Eve Simoneau

December 2017

  • PGY6 (Fellow)
  • Residency Program: McGill University
  • Supervisors: Dr. Peter Metrakos,

Background

Eve Simoneau completed medical school at McGill University in 2010, after which she started a residency in General Surgery also at McGill University. During her residency, she dedicated close to three years of additional training in research under the supervision of Dr Peter Metrakos to become a surgeon scientist. She obtained a PhD in Experimental Surgery, during which she was awarded a competitive grant from the Quebec Health Sciences Research Fund. During these years, she had the opportunity to present numerous times at international meetings, to get involved in international research collaborations and she co-authored multiple manuscripts including a recent publication in Nature Medicine. As of August 2017, she has started fellowship training in Hepatobiliary Surgery at MD Anderson Cancer Center in Houston, Texas.

 

Research Summary

Colorectal cancer constitutes a major disease burden in Western society and most patients will die with metastatic disease to the liver. Surgical resection of liver metastasis provides superior survival advantage compared to conservative treatment modalities such as systemic chemotherapy but unfortunately, the majority of patients presents with unresectable disease. Preoperative portal vein embolization is a method that can be used to convert initially unresectable patients to a resectable state but in some patients, this procedure has been associated with tumor progression in the preoperative period.

Eve’s work presented evidence that radiological tumor progression occurs in a large proportion of patients undergoing portal vein embolization, and that this affects the resectability rate of patients. Her results also show that tumor progression after portal vein embolization is closely associated to the extent of neoadjuvant chemotherapy response. Since tumor control in the preoperative setting is crucial to ensure resectability and superior outcomes, she also aimed to investigate the response to neoadjuvant chemotherapy. She and her collaborators provided evidence that response to chemotherapy, in particular to anti-angiogenic therapy, is mediated by different histological growth patterns of the liver metastasis (desmoplastic and replacement). The team also demonstrated that the histological patterns utilize different tumor vascularization processes, which explain resistance to anti-angiogenic therapy. Finally her research showed that these distinct histological growth patterns seem to determine colorectal cancer liver metastasis progression observed after portal vein embolization.