Assistant Professor

Adam Smith

Department of Laboratory Medicine & Pathobiology - Molecular Genetics


Toronto General Hospital: University Health Network (UHN)
200 Elizabeth St., Cancer Cytogenetics, Laboratory Medicine Program, Toronto, Ontario Canada M5G 2C4
Research Interests
Genetics Genomics & Proteomics, Cancer
Clinical Interests
Molecular Genetics, Cytogenetics
Appointment Status

Dr. Smith is currently the Director of the Cancer Cytogenetics Laboratory at the University Health Network.  

He is a dual-boarded Clinical Cytogeneticist and Clinical Molecular Geneticist certified by the Canadian College of Medical Geneticists (CCMG).  Dr. Smith is also a fellow of the American College of Genetics and Genomics (FACMG) and a Certified Laboratory Geneticist (erCLG) by the European Board of Medical Genetics.  

Dr. Smith completed his Master’s degree in 2000 in the Department of Laboratory Medicine and Pathobiology at the University of Toronto on the Pathomechanism of Costello syndrome. He completed his Ph.D. in the Institute of Medical Science at the University of Toronto unraveling the genetic and epigenetic mechanisms that control growth and cancer development at a locus on human chromosome 11 in the Beckwith-Wiedemann syndrome. 

Research Synopsis

The Cancer Cytogenetics Laboratory (CCL) provides clinical testing for structural variation in hematologic malignancies and solid tumours.  The CCL serves the Princess Margaret Cancer Centre, our partner hospitals in Ontario and across Canada.  

Our lab works towards a better understanding of how chromosomal changes in cancer promote tumorigenesis using new technologies leading to improvements in diagnostic testing and improving our understanding of the underlying biology of cancer. 

The CCL is currently a national leader in the development Optical Genome Mapping (OGM) for clinical use.  OGM is a new technology that assembles high resolution structural variation maps of genomes has the power to replace many conventional testing strategies currently used and reduce multiple tests performed on a sample to one single test.  
The CCL is a clinical lab and Dr. Smith is not currently seeking graduate students.  

Current projects

Clinical Development of Optical Genome Mapping 

Optical Genome Mapping is poised to replace karyotyping and FISH for many indications in Cancer Cytogenetics.

The focus of our lab is to develop standards and guidelines for the use of OGM in the clinic and to better understand and classify structural variation seen in cancer.  

The CCL is working towards the implementation of OGM in acute leukemia and myelodysplastic syndromes by comparing results to the current gold standard – karyotyping and FISH.  

Other development areas include Chronic Lymphocytic Leukemia and Multiple Myeloma where the benefit of having a full genome assessment of structural variation is shown to have a considerable association with disease prognosis.

We are developing methods to convert current FISH testing to OGM.  

Specialties: Genetics

  • Cytogenetics: Optical Genome Mapping, Karyotyping, Fluorescence in-situ hybridization
  • Molecular Genetics:  DNA sequencing, NGS, expression studies
  • Epigenetics: DNA methylation, Chromatin modifications
  • Oncology: Cancer Cytogenetics, Leukemia, Lymphoma and solid tumours.

Selected Publications

Cheung, C. C., Smith, A. C., Albadine, R., Bigras, G., Bojarski, A., Couture, C., Cutz, J.-C., Huang, W.-Y., Ionescu, D., Itani, D., Izevbaye, I., Karsan, A., Kelly, M. M., Knoll, J., Kwan, K., Nasr, M. R., Qing, G., Rashid-Kolvear, F., Sekhon, H. S., … Tsao, M.-S. (2021). Canadian ROS proto-oncogene 1 study (CROS) for multi-institutional implementation of ROS1 testing in non-small cell lung cancer. Lung Cancer, 160(April), 127–135.

Makarem, M., Ezeife, D. A., Smith, A. C., Li, J. J. N., Law, J. H., Tsao, M., & Leighl, N. B. (2021). Reflex ROS1 IHC Screening with FISH Confirmation for Advanced Non-Small Cell Lung Cancer—A Cost-Efficient Strategy in a Public Healthcare System. Current Oncology, 28(5), 3268–3279.

Daher-Reyes, G., Kim, T., Novitzky-Basso, I., Kim, K. H., Smith, A., Stockley, T., Capochichi, J.-M., Al-Shaibani, Z., Pasic, I., Law, A., Lam, W., Michelis, F. V, Gerbitz, A., Viswabandya, A., Lipton, J., Kumar, R., Mattsson, J., Schimmer, A., McNamara, C., … Kim, D. D. H. (2021). Prognostic impact of the adverse molecular-genetic profile on long-term outcomes following allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia. Bone Marrow Transplantation.

Quevedo, R., Spreafico, A., Bruce, J., Danesh, A., El Ghamrasni, S., Giesler, A., Hanna, Y., Have, C., Li, T., Yang, S. Y. C., Zhang, T., Asa, S. L., Haibe-Kains, B., Krzyzanowska, M., Smith, A. C., Singh, S., Siu, L. L., & Pugh, T. J. (2020). Centromeric cohesion failure invokes a conserved choreography of chromosomal mis-segregations in pancreatic neuroendocrine tumor. Genome Medicine, 12(1), 1–15.

Bebb, D. G., Agulnik, J., Albadine, R., Banerji, S., Bigras, G., Butts, C., Couture, C., Cutz, J. C., Desmeules, P., Ionescu, D. N., Leighl, N. B., Melosky, B., Morzycki, W., Rashid-Kolvear, F., Sekhon, H. S., Smith, A. C., Stockley, T. L., Torlakovic, E., Xu, Z., & Tsao, M. S. (2019). Crizotinib inhibition of ROS1-positive tumours in advanced non-small-cell lung cancer: A Canadian perspective. Current Oncology, 26(4).

Fiset, P. O., Labbé, C., Young, K., Craddock, K. J., Smith, A. C., Tanguay, J., Pintilie, M., Wang, R., Torlakovic, E., Cheung, C., da Cunha Santos, G., Ko, H., Boerner, S. L., Hwang, D. M., Leighl, N. B., & Tsao, M. (2019). Anaplastic lymphoma kinase 5A4 immunohistochemistry as a diagnostic assay in lung cancer: A Canadian reference testing center’s results in population-based reflex testing. Cancer, 1–9.

Kim, J. C., Zuzarte, P. C., Murphy, T., Chan-Seng-Yue, M., Brown, A. M. K., Krzyzanowski, P. M., Smith, A. C., Notta, F., Minden, M. D., & McPherson, J. D. (2019). Cryptic genomic lesions in adverse-risk acute myeloid leukemia identified by integrated whole genome and transcriptome sequencing. Leukemia, 1–6.

Garg, S., Nagaria, T. S., Clarke, B., Freedman, O., Khan, Z., Schwock, J., Bernardini, M. Q., Oza, A. M., Han, K., Smith, A. C., Stockley, T. L., & Rouzbahman, M. (2019). Molecular characterization of gastric-type endocervical adenocarcinoma using next-generation sequencing. Modern Pathology : An Official Journal of the United States and Canadian Academy of Pathology, Inc, 32(12), 1823–1833.

Wasserman, J. K. J. K., Dickson, B. C. B. C., Smith, A., Swanson, D., Purgina, B. M. B. M., & Weinreb, I. (2019). Metastasizing Pleomorphic Adenoma: Recurrent PLAG1/HMGA2 Rearrangements and Identification of a Novel HMGA2-TMTC2 Fusion. The American Journal of Surgical Pathology, 43(8), 1145–1151.

Barghout, S. H., Patel, P. S., Wang, X., Xu, G. W., Kavanagh, S., Halgas, O., Zarabi, S. F., Gronda, M., Hurren, R., Jeyaraju, D. V, MacLean, N., Brennan, S., Hyer, M. L., Berger, A., Traore, T., Milhollen, M., Smith, A. C., Minden, M. D., Pai, E. F., … Schimmer, A. D. (2018). Preclinical evaluation of the selective small-molecule UBA1 inhibitor, TAK-243, in acute myeloid leukemia. Leukemia.

Huang, S. J., Bergin, K., Smith, A. C., Gerrie, A. S., Bruyere, H., Dalal, C. B., Sugioka, D. K., Hrynchak, M., Ramadan, K. M., Karsan, A., Gillan, T. L., & Toze, C. L. (2017). Clonal evolution as detected by interphase fluorescence in situ hybridization is associated with worse overall survival in a population-based analysis of patients with chronic lymphocytic leukemia in British Columbia, Canada. Cancer Genetics, 210, 1–8.


Director of Cancer Cytogenetics, University Health Network