Dr. Fernando Pikabea Diaz:
I am a Medical Oncology fellow at the Princess Margaret Cancer Centre, focusing on thoracic malignancies. I completed my residency in Medical Oncology at Hospital Universitario Basurto in Bilbao, Spain, in 2021.
My main research interest lies in circulating tumor DNA (ctDNA) and minimal residual disease (MRD) detection in early-stage lung cancer, aiming to better predict recurrence and guide post-surgical management. Alongside this, I have been involved in real-world studies on treatment sequencing in ALK-positive NSCLC, exploring how we optimize targeted therapies beyond first-line settings.
I am particularly interested in the possibility of bridging translational biomarkers with real-world clinical decision-making.
1. Which projects are you working on?
My primary research focuses on ctDNA-based MRD detection in early-stage NSCLC. In a recent study, we used an ultrasensitive tumor-informed approach to identify patients at high risk of relapse after surgery and to better understand recurrence dynamics over time.
In parallel, I have been working on a national multicentre real-world study evaluating treatment sequencing after alectinib progression in ALK-positive NSCLC, comparing outcomes with lorlatinib and brigatinib . This work focuses not only on survival outcomes but also on treatment durability and real-world decision-making when the standard drug is not working well anymore.
Together, these projects reflect my broader interest in both early disease interception and advanced disease optimization.
2. Why did you choose to work in Canada?
I wanted to train in an environment where clinical excellence and research are deeply integrated, and Princess Margaret offered a unique opportunity to work on cutting-edge translational research, such as ctDNA and MRD, while also being involved in large-scale real-world clinical studies. It felt like the ideal place to grow both as a clinician and as a researcher. Of course, that would mean surviving to these freezing winters, but the opportunity of working in here was clearly worth it!.
3. Why did you choose to work in this lab?
What drew me to this group was the strong connection between research and clinical practice. Working with Dr. Geoffrey Liu’s team has been a unique opportunity to engage in clinically meaningful, large-scale research. He has been incredibly generous in creating an environment where fellows can contribute meaningfully, including giving me the opportunity to work with a rich, multicentre dataset even though I was not directly involved in its initial collection.
That level of openness and trust is something I really value, and it has allowed me to both learn quickly and contribute to projects that have direct clinical relevance. The collaborative nature of the group makes it an ideal place to grow as a clinician-scientist.
4. What attracted you to oncology?
Oncology combines scientific complexity with a very human side of medicine. What I find most meaningful is the ability to use evolving biological knowledge, such as ctDNA or molecular profiling, to guide real decisions for patients. It’s a field that constantly evolves, and that makes it both challenging and deeply rewarding.
5. What are your future plans?
I plan to continue in thoracic oncology, combining clinical work with translational and real-world research, hopefully being able to transfer all I will learn in here to my country, Spain. I am particularly interested in improving how we use biomarkers like ctDNA to guide treatment decisions, as well as optimizing sequencing strategies in advanced disease. Ultimately, I hope to contribute to more personalized and data-driven care in lung cancer, to make patient's lives easier and more quality-of-life focused.
6. How has your experience with COMBIEL been?
It has been an excellent experience. COMBIEL brings together high-quality data and strong collaboration across institutions, which has been essential for projects like our national ALK sequencing study. It’s a great environment to develop clinically meaningful research questions and translate them into impactful work. Thank you so much for giving me this opportunity!