TO BEDSIDE BEYOND - Sydney Catalyst...2.30pm 15 Dr Daniel Steffens Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital Feasibility and acceptability of pre-operative

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SYDNEY CATALYSTINTERNATIONAL TRANSLATIONALCANCER RESEARCH SYMPOSIUM

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2019INTERNATIONAL TRANSLATIONALC A N C E R R E S E A R C HS Y M P O S I U M WELCOME

ASSOCIATE PROFESSOR ANTHONY JOSHUA

Co-Chair

The Garvan Institute of Medical Research & St Vincent's Hospital

On behalf of the Organising Committee and Sydney Catalyst, it is our great pleasure to welcome you to the 2019 Sydney Catalyst International Translational Cancer Research Symposium.

The idea to host this biennial Symposium was born seven years ago with the aim to enhance Sydney Catalysts’ objectives to improve outcomes for people affected by cancer. This event brings together outstanding teams of researchers and clinicians, from leading institutions, working across the full translational research continuum.

Sydney Catalyst is passionate about supporting a sustainable, comprehensive and successful translational research program, which as a whole is greater than the sum of its parts. This Symposium supports that vision by bringing together exceptional International and Australian guests to share their ground breaking research and discoveries.

The theme for this years’ Symposium - From Bench to Bedside and Beyond - inspires collaboration across the translational spectrum. Our scientific program and poster sessions have been designed to foster discussions and inspire participants to initiate research collaborations.

We hope your participation at the Symposium will be scientifically rewarding and you have the opportunity to enjoy our beautiful harbour city, Sydney.

Best wishes,

Co-Chairs, Dr Claudia Rutherford & Associate Professor Anthony Joshua

DR CLAUDIA RUTHERFORD Co-Chair

The University of Sydney

• Associate Professor Anthony Joshua (Co-Chair) - The Garvan Institute of Medical Research & St Vincent’s Hospital• Dr Claudia Rutherford (Co-Chair) - The University of Sydney• Dr Prunella Blinman - Concord Repatriation General Hospital• Dr Venessa Chin - The Garvan Institute of Medical Research & The Kinghorn Cancer Centre• Merran Findlay - Royal Prince Alfred Hospital• Associate Professor Cherry Koh - The Chris O’Brien Lifehouse• Dr Marina Pajic - The Garvan Institute of Medical Research• Merilyn Heuschkel - Sydney Catalyst• Cara McFarlane - Sydney Catalyst• Eve Simons - Sydney Catalyst• Ellen Brodie - Sydney Catalyst

WORKING GROUP

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2019INTERNATIONAL TRANSLATIONALC A N C E R R E S E A R C HS Y M P O S I U M KEYNOTES

PROFESSOR IAN HARRIS

The University of Sydney & University of New South Wales

Professor Harris is a practicing orthopaedic surgeon and an academic. His clinical interests are in trauma surgery. His research interests broadly cover the topic of surgical effectiveness and clinical research. He conducts randomised trials, systematic reviews, cohort studies and methodological studies.

He has approximately 200 peer-reviewed publications and has held or currently holds grants totalling approximately $22 million from National Health and Medical Research Council, Medical Research Future Fund, professional societies and not-for profit organisations.

PROFESSOR MARGARET TEMPERO

The University of California, San Francisco, USA

Professor Tempero is Director, UCSF Pancreas Center and Leader of the UCSF Pancreas Cancer Program. She oversees a full portfolio of projects from risk assessment to early detection, biology, and therapeutics in pancreatic neuroendocrine tumors and pancreatic ductal adenocarcinoma.

Her personal research career has focused on pancreatic ductal adenocarcinoma, especially in the area of investigational therapeutics. She was a pioneer in the use of antibody-based therapies and helped develop the fixed dose rate concept for gemcitabine. Her group has developed effective gemcitabine combinations and provided a foundation for using CA19-9 as a surrogate for survival in clinical trials, and currently is assessing molecular subtypes and molecular enrichment for selecting new drugs for clinical evaluation.

PROFESSOR GALINA VELIKOVA

The University of Leeds, United Kingdom

Professor Velikova leads a clinical research group in the Leeds Institute for Medical Research to study the implementation of routine measurement of patient-reported outcomes and quality of life in oncology practice. With funding from the National Institute for Health Research of England, Professor Velikova researches the use of online patient self-reporting of adverse events during and after treatment with chemotherapy and radiotherapy. This work was recognised in 2014 by The Times Higher Education as one of “20 new ideas from UK universities that will change the world”.

Professor Velikova currently chairs the National Cancer Research Institute Psychosocial Oncology and Survivorship Clinical Studies Group. She is an elected Board member the European Organisation for Research and Treatment of Cancer (EORTC).

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2019INTERNATIONAL TRANSLATIONALC A N C E R R E S E A R C HS Y M P O S I U M PROGRAM

8.00am Registration - Tea, coffee and light refreshments provided

8.30amIntroduction and Acknowledgement of CountryDr Claudia Rutherford and Associate Professor Anthony JoshuaCo-Chairs, Sydney Catalyst International Translational Cancer Research Symposium 2019

8.40am Welcome - Professor Michael Boyer, Director of Sydney Catalyst

8.45am The future of cancer research in New South Wales - Dr Veronica McCabeDirector Strategic Research Investment, Cancer Institute NSW

CHAIRED BY ASSOCIATE PROFESSOR ANTHONY JOSHUA

9.00am K1Professor Margaret TemperoThe University of California, San Francisco, USA Dissecting Biology: Finding new therapeutic targets in pancreatic adenocarcinoma

9.40am 01

Professor John SimesSydney Catalyst, NHMRC Clinical Trials Centre, The University of SydneyEmbedding Research (and Evidence) in Cancer Healthcare: an update on the Sydney Catalyst EnRICH Program

9.55am 02

Dr Liz CaldonThe Garvan Institute of Medical ResearchBRCA1 mutation stabilises cyclin E1 in breast cancer to create a therapeutically targetable subset

10.10am 03Dr Helen McGuireRamaciotti Facility for Human Systems Biology, The University of SydneyPredictive immune signature analysis for cancer application

10.25am RAPID FIRE PRESENTATIONS (3 mins)

Rapid Fire 04

Dr Ashleigh ParkinThe Garvan Institute of Medical ResearchDual inhibition of JAK and Src: A novel and synergistic combination to target pancreatic tumours and their microenvironment

Rapid Fire 05Dr Emma RamsaySydney Catalyst, NHMRC Clinical Trials Centre, The University of SydneyProcoagulant platelets as a diagnostic predictor of thrombosis in lung cancer patients

Rapid Fire 06Dr Holly HollidayThe Garvan Institute of Medical ResearchMicroRNA-based therapeutics for the treatment of high risk neuroblastoma

Rapid Fire 07

Hansol LeeMelanoma Institute AustraliaAdvanced melanoma patients with high CD16+ macrophages have better response and survival to anti-PD-1 based immunotherapy

SESSION 1: BENCH TO BEDSIDE

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2019INTERNATIONAL TRANSLATIONALC A N C E R R E S E A R C HS Y M P O S I U M

10.40am MORNING TEA + POSTER VIEWING:

CHAIRED BY DR CLAUDIA RUTHERFORDSESSION 2: EVIDENCE IN PRACTICE RESEARCH

11.10am K2

Professor Galina VelikovaThe University of Leeds, UKThe increasing role of Patient Reported Outcomes in cancer care: From clinical trials to patient support and care quality measure

11.50am 08

Dr Diana NaehrigChris O’Brien LifehousePatient reported outcomes and treatment uptake of Integrative Oncology and Supportive Care Services at a tertiary cancer centre

12.05pm 09

Professor Phyllis ButowPsycho-Oncology Cooperative Research Group, The University of SydneyMolecular tumour profiling and whole genome sequencing: Psychosocial, ethical and behavioural issues

12.20pm 10

Hannah TimminsBrain & Mind Centre, The University of SydneyUnderstanding the relationship between patient experience and objective assessment of CIPN

12.35pm RAPID FIRE PRESENTATIONS (3 mins)

Rapid Fire 11Nicci BartleyPsycho-Oncology Cooperative Research Group, The University of SydneyCancer patients’ views and understanding of genome sequencing: A qualitative study

Rapid Fire 12Associate Professor Heather McKenzieCancer Nursing Research Unit, The University of SydneyEvaluating a shared care pathway to support chemotherapy outpatients

Rapid Fire 13

Dr Rachael DoddWiser Healthcare, The University of SydneyImplementing renewal of the Cervical Screening Program in Australia: Health professionals’ views and experiences

Rapid Fire 14

Dr Rachel CampbellSchool of Psychology, The University of SydneyImplementing patient-reported outcome measures (PROMs) in clinical practice: A meta-review of reviews

12.50pm LUNCH + POSTER VIEWING

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1.50pm K3Professor Ian HarrisThe University of Sydney and University of New South WalesRaising the bar for surgical evidence

2.30pm 15

Dr Daniel SteffensSurgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred HospitalFeasibility and acceptability of pre-operative exercise to improve patient outcomes after major cancer surgery

2.45pm 16Dr Sathira PereraIngham Institute for Applied Medical Research, The University of New South WalesEvidence based predictions for the demand for cancer surgery in Australia

3.00pmAnton EnusSBS Journalist and PresenterThe road to recovery from bowel cancer

10 MINUTE BREAK

CHAIRED BY PROFESSOR DEREK RAGHAVANPANEL DISCUSSION

3.25pm

PERSONALISED MEDICINE: IS IT LIVING UP TO THE HYPE?Panellists:• Professor Galina Velikova, The University of Leeds, UK• Professor Margaret Tempero, The University of California, San Francisco, USA• Professor Ian Harris, University of New South Wales and the University of Sydney• Dr Amy Prawira, The Kinghorn Cancer Centre

CHAIRED BY PROFESSOR DEREK RAGHAVANSESSION 3: CLINICAL RESEARCH

CHAIRED BY ASSOCIATE PROFESSOR ANTHONY JOSHUA & DR CLAUDIA RUTHERFORDCLOSING SESSION

4.10pm AWARDS AND WRAP UP

4.20pmNETWORKING DRINKS + POSTER VIEWING4.30PM: Poster Viewing5.00PM: Networking Drinks

6.00pm EVENT FINISH

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POSTERS

01 Biqi Chen Investigation Of Radiation-Induced Bystander Effects On Cancer Cells Using NMR Metabolomics

02 Megan Crumbaker Retrospective Oncological Assessment of Genome-Driven Precision Medicine for Metastatic Prostate Cancer

03 Peey Sei Kok Validation of progression-free survival (PFS) as a surrogate endpoint in randomised trials of immune

04Syer Choon Lim Targeting the androgen receptor using a new class of thiosemicarbazone anti-cancer agents to overcome development of resistance in prostate cancer

05 Cindy Tseng Targeting BET proteins and Mcl-1 for the treatment of human melanoma

06 Nicci Bartley A systematic review of patient uncertainty when undertaking cancer genomic testing

07 Luke Marinovich Guidelines on margins for breast conserving surgery: Scoping review of clinical and economic impact

08 Megan Smith-Uffen Why do patients pursue cancer genomic testing? A systematic review of motivation

09 Alison Young EaSyC RDP: Evaluation of a Smoking Cessation Referral Decision Prompt piloted within cancer services

09 Alison Young MAINSTREAMING: Evaluation of the current mainstream genetic testing in cancer services

10 Megan Best Patient preferences for receiving genomic test results

11 Emma Ramsay Procoagulant platlets as a diagnostic predictor of thrombosis in lung cancer patients

12 Megan Best Who should access Germline Genome Sequencing? A mixed methods study of patient views.

13 Jennifer Lim Predictors of Platinum Sensitivity in Advanced Non Small Cell Lung Cancer

14 Nicci Bartley Cancer patients’ views and understanding of genome sequencing: a qualitative study

15 Bea Brown Psychological distress in never, ex, current, and passive smokers diagnosed with lung cancer - analyses from


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16 Megan Best Patient preferences for receiving genomic test results

17Bea Brown Patterns of care in a prospective clinical cohort of patients with lung cancer - preliminary analyses from EnRICH

18 Linda Rogers Cone beam CT imaging dose reduces in vitro survival when combined with therapeutic irradiation

19 Claire Davies Translational-ANZGOG (TR-ANZGOG): where molecular research meets clinical trials

20 Brooke Pereira Proteomic profiling of human prostate cancer-associated fibroblasts (CAF) reveals LOXL2-dependent regulation

21Bekesho Geleta Wendimu A novel therapeutic approach to inhibit the oncogenic cross-talk between pancreatic cancer cells and the surrounding stroma

22Faten Shehadeh Tout The multi-faceted efficacy of novel thiosemicarbazone anti-cancer agents in the treatment of estrogen receptor positive breast cancer

23 Tahlia Scheinberg Evaluation of a mainstream model of genetic testing for men with prostate cancer – study schema

24 Hui-Ming Lin Plasma lipidomic profiling of prostate cancer reveals prognostic lipids

25 Lionel Leck Overcoming Pgp-mediated drug-resistance by releasing lysosomal stored doxorubicin with lysosomal targeting

26 Nicholas Hindley Real-time direct diaphragm tracking during lung cancer radiotherapy

27Joe Jabbour Development & assessment of an integrated patient information, education and support program in head and neck cancer

28Abdullah Al Emran PD-L2 and PD1 promoter hypermethylation is a prognostic factor in melanoma patients and associated with poorer overall survival

29Chindhu Shunmuga Sundaram The multi-faceted efficacy of novel thiosemicarbazone anti-cancer agents in the Treatment of Estrogen Receptor Positive Breast Cancer

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we want to hearfrom you !https://www.surveymonkey.com/r/SCITRS19

Check out the virtual posters on our website!

VIRTUAL POSTERS

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SPEA

KERS

NICCI BARTLEYPsycho-Oncology Cooperative

Research Group The University of Sydney

Cancer patients’ views and understanding of genome

sequencing: A qualitative study

Nicci is a PhD candidate at the University of Sydney, and Research Officer on the Psychosocial issues in Genomic Oncology (PiGeOn Project). She holds a Master of Evaluation, and has over 10 years’ experience working in health research and program evaluation, in Australia and Canada.

PROFESSOR PHYLLIS BUTOWPsycho-Oncology Cooperative

Research Group The University of Sydney

Molecular tumour profiling and whole genome sequencing:

Psychosocial, ethical and behavioural issues

Phyllis is currently Professor and NHMRC Senior Principal Research Fellow in the School of Psychology, the University of Sydney. She was the founding Director of the Centre for Medical Psychology and Evidence-based Decision-making (CeMPED) and the Australian Psycho-Oncology Co-operative Trials Group (PoCoG). She has taken a leading role in Australia in promoting and facilitating communication skills training for Oncology health professionals.

DR LIZ CALDONThe Garvan Institute of Medical Research

BRCA1 mutation stabilises cyclin E1 in breast cancer to create a

therapeutically targetable subset

Liz leads the Replication and Genome Stability Group at the Garvan Institute of Medical Research. Her focus is in the intersection between aberrant growth control in breast cancer and the development of resistance to anti-cancer therapy.

DR RACHEL CAMPBELLSchool of Psychology


Implementing patient-reported outcome measures (PROMs) in

clinical practice. A meta-review of reviews

Rachel is a post-doctoral researcher at the Quality of Life Office at the University of Sydney. Her research focusses on optimising the use of patent-reported outcome measures (PROMs) in oncology research and clinical practice. She is particularly interested in the implementation of PROMs in clinic to improve patient outcomes.

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DR RACHAEL DODDSchool of Public Health


Implementing renewal of the Cervical Screening Program in Australia: Health professionals’ views and

experiences

Rachael is a postdoctoral research fellow working in the School of Public Health, the University of Sydney. Her research to date has focussed around communication in healthcare in combination with assessing psychosocial impacts of HPV-related cancers.

DR HOLLY HOLLIDAYThe Garvan Institute of Medical Research

MicroRNA-based therapeutics for the treatment of high-risk neuroblastoma

Holly’s interests lie in the regulation of stem cells during development and disease. She is currently working on developing microRNA-based therapeutics for the treatment of childhood cancer neuroblastoma.

DR HELEN MCGUIRERamaciotti Facility for Human

Systems Biology The University of Sydney

Predictive immune signature analysis for clinical cancer application

Helen is a Research Officer at the Ramaciotti Facility for Human Systems Biology, an initiative established to support mass cytometry and systems biology analysis across Sydney and wider collaborative links. Her research interest lies in the clinical application of immunological studies to a range of human diseases, including cancer.

HANSOL LEEMelanoma Institute Australia

Advanced melanoma patients with high CD16+ macrophages have better

response and survival to anti-PD-1 based immunotherapy

Hansol is a PhD student with Professors Georgina Long and Richard Scolyer at the Melanoma Institute Australia. His project involves investigating the role of the innate immune system in response and resistance in advanced melanoma patients treated with immunotherapy.

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SPEA

KERS

ASHLEIGH PARKINThe Garvan Institute of Medical Research

Dual inhibition of JAK and Src: A novel and synergistic combination to target pancreatic tumours and their

microenvironment

Ashleigh completed a Bachelor of Advanced Science (Honours), at UNSW Sydney in 2015. In 2016 she began her PhD at the Garvan Institute where she is developing novel personalised medicine strategies for pancreatic cancer and investigating the mechanisms behind their therapeutic efficacy using complex in vitro and in vivo models to anti-cancer therapy.

DR SATHIRA PERERACollaboration for Cancer Outcome

Research & Evaluation University of New South Wales

Evidence based predictions for the demand for cancer surgery in

Australia

Sathira is currently a UNSW Scientia PhD Scholar. He graduated in Medicine, and later specialised in public health and health economics with master’s degrees for both specialities. He has been engaged in the fields of clinical medicine, research, academia and policy making at different levels.

ASSOCIATE PROFESSOR HEATHER MCKENZIE

Cancer Nursing Research Unit The University of Sydney

Evaluating a shared care pathway intervention to support

chemotherapy outpatients

Heather’s research interests include cancer survivorship and cancer care, social theory, the interface between acute and community services, end-of-life care for people with dementia, and pre-registration nursing education. Her primary focus is on initiatives designed to assist with keeping people well in the community and minimising preventable hospital admissions.

DR DIANA NAEHRIGChris O’Brien Lifehouse

Patient reported outcomes and treatment uptake of Integrative Oncology and Supportive Care

Services at a tertiary cancer centre

Diana is a Senior Research Fellow for Integrative Oncology and Supportive care at Chris O’Brien Lifehouse. She has a background in medicine (Radiation Oncology) and coaching psychology. Special interests include; staff wellbeing, medical communication, a holistic systems approach to health care.

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DR EMMA RAMSAYSydney Catalyst Translational Cancer

Research Centre, NHMRC Clinical Trials Centre


Procoagulant platelets as a diagnostic predictor of thrombosis in lung

cancer patients

Emma completed her PhD with Professor Phil Hogg at the University of New South Wales in 2014. On completion, she moved to UT MD Anderson Center, working on a number of early stage translational projects in pancreatic cancer. In 2017 she began work with the University of Sydney measuring procoagulant platelets in lung cancer. Emma is the current T1T2 Research Fellow ay Sydney Catalyst.

PROFESSOR JOHN SIMESSydney Catalyst Translational Cancer



Embedding Research (and Evidence) in Cancer Healthcare – an update on the Sydney Catalyst EnRICH Program

John is Director of the NHMRC Clinical Trials Centre based at the University of Sydney and a NHMRC Senior Principal Research Fellow. He is a practising medical oncologist at the Royal Prince Alfred Hospital and lectures in Clinical Epidemiology at the University of Sydney.

DR DANIEL STEFFENSSurgical Outcomes Research Centre

Royal Prince Alfred Hospital

Feasibility and acceptability of pre-operative exercise to improve patient outcomes after major cancer surgery

Daniel is the Deputy Director of the Surgical Outcomes Research Centre (SOuRCe) at the Royal Prince Alfred Hospital, and a Clinical Senior Lecturer at the Sydney Medical School, The University of Sydney. Daniel has over 10 years of experience in large-scale clinical studies and currently manages 10 research officers involved in over 50 surgical research studies, including 10 surgical RCTs.

HANNAH TIMMINSBrain & Mind Centre


Understanding the relationship between patient experience and

objective assessment of CIPN Hannah is a 3rd year PhD candidate working with the INFOCUS chemotherapy-induced peripheral neuropathy (CIPN) research group. Her research focuses on utilising neurophysiological techniques to explore chemotherapy-specific neuropathy profiles and risk factors associated with CIPN. She is investigating quantitative and functionally relevant assessment tools to quantify CIPN.

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POST

ERS

DR BEA BROWNSydney Catalyst Translational Cancer



1. Psychological distress in never, ex, current, and passive smokers

diagnosed with lung cancer - analyses from the EnRICH Program

2. Patterns of care in a prospective clinical cohort of patients with lung cancer - preliminary analyses from

EnRICH

Bea has been working in health research and research management since the early 2000s and in health services and implementation research since 2009. Prior to joining Sydney Catalyst, she was a Senior Research Fellow in the Implementation Research Group at the Sax Institute where she worked for seven years on a range of collaborative projects involving clinicians, researchers and policymakers.

BIQI CHENSchool of Life and Environmental

Sciences The University of Sydney

Investigation of radiation-induced bystander effects on cancer cells

using NMR

Biqi graduated from the University of Sydney with a Bachelor of Science, First Class Honours in 2018.

DR MEGAN CRUMBAKERThe Garvan Institute of Medical Research

Retrospective oncological assessment of genome-driven precision medicine

for metastatic prostate cancer

Megan is a medical oncologist and PhD candidate with an interest in prostate cancer genomics affiliated with the Kinghorn Cancer Centre at St Vincent’s Hospital and the Garvan Institute of Medical Research.

DR CLAIRE DAVIESAustralia New Zealand Gynaecological

Oncology Group

Translational-ANZGOG (TR-ANZGOG): Where molecular research meets

clinical trials

Claire is a medical scientist, specialising in Anatomical Pathology. With over fifteen years’ career experience in diagnostic and clinical research environments, with a particular interest in gynaecological oncology. Claire has broad expertise and knowledge in translational research processes. She is passionate about improving outcomes for women affected by gynaecological cancer.


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NICHOLAS HINDLEYACRF Image X Institute


Real-time direct diaphragm tracking during lung cancer radiotherapy

Nicholas is a PhD candidate at the ACRF Image X Institute. His research focuses on the applications of machine learning and signal processing in image-guided radiotherapy. Prior to joining Image X, Nicholas worked at the Children’s Cancer Institute where he used computer-aided drug design to discover novel therapies for neuroblastoma.

DR JOE JABBOURChris O’Brien Lifehouse

Development & assessment of an integrated patient information,

education and support program in head and neck cancer

Joe is an aspiring Head and Neck Surgeon currently finishing a PhD through the University of Sydney. In 2018 he completed an unaccredited ENT surgery position at The Tweed Hospital.

DR PEEY SEI KOKNHMRC Clinical Trials Centre


Validation of progression-free survival (PFS) as a surrogate endpoint

in randomised trials of immune checkpoint inhibitors (ICI) for

advanced solid cancers Peey-Sei is a PhD candidate at the CTC, Medical Oncologist at Prince of Wales Hospital and a Research Fellow at the CTC. Peey-Sei has a strong interest in thoracic and gynaecological cancers, developed through her fellowship with ALTG and ANZGOG at the NHMRC CTC since 2015.

SYER LIMBosch Institute


Targeting the androgen receptor using a new class of thiosemicarbazone anti-cancer agents to overcome

development of resistance in prostate cancer

Syer is a PhD student from the University of Sydney focusing on the interaction of NDRG1 with AR and characterising the molecular effects of Dp44mT and DpC in CRPC, which may lead to development of more effective treatments for prostate cancer.

DR HUI-MING LINThe Garvan Institute of Medical Research

Plasma lipidomic profiling of prostate cancer reveals prognostic lipids

Hui-Ming is a Senior Research Officer with the Clinical Prostate Cancer Research Group at the Garvan Institute. Her current research focus is on lipidomic analysis of prostate cancer to identify prognostic biomarkers and new therapeutic targets.

DR BROOKE PEREIRAThe Garvan Institute of Medical Research

Proteomic profiling of human prostate cancer-associated

fibroblasts (CAF) reveals LOXL2-dependent regulation of the tumour

microenvironment

Brooke completed her PhD at the Biomedicine Discovery Institute at Monash University in 2018. She is a Research Officer at the Garvan, where she is investigating novel stromal targets in pancreatic cancer, using a range of cutting edge approaches.

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2019INTERNATIONAL TRANSLATIONALC A N C E R R E S E A R C HS Y M P O S I U M ABSTRACTS

K1 Dissecting Biology: Finding new therapeutic targets in pancreatic adenocarcinoma

PROFESSOR MARGARET TEMPERO The University of California, San Francisco, USA Advances in therapy for pancreatic adenocarcinoma have been painfully slow. Only two regimens, FOLFIRINOX and gemcitabine plus nab-paclitaxel, currently hold a Category 1 NCCN recommendation for treatment of patients with metastatic disease and a high performance status. Thus, here is an endless quest to explore the complex biology of this KRAS driven disease in search of new targets. Recent discoveries hold much promise and are rapidly being translated into clinical investigation offering new hope for patients with this aggressive malignancy.

K2 The increasing role of Patient Reported Outcomes in cancer care: From clinical trials to patient support and care quality measure

PROFESSOR GALINA VELIKOVAThe University of Leeds, UK

Monitoring of patients’ physical symptoms and psychological problems during and after cancer treatment is essential in modern oncology practice. Patient Reported Outcome (PRO) measures (including Quality of Life questionnaires) provide the tools to include patient voices in drug development, evaluation of new treatments and increasingly to support individual patient care through online symptom monitoring. The potential for using PROs as a quality of care measure has also been recognised but not yet widely tested. Examples of PROs as a quality of care measure in practice, such as the NIHR eRAPID program and eRAPID (Electronic patient self-Reporting of Adverse-events: Patient Information and aDvice, provide an opportunity to share experiences and lessons learned for the implementation of PROs. Furthermore, the NHS England Quality of Life Metric project is a response to the Independent Cancer Taskforce’s recommendations to introduce and implement Quality of Life (QoL) data collection for cancer survivors in England. The information can be used to make changes in care that focus on improving outcomes for patients. An approach to collecting QoL data was developed through an initial research report (Phase 1) and engagement with stakeholders (Phase 2; 2016-17). A pilot project (Phase 3; 2018-19) then tested a devolved approach to collecting patient-reported QoL outcomes at the end of breast, prostate or colorectal cancer treatment across five pilot Cancer Alliances (8 different hospitals). The lessons learned led to a Phase 4 pilot of a modified approach of centralised QoL data collection. Motion plans are also being set up for a nationwide data collection launch in June 2020.

K3 Raising the bar for surgical evidence

PROFESSOR IAN HARRISThe University of New South Wales & The University of Sydney Current evidence for surgery is poor, incomplete and largely observational and there is a discrepancy between drug and surgery standards in practice. The implications for the lack of surgical evidence are widespread, and multifaceted approaches from key stakeholders, such as surgeons, policy makers and consumers, is required to change practice.

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01 Embedding Research (and Evidence) in Cancer Healthcare – an update on the Sydney Catalyst EnRICH Program

John Simes1,2, Michael Boyer2,3, Phillip Hogg3,4, Anthony Joshua5,6, Jane Young7,8,9, Venessa Chin5,6, Bea Brown3

1 The University of Sydney, NHMRC Clinical Trials Centre, NSW, Australia 2 Chris O’Brien Lifehouse, Camperdown, NSW, Australia 3 The University of Sydney, Sydney Catalyst Translational Cancer Research Centre, NSW, Australia 4 The University of Sydney, Centenary Institute of Medical Research, NSW, Australia 5 Garvan Institute of Medical Research, Darlinghurst, NSW, Australia 6 St Vincent’s Hospital Sydney / The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia 7 The University of Sydney, Faculty of Medicine and Health, The University of Sydney School of Public Health, NSW, Australia 8 Surgical Outcomes Research Centre (SouRCe), Sydney Local Health District, Camperdown, NSW, Australia 9 RPA Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW, Australia

Lung cancer accounts for 9% of all cancer diagnoses, is the most common cause of cancer related death, and is the leading cause of morbidity and burden of disease in NSW and across Australia. The outlook for patients with lung cancer remains poor with only a 15% overall five year survival rate. For patients diagnosed with advanced stage disease, five year survival is less than 5%. Improvements in lung cancer survival rates are not comparable with improvements for other cancers.

The Sydney Catalyst flagship program ‘Embedding Research (and Evidence) in Cancer Healthcare – EnRICH’, is building a program of translational research in lung cancer which aims to: describe the natural history of and patterns of care for lung cancer; identify current gaps in evidence and practice for clinical quality improvement; and create a platform for researchers across the T1-T3 translational research spectrum to extend evidence of effective treatments and increase the use of clinical care based on existing evidence. EnRICH will build on collaborations within Sydney Catalyst, across NSW, Australia, and internationally to establish a multidisciplinary program of research in scientific discovery, diagnostic and therapeutic development, clinical trials and implementation science.

EnRICH is a prospective clinical cohort of a minimum 1000 patients with lung cancer (non-small cell and small cell, any histological type, any clinical/pathological stage) from Sydney Catalyst metropolitan and regional member clinical sites. To date, more than 630 patients have been enrolled and the cohort is expected to include 1000 patients by mid-2020. EnRICH provides a comprehensive research platform. Clinical audit data is available for all patients including demographic, clinical, biomarker, molecular profile, and outcome data. Matched biological samples (FFPE diagnostic tumour tissue, and serial pre- and post-treatment blood samples) and patient-reported outcomes are available for consented patients to support a range of interconnected research from across the T1 – T3 translational research spectrum, from bench to bedside (and bedside to bench) through to policy and practice. The cohort will enable reliable estimates of outcomes both overall and within histological and genetic sub-types.

Preliminary descriptive data will be presented for the first 500 consecutive patients in the cohort, including patient, disease and treatment data to identify initial priorities for linked translational research studies and quality improvement interventions. A brief update on current linked sub-studies will also be provided.

The EnRICH program provides unique infrastructure to support translational cancer research.

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02 BRCA1 mutation stabilises cyclin E1 in breast cancer to create a therapeutically targetable subset

Diar Aziz1, Neil Portman2,3, Kristine Fernandez2, Christine S.L. Lee2, Sarah Alexandrou2, Niantao Deng2, C. Marcelo Sergio2, Dariush Etemadmoghadam4,5, kConFab Investigators4,5, David Bowtell4,5, Paul Waring1, Elgene Lim2,3, C. Elizabeth Caldon2,3

1 Centre for Translational Pathology, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia 2 The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia 3 St. Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, NSW, Australia 4 Peter MacCallum Cancer Institute, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia 5 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia

Background:

BRCA1-mutated breast cancers are typically a very aggressive subset that respond poorly to targeted therapies and chemotherapies. High cyclin E1 protein is suspected to co-occur with BRCA1 disruption in these breast cancers.

Aims:

We aimed to demonstrate a mechanistic link between BRCA1 disruption and cyclin E1, and exploit this to develop a new combination therapy for this subset of breast cancer.

Methods:

The kConFab breast cancer cohort was analyzed by immunohistochemistry to identify the relationship between BRCA1/2 disruption and the expression and phosphorylation of cyclin E1. In parallel we used breast cancer cell line models and patient derived xenografts (BRCA1 wildtype and mutant) to determine how Brca1 regulates cyclin E1 expression (western blot, flow cytometry), to assay effects of cyclin E1 expression (colony forming and DNA damage assays), and test potential combination therapies (ComBenefit synergy analysis).

Results:

High cyclin E1 specifically associated with BRCA1 loss in patient samples and not other homologous recombination gene defects, and predicted poor overall survival. BRCA1 disruption by mutation or siRNA in breast cancer cell lines led to cyclin E1 protein stabilisation during the cell cycle. This occurred via loss of cyclin E1-T62 phosphorylation, a site important in cyclin E1 stability, and mutation of the T62 site enhanced survival in colony forming assays. We subsequently confirmed that phospho-T62 was diminished in cancers with BRCA1 mutation across our patient cohort. Since cyclin E1/CDK2 can protect from DNA damage and cyclin E1 is elevated in BRCA1 disrupted cancers, we hypothesised that CDK2 inhibition sensitises these cancers to PARP inhibition. CDK2 inhibition induced DNA damage and synergised with the PARP inhibitor Rucaparib in BRCA1 mutated cell lines. CDK2 inhibitor/PARP inhibitor treatment of patient-derived xenograft models from Brca1 germline cases show significant reduction of tumour burden when used in combination.

Conclusions:

BRCA1 disruption increases cyclin E1 expression in breast cancer, and BRCA1 status and high cyclin E1 have potential as predictive biomarkers to dictate the therapeutic use of combination CDK inhibitors/PARP inhibitors in breast cancers.

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03 Predictive immune signature analysis for clinical cancer application

Helen M. McGuire1,2, Clara Choi2, Barbara Fazekas de St Groth1,2

1 The University of Sydney, Ramaciotti Facility for Human Systems Biology, NSW, Australia 2 The University of Sydney, Camperdown, NSW, Australia

Mass cytometry, or Cytometry by Time-Of-Flight (CyTOF), is a powerful platform for high-dimensional single-cell analysis of the immune system. It enables the simultaneous measurement of over 40 markers on individual cells through the use of monoclonal antibodies conjugated to rare-earth heavy metal isotopes. Coupled with our already extensive immunological knowledge of canonical immune subsets and an ability to delve into and describe subtle populations, mass cytometry presents an opportunity to investigate cumulative subtle changes across many specific immune subsets in a range of clinical cohorts.

We have concentrated on analysis of peripheral blood mononuclear cells, which are readily available as a reproducible source of tissue from patients and healthy subjects. Our aim is to develop analysis pipelines with clinical utility, for example to provide predictive tests that could inform clinical management.

Based on our previous studies in several autoimmune states, which revealed remarkably stable changes in the size of multiple peripheral blood cell subsets, we conducted a study of cell subsets in melanoma and lung cancer patients before and after therapy with the checkpoint inhibitor, anti-PD-1.

In line with multiple published studies, we found many therapy-dependent changes in expression of molecules either directly targeted by therapy, or closely associated with checkpoint pathways. These changes did not correlate with clinical response to therapy. However many of the T cell subsets previously identified in autoimmune patients, including those defined by expression of receptors responsible for tissue localisation and chemokine response, were differentially represented in baseline (pre-therapy) samples from cancer patients who failed to respond to anti-PD-1 therapy. We used a data analysis approach originally developed to analyse gene expression signatures in highly multiparametric datasets to analyse the cell subset distribution within samples.

We identified an immune signature in baseline blood samples that robustly identified patients who would subsequently make clinical responses to cancer treating anti-PD-1 therapy. Such an approach is well suited to machine learning, which will be used in future application of the predictive signature in clinical settings.

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04 Dual inhibition of JAK and Src: A novel and synergistic combination to target pancreatic tumours and their microenvironment

Ashleigh Parkin, Danielle Froio, Nicholas Vogel, Jennifer Man, Kendelle Murphy, Niantao Deng, Julia Yin, David Croucher, Jaswinder S. Samra, Anthony J. Gill, Paul Timpson, Marina Pajic

The Kinghorn Cancer Centre, Cancer Division, The Garvan Institute of Medical Research, Darlinghurst, NSW, Australia

Pancreatic cancer (PC) has a 5-year survival of only 6%, and persists as the 4th most common cause of cancer-related death in Western societies. A more tailored treatment approach may be beneficial as the current standard-of-care therapies offer only a modest increase in overall patient survival. Recent large-scale genomic studies have revealed that the Src/JAK/STAT3 signalling pathway is deregulated in up to 35% of PC, and is yet to be systematically examined in this disease. Consequently, we hypothesized that targeting pancreatic tumours with activated JAK/STAT3 signalling with selective JAK1/JAK2 or JAK3 inhibitors and an Src inhibitor represents a promising novel therapeutic strategy for this disease.

To systematically examine the in vitro and in vivo efficacy of individualised therapeutic strategies involving selective JAK1/2 and Src inhibitors. And to investigate underlying mechanisms of efficacy in the context of the complex tumour microenvironment.

We utilized well-annotated patient-derived cell-line models (ICGC), along with cell-lines generated from the aggressive KPC mouse model. Using these pre-clinical models we assessed the in vitro efficacy of therapeutic strategies involving Src/JAK/STAT3 inhibition, using cell proliferation assays, 2D-drug synergy screens, 3D organotypic invasion assays, and 3D organoid cultures. Extracellular matrix integrity post-treatment was assessed using second-harmonic generation (SHG) imaging and picrosirius staining. Multiplex cytokine arrays, and single-cell transcriptomics were used to delineate mechanisms and assess pathway modulation following treatment. To examine in vivo efficacy, we utilized a syngeneic KPC mouse model as well as patient-derived xenograft models.

We show that selected JAK and Src-inhibitors inhibit cell proliferation in candidate PDCLs and KPC lines, characterized by activated Src/JAK/STAT3 signalling, with combination therapy being synergistic in the majority of these cell-lines. Cell invasion was significantly inhibited in organotypic matrices, and there was decreased collagen contractility, and reduced fibrillar collagen coverage. We show significant changes in cytokine production, and have also identified several pathways that are modulated following treatment, via the use of single-cell transcriptomics. We also demonstrate the in vivo efficacy of these therapies, and show their effects on modulating the tumour microenvironment.

Our findings demonstrate the potential for tailored therapeutic strategies involving Src/JAK/STAT3 inhibition in PC, and suggest that therapeutic efficacy may be the result of targeting both tumour cells and the tumour microenvironment, as well as by overcoming tumour-induced immunosuppression.

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05 Procoagulant platlets as a diagnostic predictor of thrombosis in lung cancer patients

Emma Ramsay1, Heather Campbell3, John Simes2, Michael Boyer1,4, Anthony Joshua5,6,7, Venessa Chin6,7, Jane Young8.9.10, Bea Brown1, Vivien Chen3,11, Phillip Hogg1,12

1 The University of Sydney, Sydney Catalyst Translational Cancer Research Centre, NSW, Australia 2 The University of Sydney, NHMRC Clinical Trials Centre, NSW, Australia 3 The University of Sydney, ANZAC Research Institute, Concord, NSW, Australia 4 Chris O’Brien Lifehouse, Camperdown, NSW, Australia 5 St Vincent’s Hospital Sydney, Darlinghurst, NSW, Australia 6 The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia 7 Garvan Institute of Medical Research, Darlinghurst, NSW, Australia 8 The University of Sydney, Faculty of Medicine and Health, The University of Sydney School of Public Health, Wiser Healthcare, NSW, Australia 9 RPA Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW, Australia 10 Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Camperdown, NSW, Australia 11 Department of Haematology, Concord Repatriation General Hospital, Concord West, NSW, Australia 12 The University of Sydney, Centenary Institute of Medical Research, Camperdown, NSW, Australia

Thrombotic events are a major cause of morbidity and mortality in cancer. The procoagulant subset of platelets, when activated, trigger coagulation and thrombosis by providing a surface for assembly of coagulation factors. Measurement of procoagulant platelets in cancer could have prognostic significance, guiding clinical decisions and minimising thrombotic events. Using serial, citrated blood samples from a prospective cohort of patients with lung cancer enrolled in the EnRICH (Embedding Research (and Evidence) In Cancer Healthcare) Program, a flagship program of Sydney Catalyst and University of Sydney, this is the first clinical study of this measure in a cancer setting.

Aims:

1. To investigate correlation between lung cancer and elevated procoagulant platelets in the blood.

2. Identify lung cancer patients at risk of thrombosis from the procoagulant platelet population.

Methods:

Human studies were approved by Royal Prince Alfred Hospital and University of Sydney ethics committees (X16-0447, 2014/244), and conducted according to the Declaration of Helsinki. All participants gave written informed consent. Whole blood was collected in 3.2% citrate and stimulated with platelet agonists for ten minutes to reveal procoagulant platelets. Samples were labelled and analysed by flow cytometry (see Pasalic et al. JTH 16:1198, 2018).

Results:

Eighty unique patients have been analysed to date, with consecutive samples taken from thirty-one patients. Blood from cancer patients at baseline and six months had significantly higher numbers of procoagulant platelets compared to healthy individuals (healthy – 4.28 ± 0.92, baseline – 8.42 ± 0.95, 6 months – 10.67 ± 2.23 procoagulant platelets as percentage of total single platelets; mean ± SEM) when stimulated with collagen and thrombin. In concordance, patients diagnosed with more advanced lung cancer exhibited increased procoagulant platelets.

Conclusions:

The increased procoagulant platelet capacity of lung cancer patients may provide insight into the risk of thrombotic events. Further collection of data will help identify factors that increase the risk of thrombosis in lung cancer such as treatment.

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06 MicroRNA-based therapeutics for the treatment of high-risk neuroblastoma

Holly Holliday1,2, Eoin Dodson1,2, Iva Nikolic3, Niantao Deng1,2, Benjamin Elsworth1,2, Kaylene Simpson3,4, Alvin Kamili5,6, Madeleine Wheatley5, Joshua McCarroll5, Glenn Marshall7, Jamie Fletcher5, Alex Swarbrick1,2

1 Garvan Institute of Medical Research, Darlinghurst, NSW, Australia 2 St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, NSW, Australia 3 Victorian Centre for Functional Genomics, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia 4 Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia 5 Children’s Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Kensington, NSW, Australia 6 School of Women’s and Children’s Health, University of New South Wales, Kensington, NSW, Australia 7 Sydney Children’s Hospital and Children’s Cancer Institute, Kensington, NSW, Australia

Neuroblastoma is the most common extra-cranial solid cancer of childhood. High-risk patients have a 5-year survival rate below 50%. Treatment for these patients involves high-dose multi-layered chemotherapy, which is often not curative and causes severe health impacts later in life. There is therefore an urgent need to find alternative drugs to either replace or significantly improve upon conventional therapy. MicroRNAs (miRNA) are potent regulators of gene expression and are emerging as an exciting new class of therapeutic. However, our understanding of miRNA function in neuroblastoma is fragmented, restricting our ability to capitalise on their therapeutic potential.

We aim to screen and validate miRNAs that sensitise neuroblastoma cells to chemotherapy in vitro. Candidate therapeutic miRNAs will then be used to treat pre-clinical models of high-risk neuroblastoma.

We have performed a functional genomic screen of >1200 miRNA mimics in the Kelly cell line, a model of poor-prognosis disease. This was performed in combination with low doses (IC30) of doxorubicin and vincristine. Selected candidate miRNAs are currently being tested in the pre-clinical COG-N-519 patient-derived xenograft (PDX) model, originating from a patient with high-risk disease after several lines of treatment. Star-POEGMA nanoparticles are being used to deliver candidate miRNAs in combination with chemotherapy. Ongoing work includes mechanistic experiments to assess miRNA uptake and their impact on gene expression, and therapeutic experiments to monitor tumour growth and survival.

Three miRNAs, miR-99b-5p, miR-380-3p and miR-485-3p, had potent synthetic lethal interaction with doxorubicin in vitro. Analysis of a clinical cohort revealed that these miRNAs are putative tumour suppressors as they undergo recurrent copy number loss, and low expression predicts poor outcome. Excitingly, the candidate miRNA miR-99b-5p can be effectively delivered into neuroblastoma PDX tumour cells by nanoparticle injection. RNA-Sequencing analysis of miR-99b-5p-treated tumours revealed a decrease in expression of key neuroblastoma dependency genes MYCN, PHOX2B, HAND1/2, GATA3, ISL1 and EZH2. Importantly, many of these genes encode transcription factors, which are considered to be ‘undruggable’. Additionally, gene set enrichment analysis revealed upregulation of neuronal differentiation pathways, suggesting that miR-99b-5p is able to reprogram neuroblastoma cells towards a less aggressive cell fate.

We have identified novel chemosensitising miRNAs in the context of neuroblastoma that can be administered in vivo to drive favourable gene expression changes. We predict that restoring the function of tumour suppressive miRNAs in neuroblastoma patients will increase therapeutic outcome, while reducing the toxicity associated with conventional high-dose chemotherapy.

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07 Advanced melanoma patients with high CD16+ macrophages have better response and survival to anti-PD-1 based immunotherapy

Hansol Lee1,2, Ines Silva1, Marcel Batten1,2, Umaimainthan Palendira4, Angela Ferguson4, Matteo S. Carlino1,7, Robyn P.M. Saw1,5, Andrew J. Spillane1,3,6, Alexander M. Menzies1,6, Richard A. Scolyer1,5, Georgina V. Long1,6, James S. Wilmott1,2

1 The University of Sydney, Melanoma Institute Australia, Wollstonecraft, NSW, Australia 2 The University of Sydney Central Clinical School, Camperdown, NSW, Australia 3 The University of Sydney Northern Clinical School, St Leonards, NSW, Australia 4 The University of Sydney School of Medicine, Discipline of Infectious Diseases and Immunology, NSW, Australia 5 Royal Prince Alfred Hospital, Camperdown, NSW, Australia 6 Royal North Shore Hospital, St Leonards, NSW, Australia 7 Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Sydney, NSW, Australia

Anti-PD-1 and anti-CTLA-4 immunotherapies have become the standard of care for metastatic melanoma. However, the majority of patients develop resistance to therapy. Macrophages are abundant cells in tumours, but their role in immunotherapy response and resistance is largely unknown.

This study investigated the role of macrophages in anti-PD-1 +/- CTLA-4 response in stage IV melanoma patients.

Transcriptomic and multiplex immunohistochemistry (mIHC) immune profiling were performed on formalin-fixed paraffin embedded tissue pre-treatment biopsies from advanced melanoma patients treated with anti-PD-1 (n=19) or anti-PD-1 + anti-CTLA-4 (n=10). Response and progression-free survival were assessed using RECIST criteria. Using tumour dissociates, mass cytometry was used to characterize macrophages in detail.

Although there was no significant difference in CD68+ macrophages between responding and non-responding patients, responding patients had a significantly higher intratumoral density of CD14+ CD68+ CD16+ macrophages compared to non-responders at baseline (median = 192 versus 23; p = 0.006). Using mIHC, patients were classified into high/low CD16+ macrophages and differential RNA expression analysis was performed. CD16+ high macrophage tumours displayed increased expression of genes related to T cell activation (TIGIT, LAG3, ICOS, PDCD1, FASLG and TBX21), MHC class I presentation (TAP1, UBD, PSMB10 and B2M) and chemokine + cytokine activity (CXCL13, CXCL10, CXCL11, CXCL9, CXCR6 and CXCR3). Using mass cytometry, we determined that CD16+ macrophages are CD13+ HLA-DR+, ICOS+ CD86+/- LAG3- GITR- TIGIT-. Multivariate analysis showed that low LDH, low melanoma substage and the presence of high CD16+ macrophages were associated with a significantly better overall response rate (OR = 14; p = 0.011) and progression free survival (HR = 0.15; p = 0.016), but not overall survival (HR = 0.22; p = 0.068).

Presence of CD68+ CD14+ CD16+ macrophages in pre-treatment melanoma combined with low LDH and low melanoma substage strongly correlates with response and survival of advanced melanoma patients treated with immunotherapy.

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08 Patient reported outcomes and treatment uptake of Integrative Oncology and Supportive Care Services at a tertiary cancer centre

Diana Naehrig1,2, Haryana Dhillon3, Suzanne Grant1,4, Michael Marthick1, Rebecca Asher1,5, Peter Grimison1,2, Trevor Tejada-Berges1,2, Chris Milross1,2, Catherine Lambert1, Judith Lacey1,2,4

1 Departments of Integrative Oncology and Supportive Care, Medical Oncology, Radiation Oncology, Gynaecological Oncology, Clinical Services, Chris O’Brien Lifehouse, Camperdown, NSW, Australia 2 The University of Sydney Medical School, Camperdown, NSW, Australia 3 The University of Sydney, Faculty of Science, School of Psychology, Centre of Medical Psychology and Evidence-Based Decision-Making, Psycho-Oncology Co-operative Research Group, NSW, Australia 4 NICM Health Research Institute, University of Western Sydney, Campbelltown, NSW Australia 5 The University of Sydney, NHMRC Clinical Trials Centre, NSW, Australia

Integrative Oncology (IO) is increasingly becoming part of supportive care service (SCS) provision in comprehensive cancer care. These services are accessed by patients at all stages of the cancer trajectory from initial diagnosis through to survivorship or end of life care. As more patients are living longer with cancer, and may experience ongoing symptoms from the cancer or its treatment, adequate support and symptom management is important.

With the development of this new service model in a large tertiary cancer, we aimed to explore patient characteristics, patterns of access, uptake and preferences for IO. Patient reported outcome measures, collected as standard of care, were analysed to discern and better address patients’ needs in the future.

We compared patient demographics, tumor group and stage for patients accessing IO, SCS, and psycho-oncology to all patients attending our tertiary cancer center between July 2017 and June 2018. For patients accessing IO and/or SCS, we analyzed mean symptom scores (range 0-10) recorded on the Edmonton Symptom Assessment System (ESAS), and conducted a principal component analysis using VERIMAX rotation to determine symptom clusters.

Of 14,816 individual patients attending overall, 1,233 patients (8.3%) accessed IO and SCS, and 388 patients (2.6%) accessed psycho-oncology. Approximately 800 occasions of service were provided each month for IO, SCS and psycho-oncology, combined. And, slightly more than 300 patients accessed these services every month. These three groups were comparable with few exceptions due to specifically targeted treatment programs and availability of therapists within IO and SCS. The most common tumor groups were breast, lung, gynecologic, and gastrointestinal cancer. A detailed breakdown of integrative therapies including medical specialty is presented. Mean symptom scores were highest for fatigue (4.5), sleep (4.4), and wellbeing (4.3). Four symptom clusters were identified; drowsiness, fatigue and shortness of breath; anxiety and depression; sleep and pain; appetite and nausea. These symptom clusters weren’t significantly associated with baseline demographics or clinical variables.

Cancer patients accessing IO, SCS and psycho-oncology were comparable to the total population in age, gender and cancer type, however overall uptake is low (8.3%). Ongoing work will explore barriers to accessing IO and SCS services. Symptom clusters identified by patients using the IO service are similar to those reported by comparable IO services globally. Further exploration of symptom clusters with diagnostic, demographic and therapeutic modality data will inform ongoing service development and implementation of evidence-based clinical pathways.

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09 Molecular tumour profiling and whole genome sequencing: Psychosocial, ethical and behavioural issues

Phyllis Butow1, Megan Best1, Nicole Bartley1, Christine Napier2, Grace Davies1, Mandy Ballinger2, Tim Schlubb3, Chris Jacobs4, Ilona Juraskova1, David Goldstein5, Ainsley J Newson6, Jacqueline Savard7, Bettina Meiser8, Kathy Tucker9, Barbara Biesecker10, David Thomas2

1 The University of Sydney, Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, NSW, Australia 2 Garvan Institute of Medical Research, Cancer Division, Sydney, NSW, Australia 3 The University of Sydney, Faculty of Medicine and Health, The University of Sydney School of Public Health, NSW, Australia 4 University of Technology Sydney, Graduate School of Health, Sydney, NSW, Australia 5 University of New South Wales, Prince of Wales Clinical School, Sydney, NSW, Australia 6 The University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics, NSW, Australia 7 Deakin University, School of Medicine, Melbourne, VIC, Australia 8 University of New South Wales, Psychosocial Research Group, Prince of Wales Clinical School, Sydney, NSW, Australia 9 Prince of Wales Hospital, Hereditary Cancer Clinic, Sydney, Australia 10 Research Triangle Institute International, Washington DC, USA

Background:

Molecular tumor profiling (MTP) to identify personalized treatment for cancer, and whole genome sequencing (GS) to guide cancer risk prevention, are moving to mainstream oncology. Currently, little is known about the psychological, ethical and behavioural outcomes of MTP and GS. This study explored these issues in patients undergoing MTP and GS as part of two large genomics studies (MoST and RiSC) run at the Garvan Institute of Medical Research.

Methods:

Participants were adults with advanced/metastatic solid cancer offered MTP or with cancer of likely genetic origin offered GS were recruited to the PiGeOn (Psychosocial Issues in Genomic Oncology) study. Participants completed questionnaires at three time points; this presentation reports baseline data only. Semi-structured interviews were conducted with a purposively selected subsample (n = 20) in each cohort. Quantitative data were analysed descriptively, with linear and logistic regressions conducted to identify predictors of outcomes. Interview transcripts were analysed using thematic analysis.

Results:

Participants had a “why not” attitude to GS and MP. For MoST participants (n=777), MP offered final hope in the context of disappearing treatment options, with targeted treatment dominating their needs and priorities. RiSC participants (n=565) valued information to guide their own and relatives’ health protection; they expressed strong support for access to GS for their relatives (92%), and anyone who requested screening (91%), but less so, for mandatory universal access 66%). Knowledge of GS and MP was poor, with most participants wanting “gist” information, filtered by their oncologist. MoST participants (89%) would want MP even if the return of actionable result rate was as low as 1%, but only 22% would pay up to $10,000 for the test (current costs are $6-10,000).

Conclusions:

Communicating about genomics remains a challenge for oncologists. Traditional notions of consent require understanding but patients prefer expert guidance. Participants sought hope and reduction of uncertainty from MP and GS. Financial barriers may be an issue for use of GS and MP in routine care.

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10 Understanding the Relationship between Patient Experience and Objective Assessment of CIPN

Hannah C. Timmins1, Tiffany Li1, Michelle Harrison2, Lisa G. Horvath2,3, Frances Boyle4, Matthew C. Kiernan1, David Goldstein5, Susanna B. Park1

1 The University of Sydney, Brain and Mind Centre, Camperdown, NSW, Australia 2 Chris O’Brien Lifehouse, Camperdown, NSW, Australia 3 The University of Sydney Medical School, NSW, Australia 4 Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital, North Sydney, NSW, Australia 5 Prince of Wales Clinical School, University of New South Wales, Kensington, Australia

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side-effect producing pain, paraesthesia, numbness and functional impairment. Increasingly, patient reported outcomes (PROs) are utilised to examine the impact of CIPN on patients. However, links between objective neurological assessment and PROs remain ill defined.

This study aimed to identify links between neurophysiological measures and PROs in patients treated with neurotoxic chemotherapy.

Assessments were conducted in 41 taxane-treated patients (F=39, Age:66.2 ±1.6 years, median completion:20.5months, IQR:11-38months). Patients reported the severity of neuropathic symptom severity via validated questionnaire (FACT-Gog-Ntx13). Clinical neurological assessments were scored using the Total Neuropathy Score clinical (TNSc), comprising pinprick and vibration sensibility, deep tendon reflexes, strength and patient symptom report. Nerve conduction studies (NCS) recorded compound sensory action potentials (CSAPs) from the sural and median nerves, with lower limb NCS being incorporated into the TNS reduced version (TNSr).

Of the total sample, 80% reported neuropathy, with 30% reporting ‘quite a bit’ or ‘very much’ severity of tingling and numbness in their hands or feet. Sural CSAP amplitude (mean:11.55±1.0µV) was below the lower limit of normal (LLN) for 22% of patients, with 35% having median amplitudes (mean:10.24±.98µV) below the LLN. Overall PRO of neurotoxicity (FACT-Gog-Ntx13) correlated with objective assessment (TNSc:r=-.596, p<.05), even when patient reported items were removed (r=-.393, p<.05). Median amplitude correlated with clinical assessment (TNSc:r=-.333,p<.05) and overall PRO of neurotoxicity (FACT-Gog-Ntx13: r=.366, p<.05), but not specifically neuropathic symptoms in the hands (r=-.181,N.S). Sural amplitude did not correlate with overall patient reports of neurotoxicity (FACT-Gog-Ntx13: r =-.263) or specific neuropathic symptoms in the feet (r =-.281, N.S), but showed a significant correlation with the clinical assessment (TNSc:r=-.434, p<.05).

Patients with abnormal NCS did not report significantly worse symptom burden (FACT-Gog-Ntx13:40.32±1.80) compared to those with normal NCS (43.05±1.08, N.S), nor differ significantly in clinical examination once patient report items were removed (Normal:2.8±.42, Abnormal:4.6±.61, N.S). Those reporting ‘quite a bit’ or ‘very much’ numbness and tingling in the feet showed greater deficit in objective examination (TNSr: 5.5±1.09) compared to those with less symptoms even when patient report items were removed (3.45±.45, p<.05).

Relationships between patient report of symptom burden and objective measures exist, but discrepancies remain, especially when evaluating symptom distribution or using single measures. Understanding these discrepancies using a variety of assessments may help to elucidate underlying mechanisms. At present a combination of complementary assessment tools is required to assess the impact of clinical interventions and inform treatment strategies.

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11 Cancer patients’ views and understanding of genome sequencing: A qualitative study

Nicole Bartley1, Megan Best1, Chris Jacobs2, Ilona Juraskova1, Ainsley J Newson3, Jacqueline Savard4, Bettina Meiser5, Mandy L Ballinger6, Barbara B Biesecker7, Phyllis Butow1

1 The University of Sydney, Faculty of Science, School of Psychology, Centre of Medical Psychology and Evidence-Based Decision-Making, Psycho-Oncology Co-operative Research Group, NSW, Australia 2 University of Technology Sydney, Graduate School of Health, Sydney, Australia 3 The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, NSW, Australia 4 Deakin University, School of Medicine, Melbourne, VIC, Australia 5 University of New South Wales, Prince of Wales Clinical School, Psychosocial Research Group, Sydney, NSW, Australia 6 Garvan Institute of Medical Research, Cancer Division, Sydney, NSW, Australia 7 Research Triangle Institute International, Washington DC, USA

Aims:

Little is known about knowledge of, and attitudes towards, germline genome sequencing (GS) among individuals with a personal history of cancer. This qualitative study aimed to investigate knowledge and attitudes of individuals previously diagnosed with a cancer of likely genetic origin, who are undertaking GS.

Methods:

Participants were adults with a cancer of likely genetic etiology who had recently consented to undergo GS as part of a larger genetic study. Semi-structured interviews were conducted with purposively selected participants (n = 20) from the Psychosocial Issues in Genomic Oncology (PiGeOn) study, just after providing a blood sample for GS. Interviews were audio recorded, transcribed and analysed using thematic analysis.

Results:

Analysis identified three main themes: understanding of genomics; motivation; and decision-making. Whilst motivations such as obtaining health information about self and family appear to be the main drivers for undertaking GS, these motivations are sometimes based on limited knowledge and therefore create unrealistic expectations of the accuracy and utility of GS. This in turn can prolong the deliberation process and lead to ongoing decisional conflict about undergoing GS.

Conclusions: Understanding the degree and nature of patient understanding of GS, as well as attitudes and decision-making processes of individuals interested in pursuing GS, will enable health care professionals to manage patient expectations and adequately engage and support patients to make an informed decision when pursuing GS.

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12 Evaluating a shared care pathway intervention to reduce chemotherapy outpatients

Heather McKenzie1, Lilian Hayes1, Jodi McLeod2, Judith Fethney1, Judy Simpson3, Janette Vardy4, Natalie Cook5, Simon Willcock6, Chantale Boustany1, Louise Acret1, Bora Kim1, Kate White1

1 The University of Sydney, Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), NSW, Australia 2 Sydney District Nursing, Sydney Local Health District, Campsie, NSW, Australia 3 The University of Sydney, Faculty of Medicine and Health, School of Public Health, NSW, Australia 4 Concord Repatriation General Hospital, Concord West, NSW, Australia 5 NSW Primary Health Network, Sydney, NSW, Australia 6 Macquarie University Hospital, Primary Care, Macquarie Park, NSW, Australia

Cancer treatments such as chemotherapy and immunotherapy are predominantly delivered in outpatient cancer settings. Patients can be at risk of not receiving prompt support to manage treatment side effects at home, leading to an increase in preventable hospital presentations and poorer quality of life (QoL). This randomised controlled trial evaluates an intervention involving community nurse home visits for patients receiving outpatient chemotherapy to monitor and support their symptom management.

The aims of the study are:

• To test whether the intervention reduces unplanned hospital presentations and improves QoL.• To test whether the intervention demonstrates cost effectiveness by reducing hospital presentations.• To explore the perspectives and experiences of patients and family/carers, community nurses, cancer care staff and

general practitioners involved. This abstract presents the qualitative accounts of patients receiving the intervention and the perspectives of their family/carers.

345 patients commencing chemotherapy were enrolled and randomised to the intervention group or standard care. The intervention group received supportive care from community nurses who had completed a structured education program. Community nurses provided symptom assessment and management, and liaised with treating general practitioners and cancer centre staff.

In-depth interviews with 26 patients and seven family/carers explored their experiences of receiving community nurse visits at home, and identified benefits and areas for improvement.

Preliminary findings identified three themes: (i) accessibility of health and social care support, (ii) building confidence to better manage self-care, and (iii) uncertainty, frailty and comorbidities. Many participants welcomed the community nurse home visits, finding it easier to absorb and make sense of complex information in this setting, where they were not challenged by the noise and busyness of hospital and clinic environments. Repeat community nurse visits across the first three chemotherapy cycles provided sufficient time and encouragement for patients and carers to build confidence levels and develop practical strategies for managing self-care during future cycles, including decision making about when to seek advice from health professionals. This approach was particularly beneficial for patients with complex comorbidities and frailty issues.

The shared care pathway intervention involving community nurses during early chemotherapy cycles facilitates prompt identification and management of chemotherapy.

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13 Implementing renewal of the Cervical Screening Program in Australia: Health professionals’ views and experiences

Rachael H. Dodd, Helena M. Obermair, Kirsten J. McCaffery

1 The University of Sydney, Faculty of Medicine and Health, The University of Sydney School of Public Health, Wiser Healthcare, NSW, Australia 2 Liverpool Hospital, South-West Sydney Local Health District, Liverpool, NSW, Australia

In 2017, the Australian National Cervical Screening Program changed from two-yearly Pap smears for women aged 18-69, to five-yearly human papillomavirus (HPV) tests for women aged 25-74. Recent research has shown that women may be concerned about these screening changes. Health professionals have been shown to be influential when changes occur or when recommendations are required. Research with health professionals practising in Australia was conducted prior to the renewal of the cervical screening program, but attitudes since the implementation of the renewed program are unknown.

This study aims to explore the attitudes and experiences of health professionals practising in Australia towards the renewed National Cervical Screening Program.

Semi-structured interviews were conducted with 31 health professionals in Australia who are involved in cervical screening in November and December 2018. This included general practitioners, obstetricians & gynaecologists, gynaecological oncologists, pathologists and nurses. The interviews were analysed using thematic analysis.

In total, 31 health professionals were interviewed. Overall, health professionals had positive attitudes to the renewed cervical screening program. Four main themes emerged from the data: practical system challenges, communication and education, screening outside the guidelines and other unexpected downstream effects. Practical system challenges included increased colposcopy referrals, limited access to the National Cancer Screening Register, complex screening pathways and issues with self-collection. In terms of communication and education, the limited public education was recognised, in addition to challenges with particular age groups of women. Screening outside of the guidelines was described, for example over-referring women for co-testing by stating symptoms, which could lead to overtreatment. In addition, there was some description of self-collection guidelines not being followed. Other perceived collateral was demonstrated through reduced opportunistic screening opportunities due to less frequent primary care presentations, and a concern over the potential for further underscreening in those population groups who were already under screened.

Women’s understanding and experience of the renewed National Cervical Screening Program will likely depend upon clinicians’ ability and willingness to explain the rationale behind the changes, and to respond confidently to patient concerns regarding these changes. It is essential that concerns and challenges identified in this study are addressed with health professionals to improve implementation of this screening program and to provide guidance for future deimplementation of screening programs. These findings also provide insight into the challenges health professionals are facing with the renewed program, in terms of practical issues and unexpected downstream effects which need to be addressed. Addressing these challenges may also reduce screening outside of the guidelines and reduce the potential of overtreatment from over testing.

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14 Implementing patient-reported outcome measures (PROMs) in clinical practice: A meta-review of reviews

Rachel Campbell1, Claudia Rutherford1,2, Fabiola Müller1, Natasha Roberts3,4,5, Melissa Tinsley6, Robyn Speerin6, Linda Soars7, Anna Butcher8, Madeleine King1

1 The University of Sydney, Faculty of Science, School of Psychology, NSW, Australia 2 The University of Sydney, Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), NSW, Australia 3 Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia 4 Queensland University of Technology, Brisbane, QLD, Austrlia 5 Metro North Health Service, Brisbane, QLD, Austalia 6 NSW Agency for Clinical Innovation, Chatswood, NSW, Australia 7 Western Sydney Local Health District, North Parramatta, NSW, Australia 8 Northern Sydney Local Health District, St Leonards, NSW, Australia

Implementation of PROMs in clinical practice can improve care at the micro-level (i.e. by informing and improving the management of individual patients) and at the meso- and macro-levels (i.e. where aggregated data can help to guide improvements in clinical care and inform health policy). However, various practical, methodological and attitudinal barriers can hinder their effective implementation.

This meta-review of reviews aimed to synthesise evidence about (1) why PROMs are used in clinical practice (e.g. for what purpose); (2) their effectiveness in improving care and outcomes; and (3) the barriers to implementing PROMs at micro, meso and macro levels.

In accordance with methods for umbrella reviews, we searched five electronic databases for reviews that met the following criteria: published in English; comprehensively or systematically examined the use or implementation of PROMs in any health condition, setting, and geographical location; published between 1999 and February 2019. Two independent reviewers applied the inclusion criteria. Data was extracted by one reviewer and cross-checked by another. Key findings were qualitatively synthesised.

We identified 48 reviews. There is convincing evidence that using PROMs in clinic improves processes of care (i.e. patient-clinician communication and patient satisfaction). There is emerging evidence that PROMs can predict prognosis, and accurately screen for mental health issues and unmet needs. However, the evidence that PROM assessment improves patient health outcomes is equivocal. Barriers to PROM implementation include: 1) pre-existing clinical practice, culture and behaviours; 2) difficulty in choosing appropriate and informative PROMs for a given context; 3) lack of knowledge/understanding of PROMs (e.g. how to use and interpret PROM data) and their value in the clinical context (e.g. how to use PROMs in real-time to inform care). There is a dearth of studies examining the utility of PROM data for decision making at meso- and macro-levels.

Conclusive evidence supports the use of PROMs in clinical practice for treatment planning and decision-making for individual patients. Use of PROMs facilitates the provision of timely person-centred care, improves patient-clinician communication, and the provision of tailored referrals based on patient needs. However, evidence is equivocal about whether patient outcomes also improve. This is possibly due to a multitude of context-specific factors. The effective implementation of PROMs may be key to availing of their full potential. More research is needed to examine the use of PROM data for quality assurance and policy-making.

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15 Feasibility and acceptability of pre-operative exercise to improve outcomes after major cancer surgery

Daniel Steffens1,2, Jane Young1,2,3, Paula R. Beckenkamp4, James Ratcliffe5, Freya Rubie5, Nabila Ansari1, Neil Pillinger2,6, Michael Soloman1,2,3

1 Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Camperdown, NSW, Australia 2 The University of Sydney School of Medicine, NSW, Australia 3 Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, Australia 4 The University of Sydney, Faculty of Health Sciences, Discipline of Physiotherapy, NSW, Australia 5 Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, Australia 6 Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, Australia Background:

Survival outcomes for patients undergoing major abdominal cancer surgery are now acceptable, however, the high rate of postoperative complications remains a challenge. Currently, there is some evidence suggesting that preoperative exercise may reduce postoperative complications. The primary aim of this pilot trial was to establish the feasibility and acceptability of a preoperative exercise program designed to improve patient outcomes after cytoreductive surgery and pelvic exenteration. The secondary aim was to obtain pilot data on the likely difference in key surgical outcomes to inform the sample size calculation for a full-scale randomised controlled trial.

Methods:

Patients scheduled to undergo pelvic exenteration or cytoreductive surgery were invited to participate. Participants were randomised (1:1 ratio) to a 2-6 weeks preoperative, face-to-face, individualised exercise program (intervention group) or to usual care (control group). Feasibility was assessed with consent rates to the study, and for the intervention group, retention and adherence rates to the preoperative exercise program. Acceptability of the exercise program was assessed with a semi-structured questionnaire. In addition, postoperative complication rates, length of hospital stay and quality of life measures were collected at baseline, day before surgery and in-hospital.

Results:

Of 122 patients screened, 26 (21%) were eligible and 22 (85%) accepted to participate in the trial and were randomised to the intervention (11; 50%) or control group (11; 50%). No difference in baseline characteristics were found, with most patients being male (55%) and presenting a median age of 63 years, with 11 (50%) undergoing pelvic exenteration. All participants completed the trial with no crossovers. Adherence to the preoperative exercise sessions was 92.7%, with all participants either satisfied (33%) or extremely satisfied (67%) with the overall design of the preoperative exercise program. No significant differences in postoperative complication rates, length of hospital stay and pre-discharge quality of life outcomes was found between groups.

Conclusions:

The results of our pilot trial demonstrate that a preoperative exercise program is feasible and acceptable to patients undergoing major abdominal cancer surgery. There is an urgent need for a definite trial investigating the effectiveness of a preoperative exercise program on postoperative outcomes in patients undergoing major abdominal cancer surgery.

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16 Evidence based predictions for the demand for cancer surgery in Australia

Sathira Perera, Michael Barton, Susannah Jacob

Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia

Estimating the optimum rate for utilization of surgery in the management of cancer, helps to identify any existing treatment gaps, estimate the survival and economic impacts of such gaps and to predict the population level demand for cancer surgery. A population-based benchmark rate for optimum surgical utilization has not been estimated before in Australia or elsewhere.

Developing models to estimate the optimum cancer surgical utilization rates, required complexity and the demand for cancer surgery in Australia.

Latest clinical guidelines were examined, and decision trees were created using the Tree Age Pro software to map treatment pathways for individual cancers. Epidemiological data in the trees were sourced from Australia and other settings and the optimum surgical utilization rate for each cancer was calculated. These rates and the cancer incidence data were then used to estimate the present and future demand for cancer specific surgery in Australia.

The model calculated that surgery is indicated in 58% (95%CI 57%-59%) of newly diagnosed cancer patients in Australia, at least once during the course of their treatment. The optimum surgical utilization rate for breast cancer was 0.97 (95% CI 0.96 to 0.98), whiles the rates for colon cancer 0.86 (95% CI 0.85 to 0.97), rectal cancer 0.89 (95% CI 0.88 to 0.99), prostate 0.22 (95% CI 0.17 to 0.24) and lung cancer was 0.33 (95% CI 0.31 to 0.34). The surgical complexity grade V accounted for the highest estimated surgical volume of 34%. The procedures under this category included procedures such as radical prostatectomy, mastectomy, pneumonectomy, lobectomy, cystectomy, nephrectomy, resection of brain cancer, abdominoperineal resection and colectomy.

Gastro-intestinal cancers accounted for the highest estimated number (21414) of surgical procedures required in year 2020, followed by skin cancer (17219), breast cancer (16694) and genitourinary cancer (12215). The total annual number of estimated surgical procedures to be performed under optimal circumstances by year 2020 will be 85030. This is expected to increase to more than 150000 if the current incidence rates of cancer remain stable during the next couple of decades.

These numbers provide useful insights for planning the future investment required for funding cancer surgical care. It also produces evidence based numerical inputs on the cancer surgical burden required to plan the future human resource requirements for cancer surgery in Australia.

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COMING SOON...

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FUNDINGRESEARCH

FOR

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Type of Award Funds and Purpose

T1T2 Pilot & Seed Award Two Awards of up to $50,000 each for projects to be completed by June 2021

T2/T2T3 Pilot & Seed Award One Award of up to $50,000 each for projects to be completed by June 2021

T3 Pilot & Seed Award* One Award of up to $50,000 each for projects to be completed by June 2021

*If a T3 project of a suitable standard is not identified, the award will be conferred at the discresion of the T2T3 Review Panel

Tuesday 8 October 2019 Applications open online

Monday 18 November 2019 Applications close, 5pm AEST

Monday 9 March 2020 Successful applicants notified for funding to commence March 2020

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19 November 2019

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Sydney Catalyst is supported by:

This event is proudly sponsored by:

Cancer Research Network, The University of SydneySpecial thanks to:

The Garvan Institute of Medical Researchfor hosting this event

TO BEDSIDE BEYOND - Sydney Catalyst...2.30pm 15 Dr Daniel Steffens Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital Feasibility and acceptability of pre-operative

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