14 October 2010
The Cancer Institute NSW has awarded the Garvan Institute’s Cancer Research Program $3.7 million, research funding that should lead to improved clinical decision-making for breast, prostate and pancreatic cancer within the next 5 years.
Garvan researchers will use the latest technologies to identify potential ‘biomarkers’, specific changes in cells at the molecular level that indicate the presence and type of disease.
Biomarkers will be used to stratify patients with different subtypes of the three target cancers, in other words, to differentiate ‘good’ from ‘bad’ types of breast, prostate and pancreatic cancer.
Biomarkers will also be developed to predict response to therapy. This approach, known as ‘personalised medicine’, will nominate treatments for individual patients based on the specific characteristics of their tumours.
The Kinghorn Cancer Centre, currently being built by Garvan and St Vincent’s Hospital (scheduled to open in mid-2012), will adopt personalised medicine approaches and will focus on finding ways to minimise timelines between research discoveries and treatments.
Professor Rob Sutherland, leader of Garvan’s Cancer Program, Director of The Kinghorn Cancer Centre and primary grant recipient, says the grant will allow much ongoing research to progress to the next stage. “We’ve already discovered many potential drug candidates through the ICGC [International Cancer Genome Consortium] project and through various NHMRC, Cancer Institute and Cancer Council grants,” he said.
“Our work is advancing to the point where there are possibilities through genomics work to identify and design specific markers for individual patients.”
“By looking at the proteomic or genomic profiles of tumours, you can actually identify specific genetic mutations or rearrangements that are specific for that tumour.”
“You can then monitor the presence of those abnormalities in the blood, in response to therapy, and watch how the disease progresses and how the patient responds to that specific therapy.”
“The National Cancer Institute in the United States and Cancer Research UK developed a ‘pipeline’, or strategy, for biomarker discovery and development.”
“We have a number of discoveries that are currently at different stages down that pipeline. We have, for example, biomarkers of responsiveness to anti-oestrogens, or aromatase inhibitors, in breast cancer. In addition, we have samples from international clinical trials from women who’ve been treated with those agents. That puts us in a position to see how effective those markers are in predicting responsiveness to treatment – and to run a prospective clinical trial of our own.”
“In prostate cancer, at the time of diagnosis, we want to be able to identify which men really need to be treated, as opposed to those who have got a less serious form of the disease.”
“What happens now is that people get over-treated because we can’t do the test that differentiates one prostate cancer from another.”
“To correct that situation, we’re testing prospectively for the prostate cancer marker throughout teaching hospitals in Sydney. In a couple of years, we’ll be in a position to confirm whether or not the marker actually does identify the patients that have the aggressive form of prostate cancer.”
“Once we have evidence from both retrospective and prospective studies that a test works, we have to roll it out into the clinical situation – which is all about regulatory approval.”
“The grant from the Cancer Institute covers the whole ‘pipeline’ spectrum – from discovery through assay development, pilot studies, retrospective clinical analysis, prospective clinical trials and clinical implementation.”
“The term of the grant is five years, and by the end of that time we would expect to have some tests that are being rolled out to patients in The Kinghorn Cancer Centre.”