst oncology clinicians and researchers. There is a lack of information regarding the current NMSC epidemic, the immense burden across all stakeholders, and the paucity of research despite BCC and SCC being the two most common cancers in North America – by far! I am very fortunate to have had early support by the Terry Fox Research Institute – Marathon of Hope Cancer Centre Network with a Clinician Scientist Award, which really kickstarted my career, along with help from the JGH Foundation (Carole & Myer Bick, Steven & Irwin Kramer). Now I have support from SkIN Canada, FRQS, CFI, CDF, CRS, IRDM and CQDM.

3. What do you think can be done to grow the impact of skin research in Canada?
More funding for skin research given how it affects patients in a disproportionate way compared to the current financial support levels. Raising awareness about how serious many skin conditions are, and how they are public health issues/emergencies affecting patients, caregivers, governments/payers, and the healthcare system as a whole. From a dermatologist standpoint, I think being more present within the research institute and within the hospital ecosystem itself, including on wards and in hospital-wide/department-wide meetings, raises our profile as skin specialists. Growing existing consortia like SkIN Canada is key. Given the small size of the skin research community in Canada, we need to collaborate more and use each other’s strengths instead of competing for the same pool of money. A federated approach like cancer research consortia seems to increase the buy-in for collaborations. I personally think setting up smaller, realistic goals in the first place, instead of going for the home run, increases our chances of achieving success together so we become trusting long-term research partners.

4. If you have worked with patients as part of the research team, what did you learn? If you have not yet, what are you looking forward to learning from patient research partners?
Skin cancer patients involved in our research want the same as us: faster, earlier and better diagnosis, less invasive procedures, more targeted treatments for all stages, and improved prognostication/stratification. But I became much more aware of the communication aspects – how, when, and what. It matters for the lived experience of patients and their caregivers. Also, after several interactions with patient partners, I try to empower patients more – for monitoring, management, prevention, etc.. I keep translating from bedside to bench then to bedside the major priority of our work. Indeed, patients are at the heart of my research program, as I focused primarily on patient-derived tumors from our biobank currently. After interactions with patient partners in research, I actively try to become more involved with biotechs and collaborators willing to bring innovations and therapeutics towards phase I.
5. What are the key factors that attract trainees and early career investigators to choose skin research as their field of study?
Skin issues affect a lot of us. Many people care much more about what they see every day than a blood test for instance. Skin cancer is preventable and is easy to conceptualize.
Skin research, especially inflammatory disorders, has undergone a major translational revolution regarding better, safer, broadly applicable treatments such as small molecule inhibitors and biologics. These are life-changing for significant proportions of patients when we look at the demographics (5% prevalence for psoriasis or atopic dermatitis).
Related to skin cancer, the translational potential for testing out novel therapeutics, diagnostics, or tools is huge since it’s so accessible. It’s always great to collaborate with clinicians, translational researchers, basic scientists, biotechs, and patient partners from all fields of oncology to test new XYZ in very cool and innovative systems! I love the underlying human interactions from these collaborations. There is a paucity of data and treatment for NMSC, so a lot of open space to fill.