Providence Research Profiles: Dr. Bradley Quon

In our Providence Research Profiles series, we spotlight some of our exceptional scientists engaged in innovative health research. This month, we are featuring Dr. Bradley Quon, a Principal Investigator with the Centre for Heart Lung Innovation (HLI), medical and research director of the Cystic Fibrosis Adult Care Program at St. Paul’s Hospital, and an associate professor in the Department of Medicine at the University of British Columbia (UBC). 

Dr. Quon’s research is dedicated to developing better tools to diagnose and monitor cystic fibrosis (CF), a genetic disorder that impacts respiratory, digestive, and reproductive health. His work spans biomarker research, epidemiological research, and clinical trials. 

He studied medicine at McGill University, completed an internal medicine residency and a respirology fellowship at UBC, and received a Master’s of Science in Epidemiology and Biostatistics at the University of Washington. He served as the inaugural medical director for Cystic Fibrosis Canada’s clinical trials network, CanACT, a program that aims to engage CF patients in clinical trials and increase research capacity. 

“Dr. Quon is an exceptional clinician-scientist, who over his career has improved the lives of patients living with cystic fibrosis through his cutting-edge research program, clinical care and tireless advocacy. He is an even better person – caring, compassionate and diligent,” says Dr. Don Sin, Director of the HLI. 

Identifying biomarkers to enable precision medicine

One focus of Dr. Quon’s research involves discovering biomarkers to improve disease monitoring and clinical care for CF patients. CF exacerbations, which worsen symptoms and often require hospitalization, can be triggered by viral or bacterial infections. Dr. Quon is investigating whether biomarkers can help identify the specific type of exacerbation, allowing for more targeted treatment.

He has also conducted research into using levels of inflammatory cytokines, proteins released by immune cells in response to infection or injury, to detect if a patient is at risk for exacerbations and identify illness earlier. 

“PHC has been extremely supportive of all the research I’ve been involved with over the past ten-plus years,” says Dr. Quon. 

Studying the impact of game-changing CF treatment

In the last few years, a new medication has revolutionized CF treatment. Cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy, known as Trifakta, targets the malfunctioning protein that causes the disease, greatly improving outcomes and life expectancy for the majority of CF patients. CF-related hospitalizations have decreased by eighty per cent, and the need for lung transplants has dropped. Where previously Dr. Quon would see five to six CF patients a year who would require a lung transplant, he has seen none since this treatment has become available.

“I couldn’t imagine a more effective medication for our patient population,” says Dr. Quon. “Patients are planning for their future again.”

Dr. Quon has been conducting research in several areas to study the impact of this treatment on patients and the healthcare system, collaborating with HLI colleagues including Drs. Jordan Guenette, Rachel Eddy and Don Sin on studies involving exercise and detailed MRI scans of patients’ lungs. He has been examining inflammatory biomarkers to understand the treatment’s effect on lung inflammation, quality of life, work productivity, and other important factors.

He is additionally studying the mental health impacts of this treatment, finding that while most CF patients had their anxiety and depression scores improve, around 10% had their score worsen, likely due to challenges adjusting to a suddenly increased life expectancy. Patients who once may have expected to live into their forties now may live into their seventies or eighties and may not have planned for retirement or invested in their education.

While Trikafta is approved to treat ninety per cent of CF patients, who have the most common mutation that causes the disease, another five per cent with rarer mutations could potentially benefit but weren’t included in the clinical trials. Dr. Quon is testing how nasal cells from these patients respond to the drug. If the cells show a positive response, that information could be used to advocate for these patients to access this treatment.

Additionally, he is conducting epidemiological research to understand the impacts of Trikafta on economic factors including healthcare utilization, such as the decreased need for hospitalization, and reduced use of other medications. Before starting Trikafta, patients would require time-consuming and expensive nebulized treatments daily to break up mucus and treat bacterial infections. Since the addition of Trikafta, many patients have been able to stop these burdensome treatments completely. 

An exciting time in CF research

The success of CTFR modulator therapies has changed many of the outcomes that researchers have focused on in the past, such as hospitalizations due to exacerbations. This has resulted in a reset in the field as researchers work to adjust study designs to measure outcomes that are clinically meaningful to patients. 

While CFTR modulators are very effective, they do not fix the underlying genetic defect and must be taken daily. Dr. Quon believes that the next wave of CF studies will be focused on gene editing, gene replacement, and mRNA therapies to ultimately cure the disease.

“There’s still a lot of exciting research to come,” says Dr. Quon. 

He finds significant fulfillment in research, which allows him to help patients and impact many lives. He has had great mentors while working at Providence, including Dr. Sin. 

“Dr. Quon is also training the next generation of clinicians, who will care for patients living with CF. He is the embodiment of the ‘triple threat’ – an excellent clinician, researcher and teacher,” says Dr. Sin.