Molecular Classification Of Carcinoma Of Unknown Primary
Funder
National Health and Medical Research Council
Funding Amount
$418,250.00
Summary
Carcinoma of unknown primary (CUP) is the fourth largest cause of cancer death. The condition has a particularly poor outlook, with a median survival of less than one year. Current methods for diagnosis of CUP include histopathology and sophisticated imaging. These are successful in approximately 40% of cases. Frequently the reason for the poor outcome in this disease is that the 60% of patients with CUP for whom no diagnosis is made do not benefit from chemotherapy specifically designed for a p ....Carcinoma of unknown primary (CUP) is the fourth largest cause of cancer death. The condition has a particularly poor outlook, with a median survival of less than one year. Current methods for diagnosis of CUP include histopathology and sophisticated imaging. These are successful in approximately 40% of cases. Frequently the reason for the poor outcome in this disease is that the 60% of patients with CUP for whom no diagnosis is made do not benefit from chemotherapy specifically designed for a particular tumour origin. These patients receive a less effective, generic, chemotherapy. The aim of this project is to use microarrays to identify the gene expression profile in many known tumours to create a molecular fingerprint of the various tumour types. By comparing the fingerprint from a CUP with the database we should be able to identify the true tumour type in CUP, and allow patients to benefit from more specific chemotherapy.Read moreRead less
Investigation Of The Role Of The Renin-Angiotensin System In Hepatic Fibrosis.
Funder
National Health and Medical Research Council
Funding Amount
$246,990.00
Summary
Hepatic fibrosis is a common response to chronic liver injury, during which the normal liver architecture is distorted by scar tissue. Hepatic fibrosis can lead to cirrhosis and liver transplantation may be required for patients with liver failure and hepatocellular carcinoma. The chronic liver injury may result from a number of causes including alcohol, persistent viral infections and metabolic disorders. The mechanisms causing fibrosis in liver are similar to those causing fibrosis in other or ....Hepatic fibrosis is a common response to chronic liver injury, during which the normal liver architecture is distorted by scar tissue. Hepatic fibrosis can lead to cirrhosis and liver transplantation may be required for patients with liver failure and hepatocellular carcinoma. The chronic liver injury may result from a number of causes including alcohol, persistent viral infections and metabolic disorders. The mechanisms causing fibrosis in liver are similar to those causing fibrosis in other organs such as kidney and heart. In those organs, the renin-angiotensin system has been shown to contribute to the progression of fibrosis. This system has not been investigated in hepatic fibrosis. We have recently shown in patients with chronic hepatitis C (HCV), that those patients who are genetically pre-disposed to produce higher levels of angiotensin have more liver fibrosis. This application will investigate the role of the renin-angiotensin system in hepatic fibrosis and whether using currently available drugs to inhibit this system can decrease the rate of progression of fibrosis in liver. Liver failure due to chronic HCV infection is currently the leading indication for liver transplantation in Australia. For those patients who fail to respond to anti-viral therapy, there are currently no approved therapeutic options designed to delay or reverse the progression of fibrosis. Based on current known numbers of HCV patients it has been estimated that by the year 2020, over 2000 HCV patients will require a liver transplant each year in Queensland alone. Currently the number of donor livers available allows about 50 transplants per year. Thus there is a desperate need for therapeutic treatments that will delay or reverse the progression of hepatic fibrosis. A successful conclusion to this study will provide a clinically useful treatment strategy that can delay the progression of hepatic fibrosis and thus prevent the need for liver transplantation in many patients.Read moreRead less
FAST-Australia: A Phase II Study Of Family History Screening For Chronic Disease Prevention In Primary Care.
Funder
National Health and Medical Research Council
Funding Amount
$343,429.00
Summary
Risk of developing certain cancers, heart disease and diabetes is increased by having an affected family member. People found to be at risk can be offered ways to prevent or detect these diseases early through lifestyle advice or disease screening. This project will develop and evaluate a family history questionnaire in preparation for a trial of family history screening and its impact on disease prevention.
BEST-Australia: A Phase II Study Of Non-Endoscopic Screening For Barretts Oesophagus In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$513,481.00
Summary
Barrett's oesophagus is common in people with heartburn and may progress to oesophageal cancer. Most cases of oesophageal cancer are diagnosed at a late stage when chances of survival are poor. Currently Barrett's is only diagnosed by endoscopy. We will test how effective and acceptable a non-endoscopic sponge capsule and novel laboratory test is at detecting Barrett's oesophagus early. This could potentially enable early detection of this pre-cancerous condition in general practice.
A Clinical Trial Evaluating Neoadjuvant Chemotherapy For Women With Large Operable Or Locally Advanced Breast Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$269,805.00
Summary
Larger operable and locally advanced breast cancers (BC) which can involve the skin of the breast and lymph nodes under the arm are associated with poorer survival. Standard treatment usually includes neoadjuvant (or preoperative) chemotherapy to try to reduce the size of the cancer, followed by surgery and radiation therapy to treat any remaining cancer in the breast. Many women, despite maximum treatment, will still die from their disease, hence the need to develop more effective drug therapie ....Larger operable and locally advanced breast cancers (BC) which can involve the skin of the breast and lymph nodes under the arm are associated with poorer survival. Standard treatment usually includes neoadjuvant (or preoperative) chemotherapy to try to reduce the size of the cancer, followed by surgery and radiation therapy to treat any remaining cancer in the breast. Many women, despite maximum treatment, will still die from their disease, hence the need to develop more effective drug therapies. The advantages of neoadjuvant chemotherapy include: the potential to reduce the size of the breast cancer which may allow breast conserving surgery rather than mastectomy; and, the ability to directly assess the response of breast cancers to new drug treatments. This new research project aims to evaluate standard chemotherapy (epirubicin and cyclophosphamide) followed by a course of two newer, possibly more beneficial, chemotherapy drugs for breast cancer (docetaxel and gemcitabine (DG)) followed by surgery, in women with large operable-locally advanced breast cancer. The trial will allow patients with HER2 positive breast cancer to receive trastuzumab (Herceptin ) in addition to the DG chemotherapy treatment cycles. The study will measure the tumour response rates, efficacy and safety of the proposed treatments. Patients will be asked to consent to an extra core biopsy and a small sample of their breast tissue collected at the time of their breast surgery to be used for research to help better understand the biology of the disease and responses to treatment. The study could plausibly offer a better treatment for patients, resulting in a better prognosis for women who present with large operable or locally advanced breast cancer. The trial will be conducted, in Australia and New Zealand, by the Australian New Zealand Breast Cancer Trials Group (ANZ BCTG) and will involve approximately twenty Australian hospitals.Read moreRead less
Pain associated with bone cancer, fractures, osteoporosis, osteoarthritis, osteomyelitis (and other bone infections) often presents the clinician with a difficult problem of treatment as the pain can be debilitating and intractable. Most current treatments for bone pain are based on the assumption that the neural mechanisms underlying pain from different sources, whether it be visceral, cutaneous, muscular or bony, are the same, and can therefore be targeted with similar therapies. However, litt ....Pain associated with bone cancer, fractures, osteoporosis, osteoarthritis, osteomyelitis (and other bone infections) often presents the clinician with a difficult problem of treatment as the pain can be debilitating and intractable. Most current treatments for bone pain are based on the assumption that the neural mechanisms underlying pain from different sources, whether it be visceral, cutaneous, muscular or bony, are the same, and can therefore be targeted with similar therapies. However, little is known of the response properties, structure and organization of receptors and neurones responding to, and relaying information about painful stimuli, from bone to the brain. The objectives of this project are to reveal the fundamental neural mechanisms that account for the perception of bone pain. The project will test a series of specific hypotheses in order to explain why bone pain is often poorly controlled by standard pharmacological or surgical approaches. It is expected that this study will reveal the neural mechanisms responsible for relaying sensory information, in particular, that regarding painful stimuli, from bone to the brain. It will lead to a better understanding of the mechanisms of bone pain and form the template for future studies of its treatment.Read moreRead less
Screening For Chlamydia Trachomatis With Routine Pap Smears In General Practice: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$350,500.00
Summary
Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertilit ....Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility. The economic costs of Chlamydial infection in Australia have been estimated to be as high as $160 million each year. In the ACT 73.8% of chlamydial infections occur in the 20-40 year old group. Between 60 and 70% of women in this age range participate in Pap screening every two years. While targeted screening for Chlamydia in women is effective in the US, there are few studies that investigate its value in an Australian setting. In this randomised controlled clinical trial we aim to test the novel hypothesis that the routine offer of chlamydia testing to women between 20 and 40 years who undergo Pap screening significantly increases the detection of Chlamydia in that population. This is the first randomised-controlled trial of its type and is an extension of a current non-randomised pilot study of linked Chlamydia-Pap screening in the primary care setting. The aim is to determine if the program can be incorporated more widely in the ACT. The study will: Measure the impact of linked chlamydia-Pap screening on chlamydia screening participation rates More accurately determine the epidemiology of genital chlamydial infection in this age group and social setting; Undertake an economic evaluation of this approach; Determine if promoting the Pap smear as an opportunity for chlamydial screening increases the uptake of Pap screening in younger women Aid in the development of a National Chlamydia Screening strategyRead moreRead less
Efficacy Of Exercise Physiologist Counselling In Primary Care Patients: A RCT Of Two Pragmatic Approaches
Funder
National Health and Medical Research Council
Funding Amount
$940,925.00
Summary
Physical activity is one of the most powerful contributors to health, but population levels of activity are low. General practitioners (GPs) are well placed to provide physical activity counselling, but many are too busy. This project examines the effectiveness of referral of insufficiently active adults to an exercise physiologist (EP), using step counts from a pedometer as the outcome. We compare usual care from the GP with: (1) 5 EP visits, and (2) a single visit and telephone follow up.
Evaluating The Effectiveness Of Comprehensive Primary Health Care In Local Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,635,268.00
Summary
This research will develop and implement a program logic evaluation in order to assess the effectiveness of various models of primary heatlh care service delivery. Although comprehensive primary health care holds considerable promise to meet the growing demands on the health system, it has not been thoroughly evaluated. Comprehensive primary health care is a large and complex area, therefore part of the project focuses on services and client experiences in two chromic diseases: diabetes and depr ....This research will develop and implement a program logic evaluation in order to assess the effectiveness of various models of primary heatlh care service delivery. Although comprehensive primary health care holds considerable promise to meet the growing demands on the health system, it has not been thoroughly evaluated. Comprehensive primary health care is a large and complex area, therefore part of the project focuses on services and client experiences in two chromic diseases: diabetes and depressionRead moreRead less