Molecular Determinants Of Risk, Progression And Treatment Response In Melanoma
Funder
National Health and Medical Research Council
Funding Amount
$8,381,820.00
Summary
Melanoma is a major Australian health problem. NSW figures for 2002 show it to be the second most common cancer in men and women. It has a disproportionately heavy impact on productive years of the life of young Australians because it is the commonest cancer in those aged 15-45 years. The investigators are all associated with the Sydney Melanoma Unit (SMU), the world�s largest clinical service dedicated to the treatment of melanoma, treating >1200 new melanoma patients annually. We have also ....Melanoma is a major Australian health problem. NSW figures for 2002 show it to be the second most common cancer in men and women. It has a disproportionately heavy impact on productive years of the life of young Australians because it is the commonest cancer in those aged 15-45 years. The investigators are all associated with the Sydney Melanoma Unit (SMU), the world�s largest clinical service dedicated to the treatment of melanoma, treating >1200 new melanoma patients annually. We have also recruited large cohorts of individuals with high susceptibility to melanoma, both familial and population-based, throughout southeastern Australia. We aim to utilise these unique, internationally-recognised resources to develop a scientific basis for 1) improved management of individuals at high risk for development and progression of melanoma, and 2) improved treatment of patients with early and disseminated melanoma. We will base this on consolidation of existing collaborative research into molecular predictors of risk, progression and treatment response in melanoma.Read moreRead less
Breast cancer is the most common cancer diagnosed in Australian women, affecting one in 8. While physical examination, mammography and ultrasound remain first-line screening tools, there are no reliable blood tests to aid diagnosis. This project aims to discover proteins in breast cancer tissue, or in the bloodstream of patients, which can be measured to provide information about the presence and severity of breast cancer. A new, reliable diagnostic test could benefit millions of women.
Prognostic Importance Of Androgen Receptors In Epithelium And Stroma In Early Stage Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$348,750.00
Summary
The use of serum prostate specific antigen (PSA) to screen asymptomatic men for prostate cancer has reduced the stage of disease at diagnosis. The majority of tumours are now small and potentially organ-confined. The use of nomograms, algorithms based on preoperative clinical features of these patients (serum PSA level, Gleason grade, clinical stage) has facilitated this process, but is imperfect as 20-30% of patients experience disease relapse within 5-7 years. Tumours with similar preoperative ....The use of serum prostate specific antigen (PSA) to screen asymptomatic men for prostate cancer has reduced the stage of disease at diagnosis. The majority of tumours are now small and potentially organ-confined. The use of nomograms, algorithms based on preoperative clinical features of these patients (serum PSA level, Gleason grade, clinical stage) has facilitated this process, but is imperfect as 20-30% of patients experience disease relapse within 5-7 years. Tumours with similar preoperative clinical features have markedly different outcomes, reinforcing the inadequacy of current approaches to determining whether or not an individual patient has organ-confined disease. A new approach is to incorporate into the standard diagnostic nomograms, biological features from preoperative core biopsy linked to the process of disease relapse, and which independently predict patient outcome risk group. Our preliminary studies using a small hypothesis-generating cohort of patients with early stage prostate cancer determined that elevated levels of androgen receptors (AR) in malignant epithelial cells and reduced levels of AR in peritumoral stromal cells independently predict disease relapse after surgery. In this project, AR measurements will be analysed in independent cohorts of patients derived from two Australian institutions to determine whether the predictive value is maintained across multi-Institutional cohorts. Selected androgen-regulated markers of tumour growth and spread (proliferative, apoptotic, metastatic) will be examined in microarrayed postoperative tissue samples. The postoperative markers will be examined for independence of prediction of relapse. Independent markers will be examined for ability to increase predictive efficacy in standard diagnostic nomograms. Levels of the two markers with greatest predictive value will be measured in preoperative core biopsies and tested for predictive ability as a prelude to clinical practice.Read moreRead less
Gastric Cancer: Early Detection Of Disease, Relapse And Prediction Of Extent Of Disease
Funder
National Health and Medical Research Council
Funding Amount
$421,800.00
Summary
Gastric cancer (GC) is the second commonest cause of cancer in the world. The mainstay of treatment for GC is surgical resection, but despite improvements in surgical interventions the mortality rate remains high. The 5 year survival rate of GC is about 30% over 5 years. Accurate staging is fundamental to the management of GC and current investigations are inadequate. It has become possible to measure the activity of thousands of genes to identify those genes that predict whether a patient will ....Gastric cancer (GC) is the second commonest cause of cancer in the world. The mainstay of treatment for GC is surgical resection, but despite improvements in surgical interventions the mortality rate remains high. The 5 year survival rate of GC is about 30% over 5 years. Accurate staging is fundamental to the management of GC and current investigations are inadequate. It has become possible to measure the activity of thousands of genes to identify those genes that predict whether a patient will survive or succumb to their disease. We propose to use gene expression profiling to predict the risk of recurrence of gastric cancer in patients. We will examine over 270 tumours and use an independent group of patients to evaluate the test. We aim to develop a test that will help the clinician decide the type of surgical resection to perform or whether to give adjuvant chemotherapy. The test may also guide the use of more specific anticancer drugs. Early detection of GC is very important because patients with early stage GC have better outcome. We have already analysed over 60 GC tumours with microarrays and found genes that are specifically expressed by the tumours that are potential candidates as cancer markers. We plan to examine more cases of GC, both to find more genes and validate our candidate genes as tumour markers. We also want to look for patterns of proteins in blood of patients that identifies GC and use this pattern to follow patient progress to treatment.Read moreRead less
Health System Performance And Outcomes For Indigenous Australians With Cancer: A National Study.
Funder
National Health and Medical Research Council
Funding Amount
$412,354.00
Summary
Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained ab ....Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained about health system performance for Indigenous Australians from national administrative databases and registers. This project will assess health system performance and outcome for Indigenous people with cancer at a national level for the first time. It will compare Indigenous with non-Indigenous cancer survival rates for Australia as a whole, including regional (urban-rural-remote) variations and time trends. For those states where data on stage at diagnosis and hospital treatment are available, it will also investigate the performance of diagnostic and treatment services for Indigenous cancer patients by comparing their stage at diagnosis and surgical treatment with that for non-Indigenous patients. Time trends for each of these issues will be examined using data from those states with data of adequate quality and consistency over the past 10-15 years. This project will provide the methodological basis for regular reporting of Indigenous cancer survival and related statistics in the national cancer reporting system and demonstrate that national monitoring of the acute care system for Indigenous people is possible for other conditions. The results of this research will directly inform acute care policy and practice for Indigenous people with cancer (particularly the relative need for improvement in primary health or acute care services), and have implications for the performance of the acute care system system more generally for Indigenous Australians.Read moreRead less
Simultaneous Imaging And Drug Delivery For Prostate Cancer Theranostics
Funder
National Health and Medical Research Council
Funding Amount
$565,205.00
Summary
Prostate cancer (PC) is the most common cancer in men over 50. The answers to the key questions in advanced PC (Who to treat, and how to treat: loco-regionally or systemically?) rest with clinical staging – something that has hitherto been very imprecise. We have generated a highly-sensitive 19F-molecular imaging agent which could help resolve both questions and create a targeted therapy, diminishing the burden of harm of today’s therapies by using nanoparticles to diagnose and treat PC.
Prognostic Factors Following A First Episode Of Central Nervous System Demyelination Suggestive Of Multiple Sclerosis.
Funder
National Health and Medical Research Council
Funding Amount
$719,475.00
Summary
Multiple sclerosis is the second most common cause of neurological morbidity in young Australians after trauma. Knowing who will progress to develop multiple sclerosis after a first attack and at what rate they will progress is an important question as it will allow us to target treatment to those at greatest risk and modify a person's lifestyle to reduce the risk of developing MS or slow their rate of progression.
Optimizing Lung Cancer Diagnostic And Staging Pathways Through The Innovative Use Of Thoracic Imaging
Funder
National Health and Medical Research Council
Funding Amount
$189,384.00
Summary
This research aims to simplify the initial work-up for lung cancer diagnosis. Currently most patients undergo complex investigations and multiple biopsies. Common imaging technology e.g. ultrasound, PET and CT scans may help choose the best and least invasive biopsy procedure. My research will explore this through three complementary studies. If positive, >10000 Australians with lung cancer will benefit each year, and the majority of them will only have to undergo one biopsy procedure.
Analysis Of Gene Amplification-loss And Methylation Associated With Progression To Metastatic Colorectal Cancer
Funder
National Health and Medical Research Council
Funding Amount
$620,197.00
Summary
Many bowel cancers can be removed by surgery, but in many cases the cancer reoccurs. While chemotherapy can reduce the chance of recurrence, it can produce significant side effects. Currently there are few markers to indicate change of recurrence, therefore deciding who should, or should not receive chemotherapy is difficult to decide. This study will analyse differences in DNA from patients that do and do not relapse, to guide future decisions on patients who will benefit from chemotherapy.