Skin Cancer Fund

Cancer is primarily a disorder of cell growth which ultimately kills the patient. Historically, the study of cancer growth pathways have focused on a rare, non-representative cell lines and the results have not translated into effective clinical therapy. Worldwide, very few comprehensive metabolism studies have been performed with primary cancer samples from patients. South Australia stands poised to be a world leader in this new and vital area of research for three critical reasons:-

• (i) We have some of the best clinically annotated tissue banks in Australia and an outstanding track record in clinical trials for targeted therapies, beginning with blood cancers;
• (ii) world class investment in mass spectrometry
  expertise and,
• (iii) cancer researchers in South Australia have engineered sophisticated in vivo models of cancer using primary cells, including humanized ossicles, multiple myeloma metastasis models, colon organoids and in situ brain cancer models. We are thus well-positioned to begin to measure primary cancer cell growth in pre-clinical models and clinical trial patients receiving targeted therapy.

Recently, we and others have used new non-radioactive isotope technology to label and track nutrients inside cancer cells (see attachment in CIA letter of Support). This has revolutionized the study of cancer growth. We have the opportunity to lease cutting edge equipment, software, standards and isotopes to track how cancer cells metabolise any nutrient or any small molecule from a world class company that has developed dedicated components and analytical methods. The package includes training and financial support of future PhD students and a dedicated operator to work leading cancer researchers in SA. Our
exciting results published in leading journals have shown that primary human cancer cells metabolise nutrients in many different ways and struggle to adapt to sudden changes in metabolism, unlike healthy normal cells.

We have developed new small molecules that can block cancer cell metabolism at key branch points in the cell. Blocking cell growth pathways represent a unique opportunity to target cancer without chemotherapy or radiotherapy. The equipment and skills arising from this infrastructure grant will establish our centre in Adelaide as a world leader in primary cell tissue banking and metabolic flux analysis. Marten Snel is a world leader in applied mass spectrometry and lipidomic imaging, leads an outstanding core facility at SAHMRI and will assist in training PhD and post-doctoral researchers together with leading cancer investigators.

The South Australian Cancer Research Biobank (SACRB) is a statewide research facility that collects blood, bone marrow, and other tissues from cancer patients, and stores them for future use in research. Biomedical researchers in South Australia can apply to the biobank for the samples needed for their research projects.

Long-term collection and storage of samples is essential to study a cancer at diagnosis, after treatment, and at relapse. It also enables the collection of substantial numbers of samples, even from rare cancers. SACRB complies with relevant ethics and governance regulations and is recognised by the National Health and Medical Research Council as a public biobank. It is one of the largest biobanks of blood cancers in Australia.

Since its inception in 2012 the Biobank has enabled local cancer researchers to obtain 37 million dollars in research funding, contributed to many high profile international studies, and over one hundred high impact research papers. The Adelaide Biomed City Precinct funds majority of the running costs of the biobank.

Drug therapy can successfully prevent vomiting after chemotherapy but the majority of patients still suffer nausea. Patients differ in what symptoms they label as nausea which appears to be a cluster of several symptoms all of which may need separate treatment. We will develop an App to find what symptoms each patient reports as nausea to see if we can improve it by treating each unique symptom. We will also monitor risk factors for nausea to see if we can prevent it occurring before treatment.

Professor Ross McKinnon; Flinders University

My wife succumbed to breast cancer when aged 40. During the 15 months she lived with cancer, she experienced major drug toxicities and many ineffective drug treatments, many of which could have been avoided with better utilisation of biological markers and a higher level of pharmaceutical care. Her experience motivated me to optimise drug treatments for future generations, ensuring that others don’t have to experience what she went through.

The ongoing support of Cancer Council’s Beat Cancer Project will help us develop better and more effective drugs to treat cancer. We are researching across three main areas: using Indigenous knowledge and Australia’s remarkable marine biodiversity to identify new compounds with therapeutic potential in cancer and related conditions; using sophisticated statistical methods to determine if such biomarkers (biological indicators of disease) will be useful decision tools in cancer therapy; and studying the mechanisms by which cancer drugs are metabolised to determine ways to optimise drug strategies.

My message to donors is that drug discovery is difficult and challenging, but through a continuity of funding, we are getting closer to drug breakthroughs every day.

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Professor Tim Hughes; University of Adelaide

Just over a decade ago, Chronic Myeloid Leukaemia (CML) was still considered a death sentence. This research has pioneered the use of tyrosine kinase inhibitors (TKIs) to treat a range of cancers including CML, which was once known as one of the most devastating forms of blood cancer. Through the use of TKIs and research into individualised therapies, we have seen significant breakthroughs, with some CML patients even achieving treatment-free cancer remission. This in itself is a remarkable achievement considering that previously, only one in six CML patients survived eight years after their diagnosis.

Thanks to Cancer Council’s Beat Cancer Project, our team has received ongoing funding to support our work since 2013. We’re currently leading a global trial of a promising new therapy for CML, with results to be released later this year. Funding from the Cancer Council’s Beat Cancer Project has enabled our team to lead this and other research projects in South Australia which will ultimately change lives.

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Professor David Roder; University of South Australia

The primary aim of our unit is to develop more efficient and cost-effective services, especially related to cancer screening and treatment. With cancer impacting one in two Australians by the time they turn 85, our work is to benefit the whole Australian population, with the funding we receive from Cancer Council SA greatly increasing the reach of our work.

Through your support, our next step is to assist in the implementation of evidence-based health policies and evaluate their effectiveness. This work is ongoing, with a major emphasis on evaluating and improving outcomes of services for Aboriginal people. We are also working on assessing side effects of cancer therapies in order to improve the quality of life for those who survive their cancer diagnosis and looking at service evaluation and policy development for breast and cervical screening and cancer treatment services.

Alcohol is the leading cause of death and disability among 15-24 year olds globally. Parents are the most common source of alcohol for underage drinkers, leading to risky drinking, poor mental health and alcohol dependence in adulthood. We know little about parents’ views on the ages of drinking onset that are acceptable. This study will examine parenting styles and parents’ views about their adolescents drinking to develop new messaging to reduce parental supply.

Dr Tessa Gargett; University of South Australia

Immunotherapy stimulates the immune system to attack and kill tumours. The immune system contains cells that have the unique capacity to destroy cancer, however tumours often develop ways to turn off these cells and escape destruction. The most successful new immunotherapies (trade names Keytruda, Opdivo and Yervoy) work by blocking the tumour’s method of escaping and allowing the immune system to kill cancerous cells. These therapies can be highly effective and around 40 per cent of patients with melanoma will respond to therapy, with some patients even achieving a complete response where their tumours are eradicated.

However, despite these promising results, approximately 60 per cent of melanoma patients do not respond. Other forms of solid cancers like brain cancer also fail to respond, and so these patients are completely missing out on these breakthrough treatments. Through the support of Cancer Council’s Beat Cancer Project, we plan to extend the promise of immunotherapy to all patients. We’re testing brand new immune-based therapies specifically designed to boost the immune system in solid cancer patients. We have one clinical trial currently running at the Royal Adelaide Hospital which tests a personalised cell therapy in patients with melanoma. We will soon commence two new cell therapy clinical trials in patients with brain cancer. This project will help develop these trials and also follow patients receiving the new treatment to see how they respond, with the hope that the results can help inform treatments for all patients diagnosed with solid tumours.

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Dr Nicola Poplawski; CALHN

When a client is referred to the AGU we collect and record family history information. The data is collated in KinTrak and clinical staff use the information to determine which cancer genes will be tested and provide an assessment of personal cancer risk.

If a genetic error is identified in a cancer gene, clinical staff use the information to manage risk notification and predictive genetic testing for current and future generations of the family; ensure relatives who do not have the genetic error avoid unnecessary cancer surveillance and provide relatives who do have the genetic error with gene specific risk management advice that lowers their cancer risk (prevention and risk reduction) and enhances detection of early stage cancer (surveillance).

Where ethically approved, research staff use the information to identify individuals/families who are eligible for recruitment to familial cancer research projects; identify individuals/families who are eligible for research or translational genetic testing and contribute data to local, national and international research initiatives relevant to familial cancer

Through support from Cancer Council’s Beat Cancer Project we will be able to employ a data officer to take over these tasks and also support and contribute to AGU research activity, freeing clinical staff for research activities.

Associate Professor Andrew Roland; Flinders University

The project undertaken through this Mid-Career Research Fellowship will address an important impasse that currently prevents cancer patients from achieving the maximum benefit from the use of a key class of anti-cancer medicines. Observational studies consistently show that the benefit achieved by using the class of anti-cancer drugs called kinase inhibitors (KIs) can be dramatically improved, in cases even doubled, by getting the right dose for each patient. Importantly, however, the evidence that comes from these studies is not strong enough to inform practice, and because of this potential value of ‘precision dosing’ for these drugs continues to go unrealised. I have already engaged, and secured funding from, leading local and international academic and pharmaceutical industry partners and established a novel, readily actionable strategy (‘ADMExosomes’) to track the impact of variability in drug exposure on the effectiveness and tolerability of a drug.

Through this fellowship I will evaluate the capacity of this strategy to efficiently generate practice changing evidence defining the value of precision dosing for KIs. Importantly, I have also already established a framework through engagement with my existing network of clinical, consumer and industry collaborators to translate the findings, where appropriate, into actionable ‘companion diagnostics’ that maximise KI effectiveness and tolerability in real world cancer patients.

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Cancer Council SA’s Behavioural Research Team is based at our offices at Greenhill Road. Through your support, the team conducts monitoring, applied research and evaluation to inform the development of Cancer Council SA’s cancer control programs and services. The Behavioural Research Team works closely with the Cancer Council SA Postdoctoral Fellow (Cancer Support) who is jointly based at the Flinders Centre for Innovation in Cancer. Together with two new postgraduate research students from Flinders University, they are interested in people’s knowledge, attitude, behaviours and the decisions individuals make that may lead to healthy or unhealthy behaviours in the area of cancer control, as well as research into the psychosocial impact of cancer on those directly and indirectly affected by cancer.

Dr Madelé van Dyk; Flinders University

Since the discovery kinase inhibitors (KIs), a class of targeted therapy against terminal cancers, progression free survival and overall survival has greatly improved. However, TKIs undergo complex metabolism via liver enzymes (CYP3A4), which is known for its substantial variability in activity. However, no marker to identify CYP3A4 activity in patients currently exists.

Due to the wide inter-individual variability, KI concentrations have varied up to >10 fold. Despite knowing this, variability between patients are inadequately addressed and a ‘one-size fits all’ prescribing is used. This clinical issue is widely recognised but still we do not account for this variability, resulting in some patients experiencing therapeutic failure or toxicity because the dose is not enough or too much.

Therapeutic drug monitoring (TDM) can address this, measuring drug concentrations and changing the dose until the patient’s concentration is in the ‘target concentration’. Based on my previous work I have shown that with the implementation of TDM, we can prolong progression free survival significantly and thus improve patient quality of life. I have also shown that patient characteristics can be used to account for this inter-individual variability. Therefore, this study will evaluate the capacity and benefit of TDM to optimise KI dosing and determine which patient characteristics can help to predict a better dose so that we can personalise treatment to each individual and maximising treatment and minimising side effects. Since the economic health benefit has never been evaluated, this study will the first to address this by performing a cost-benefit analysis.

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Professor Michael Sorich; Flinders University

The research will develop online tools that will help patients to work through difficult decisions about how and when to use an anti-cancer medicine for the treatment of cancer. It will do so by utilising innovative methods to comprehensively analyse a very large amount of data that has recently become available from both clinical studies of medicines and routine use of the medicines by patients. This analysis will allow high-quality predictions to be made regarding a patient’s specific likelihood of benefits and harms from using an anti-cancer medicine.

This research will help overcome barriers to the communication of key information and empower patients by providing doctors with a toolkit to present the treatment options and their key outcomes to the patient in a manner that is personalised to their specific circumstances and characteristics. By having this personalised information, patients can feel more confident and empowered to make the most appropriate decision for them specifically regarding their treatment and will be better prepared by having more accurate expectations for their treatment outcomes.

Additionally, the research will provide insight into the patient and disease characteristics influencing benefit and harms from treatment. These insights provide opportunities to better understand why medicines sometimes don’t work well for certain individuals and how this may be overcome.

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Dr Stephanie Reuter Lange; University of South Australia

Whilst there have been substantial improvements in the treatment of cancer, it remains that three out of 10 patients will not survive longer than five years, a result of either cancer progression or death from severe treatment-related side effects. Cancer medicines must be administered at a dose that is enough to treat the cancer, but not too much to cause toxic side effects. While this is well known, most cancer treatments are given as a “one-size-fits-all” amount. Given the large variability in response seen with many cancer medicines, this means that for the same dose some patients are likely to be under-treated and others a likely to be over-treated.

The concept of dose individualisation is tailoring the amount of drug administered to each individual patient to maximise tumour response and minimise side effects. This fellowship program will use computer-based modelling methods to identify dose individualisation strategies for best treatment practice. This will be conducted for a range of diverse projects that will illustrate the value in this approach to cancer treatment and provide a framework for determining the best use of new and existing cancer medicines.

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Cancer Council 13 11 20 is a free, confidential information and support service where you can talk to experienced cancer nurses about anything to do with cancer. Anyone can call Cancer Council 13 11 20 – people living with cancer, their families, carers and friends, the general public, workplaces and healthcare professionals. We can help answer your questions about cancer, provide emotional support or help with practical matters.

For regional South Australians, having to travel to Adelaide for cancer treatment (including skin cancer) can often compound the challenges associated with their diagnosis. Our Lodge provides a friendly place to stay, connecting guests to a network of services including meals and shopping, transport to treatment and on-site social work support to help ease the burden of cancer.

In the last year alone, Cancer Council SA provided 28,700 nights of accommodation to South Australians at our Lodges. Thanks to the generous support of the South Australian community, especially our fundraisers in regional areas, we are able to continue to provide this service, which acts as a home away from home for all regional South Australians travelling to Adelaide for cancer treatment.

Cancer Council SA provides free counselling, either over the phone or in person, to anyone impacted by a cancer diagnosis (including skin cancer) and their loved ones. We work with people across all stages of their cancer experience, starting from the initial diagnosis, right throughout their treatment and beyond, ensuring that they receive the best support possible throughout their cancer journey.

Thanks to the generous support of the South Australian community, we were able to offer more than 1,800 free counselling sessions last year to South Australians impacted by cancer. Our professional counsellors can help their clients find new ways to manage stress, set personal goals, develop ways to achieve them, or find ways to talk to family and friends about their concerns.

By giving to the Cancer Council SA Skin Cancer Fund, you’ll be helping to ensure this essential service is available to all who need it.

For some, a cancer diagnosis can cause considerable financial stress. That’s why Cancer Council SA offers one-off financial grants to eligible people to help pay household utilities, easing the financial burden of cancer (including skin cancer).

Your donation today will help us to continue to provide this service for years to come.