Research Projects

Cancer

• Preventing aggressive forms of prostate cancer

  Clinical problem
  Prostate cancer is the most common cancer and the second biggest cause of cancer death in men. Each year around 10,000 new cases are diagnosed and 2,800 men die from the disease. Some cases of prostate cancer are more aggressive than others, which means they spread more quickly and patients have fewer treatment options.
  
  The study
  Past research has suggested a link between aggressive prostate cancer and two enzymes - prostate-specific antigen (PSA – the current bio-marker for prostate cancer) and a related enzyme, kallikrein 4. This project aims to identify whether these two substances, acting together, trigger a process that causes prostate cancer to spread faster.
  
  Ultimate aim
  The findings could lead to developing new therapeutic strategies to act against the enzymes and the resulting metastases (or cancer spread) as an extra weapon to combat prostate cancer.
  
  Researcher
  Dr Astrid Whitbread, Post-doctoral Research Fellow
  
  Project sponsor
  Xstrata
  
  Project partner
  Queensland University of Technology

• Combining chemotherapy and radiotherapy to treat osteolymphoma

  Clinical problem
  Osteolymphoma, a rare type of bone cancer, is a variant of a more common group of diseases found predominantly in the lymph nodes, such as Non-Hodgkin’s Lymphoma. Recent studies of Non-Hodgkin’s Lymphoma revealed that patients benefit from a combination of chemotherapy and radiotherapy in the early stages of the disease and it is believed the same rationale may apply to patients with osteolymphoma.

  The study
  This project commenced in mid-2000 and involves a sample of 70 patients with the disease for a period of 10 years. During this time, patients will undergo three cycles of chemotherapy and radiotherapy.

  Ultimate aim
  It is expected the combination therapy will offer patients improved quality of life and a better chance of survival.
  Results to date have been outstanding, with the survival rate of patients receiving a combination of chemotherapy and radiotherapy exceeding 90 per cent – a significant increase on previously recorded survival rates.
  
  Researcher
  Associate Professor Dr David Christie, Radiation Oncologist, East Coast Cancer Centre
  
  Project sponsor
  Justin Cameron Cancer Care Foundation
  
  Project partner
  East Coast Cancer Centre, John Flynn Memorial Hospital

• Effects of chemotherapy on cognitive functioning of women with breast cancer

  Clinical problem
  Anecdotal evidence has suggested women who have chemotherapy for breast cancer suffer changes to their cognitive function including mild impairment of memory, attention and complex reasoning.

  The study
  In this study, breast cancer patients undergoing chemotherapy are seen on four occasions over 18 months to asses their cognitive performance. The project will also assess changes in quality of life, anxiety and depression.

  Ultimate aim
  Following the study, researchers will design diagnostic tools and early interventions for breast cancer sufferers, and develop management strategies for those affected.
  
  Researchers
  Dr Geoff Beadle, Medical and Radiation Oncologist
  Dr Margaret Wright, Senior Research Officer
  
  Project sponsors
  Queensland Cancer Fund
  National Breast Cancer Foundation

• Response of osteosarcoma to chemotherapy

  Clinical problem
  Osteosarcoma is a highly aggressive bone cancer that is the second most common primary bone malignancy after myeloma. It typically occurs in adolescents and young adults. Prior to treatment with chemotherapy, amputation was the method used with a 10 to 20 per cent survival rate. Over the last 25 years, chemotherapy has been used to treat osteosarcoma, increasing long-term survival to approximately 60 per cent.

  The study
  This research project will use micro array analysis (a representation of gene abundance) of tumour tissue to determine whether the responsiveness of an osteosarcoma to chemotherapy can be predicted by the patient’s genetic profile.
  To date, 27 patient samples have been screened in duplicate and researchers have identified a gene that is over-expressed in all the osteosarcoma patients.

  Ultimate aim
  This project will allow doctors to use genetic screening to develop individually tailored treatment for patients to ensure the best possible result for the 30 to 40 per cent of patients who do not respond well to traditional therapeutic strategies.
  
  Researchers
  Dr Scott Sommerville, Orthopaedic Surgeon
  Associate Professor Nick Saunders, Senior Research Fellow
  Dr Nigel McMillan, Senior Research Fellow
  
  Partners
  University of Queensland

• Predicting late rectal damage from radiotherapy for prostate cancer

  Clinical problem
  Every year approximately 1,000 Queensland men have radiotherapy for prostate cancer, with 10 per cent of these patients developing gastrointestinal side effects such as severe bleeding, pain and frequency after one or two years. While some patients can be treated with medication, some require a permanent colostomy or reconstructive surgery.

  The study
  Past research has suggested these side effects are attributed to a heightened sensitivity to radiation that can be traced back to genetics. This project will identify these genetic factors by studying the gene expression profiles of patients who had a normal or severe response.

  Ultimate aim
  This research will lead to testing patients’ genetic makeup to identify if they are likely to be highly sensitive to radiation damage. If so, their treatment can be modified to avoid the debilitating side effects.
  
  Researchers
  Dr Geoff Birell, Research Officer, Oncology and Cell Biology, QIMR
  Dr John Lumley, Consultant Surgeon, The Wesley Hospital
  
  Project sponsor
  Xstrata
  
  Project partner
  QIMR

• Trialling a new treatment for brain tumours

  Clinical problem
  Malignant gliomas are generally untreatable tumours of the central nervous system (the brain and the spinal cord). After normal treatment with surgery, radiotherapy and occasionally chemotherapy, the outlook for patients with the most common and aggressive forms of malignant glioma is poor with a median survival rate of a little over a year.

  The study
  Previous research suggests tumour vaccines are likely to be more effective when given with other adjuvant treatments, such as chemotherapy. This project is combining a vaccine trial conducted since late 2003, with the safety of dendritic cell vaccine therapy and temozolomide (an oral chemotherapeutic agent) for patients with malignant glioma. It will determine whether concomitant dendritic cell vaccine therapy and oral temozolomide are safe and effective in patients, both radiologically and in terms of patient survival.

  Ultimate aim
  By combining dendritic cell vaccine therapy with chemotherapy in a novel treatment, the study expects to increase the survival rate for affected patients.
  
  Researchers
  Dr David Walker, Neurosurgeon
  Dr Frank Tomlinson, Neurosurgeon
  Dr Chris Schmidt, Senior Scientist, QIMR
  
  Project partner
  Queensland Institute of Medical Research

• More accurate diagnosis of a common breast cancer

  Clinical problem
  Invasive lobular carcinoma is the second most common breast cancer. However, it is difficult to diagnose by mammography and other imaging techniques because it does not always look the same.

  The study
  This study is investigating the different imaging characteristics of invasive lobular carcinoma and correlating the findings with other features of these tumours.

  Ultimate aim
  The study will provide information on whether distinct forms of the invasive lobular carcinoma can be identified using the imaging techniques, and whether they correlate with the observed clinical variability of the tumours.
  
  Researchers
  Dr Alan Porter, Radiologist
  Professor Sunil Lakhani, Molecular and Cellular Pathology Professor
  Dr Peter Simpson, Postdoctoral Research Fellow
  Dr Elizabeth Evans, Research Coordinator
  
  Project partners
  The University of Queensland
  Queensland Institute of Medical Research
  The Wesley Breast Clinic

• Rapid, low cost detection of cervical cancer in women in a developing nation

  Clinical problem
  There is a major problem with cervical cancer in developing nations, but there is a lack of funding to provide women with routine PAP smears.

  The study
  This project is assessing the safety, acceptability and feasibility of the use of vinegar (VIA) and Lugol’s iodine (VILI) applied to the cervixes of women as a cervical cancer screen in Ni Vanuatu. All participants also have a PAP smear, HPV test, colposcopy +/- biopsy to evaluate the effectiveness of the VIA/VILI technique as a cheap and easy cervical cancer screening test.

  Ultimate aim
  This project will enhance healthcare for women in developing nations.
  
  Researchers
  Dr Scott Kitchener, Consulting Research Physician
  Dr Margaret McAdam, General Practitioner
  Professor Ian Frazer, Director, Centre for Immunology and Cancer Research
  Dr Graham Tronc, Obstetrician and Gynaecologist
  
  Project partners
  The University of Queensland
  Brisbane Women’s Health Medical
  Brisbane Women’s Health Medical

• Preventing the spread of bone cancer

  Clinical problem
  Osteosarcoma is the second most common primary cancer of bone. The majority of patients afflicted by this disease are only in their teens and approximately 30% of these patients will die. The primary cause of death is metastasis (spread of the cancer), most commonly to the lung. Treatment for osteosarcoma has not changed significantly in the past 20 years and patients who do not respond to the traditional drug therapy have no curative options open to them.

  The study
  The Wesley Research Institute previously provided seed funding for the researchers to perform a comprehensive genetic analysis of a number of patient tumours. They identified a gene that was expressed, to different degrees, in patients’ tumours when they were first diagnosed. The level of expression allowed the researchers to predict, with 93 per cent accuracy, those patients whose primary cancer would subsequently spread. Significantly, their preliminary data also indicated that this gene is likely to be actively involved in regulating cancer spread. The current project will determine whether the protein product of this gene is responsible for metastasis of this cancer.

  Ultimate aim
  If successful, this factor will represent a viable therapeutic target to treat osteosarcoma patients before cancer spreads to other parts of the body and may lead to the first new treatment for osteosarcoma since the development of adjuvant chemotherapy.
  
  Researchers
  Dr Scott Sommerville, Orthopaedic Surgeon
  Dr Liliana Endo-Munoz, Research Officer
  A/Prof Nick Saunders, Principal Research Fellow
  Dr Ian Dickinson, Orthopaedic Surgeon
  Dr Alexander Guminski, Medical Oncologist
  
  Project partners
  Diamantina Institute for Cancer, UQ, Princess Alexandra Hospital

• Predictors of clinical outcome for breast cancer patients

  Clinical problem
  The currently available prognostic markers for patients with breast cancer that are used to guide the physician in treatment regimes are problematic. This means that the overwhelming majority of patients are exposed to the inconvenience, cost and side effects of chemotherapy and hormone treatments with little chance of survival. Also, since the subset of patients who would benefit from these treatments cannot currently be distinguished, they do not receive more intensive treatment.

  The study
  Recent studies implicate the insulin/insulin-like growth factor pathways of potential clinical relevance in breast cancer. Thus the current study will investigate the expression of members of the insulin family of growth factors in breast cancer specimens held for more than 10 years after diagnosis, with full documentation of the clinical outcomes of these patients.

  Ultimate aim
  The study aims to provide a new prognostic marker for breast cancer behaviour. Most importantly, it aims to identify subsets of patients with differing prognoses, which in turn would more effectively guide treatment regimes.
  
  Researchers
  Dr Geoffrey Beadle
  Professor Zee Upton
  Dr David Leavesley
  Professor Kerrie Mengersen
  Dr Glenn Francis
  
  Project partners
  IHBI – Queensland University of Technology
  Princess Alexandra Hospital

• The onset and incidence of lymphoedema in women with gynaecological cancer

  Clinical problem
  Pathological swelling of the lower limbs (lymphoedema) is a common consequence of treatment for gynaecological cancer. This swelling impacts physically and emotionally on otherwise healthy women. Lymphoedema can also affect patients’ ability to earn an income, especially if their work requires prolonged periods of standing or walking.

  The study
  The primary objective is to establish the time of onset incidence and severity of lymphoedema after gynaecological cancer treatment. It will also measure the burden of lymphoedema on patient’s pain, quality of life, body image and sexual and financial well being.

  Ultimate aim
  This study will provide baseline rates of lymphoedema for future studies devoted to prevention, early detection and early treatment of this condition.
  
  Researchers
  Dr James Nicklin, Wesley
  Prof Andreas Obermair, RBH
  Dr Monika Janda, IHBI, QUT
  Dr Sandi Hayes, QUT
  Ms Hildegard Reul-Hirche, RBH
  A/Prof Leigh Ward, UQ

• Breast cancer data bank

  Clinical problem
  Information needs to be gathered about the screening, diagnosis, treatment and outcome of breast cancer patients across Queensland so that strategies for improvement can be devised.

  The study
  The Queensland Cancer Control Analysis Team (QCCAT) within Queensland Health is trying to put together all the data that exists across Queensland on breast cancer. To this end, the CSIRO e-Health Research Centre has developed software to link patient information across enterprises while allowing for the individual institutions to maintain control of their data.
  
  The aim of the study is to link The Wesley Hospital into the site so that its breast cancer data can be incorporated into that held at QCCAT. Staff from e-Health will form the linkage then work with WRI data management staff within the WRI Clinical Trials Centre to map the data sets to a common data dictionary. The software will then automatically import the required data into the registry.

  Ultimate aim
  This is not a research project per se, but comes through our joint The Wesley Hospital Patient Outcome Research Committee. The linked data set will be used to determine treatment, patient journey and adherence to evidence-based practice across Queensland.
  
  Researchers
  Dr Colin Furnival, The Wesley Hospital
  Dr David Hansen, E-Health Brisbane
  Prof Bruce Barraclough, CSIRO, NSW
  Ms Shoni Colquist, Queensland Health
  

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