Accelerating research outcomes to clinical practice
Integrating genomic testing in clinical practice
The principle of precision oncology is to ‘give the right drug to the right patient at the right time’. The key to this is genomic molecular profiling of tumours to identify targetable alterations. Greater use of new technologies is enabling application of this cutting-edge diagnostic tool to benefit more patients.
The VCCC Precision Oncology Program builds on expertise and infrastructure at the University of Melbourne Centre for Cancer Research and Peter MacCallum Cancer Centre to increase use of genome sequencing technologies, expand patient access and develop tools for treatment decision-making.
Ethics and governance approval for genomic sequencing was approved in early 2019 and within 12 months 121 patients with 11 tumour types accessed truly comprehensive genomic testing. Of these, clinicians were able to glean clinically useful information for 62 per cent of patients and targetable alterations for 44 per cent.
In addition, three Research Tissue Coordinators are working across VCCC clinical member sites to facilitate tissue retrieval and distribution for multisite translational research projects, including those related to precision oncology, immunotherapy and targeted therapies. To date, the tissue coordinators have supported 19 collaborative research projects.
Improving consistent risk assessment and screening practices
Coordinated precision prevention and tailored screening models provide consistency of risk assessment and cancer screening practices.
A VCCC program has prioritised three projects to bridge translational gaps connecting alliance members to develop communication and prototype tools to:
- Optimise the implementation of the new national guidelines for the use of aspirin for the chemoprevention of colorectal cancer
- Understand how breast cancer screening resources can be optimised to achieve greatest efficiency, effectiveness and equity for Victorian women in breast cancer prevention
- Develop an applied risk model to assess the genomic risk of multiple cancers.
Short circuiting Victoria’s deadliest cancer
In late 2019, Cancer Australia opened an enquiry into a National Targeted Lung Cancer Screening Program to determine the best way to implement a national lung cancer screening program. The R&E Lead for Lung Cancer, supported by the R&E Lead for Primary Care brought together experts from multiple disciplines and organisations, including consumers, to coordinate a consensus response, culminating in a detailed plan.
The issues set out in the submission have become the blueprint by which Cancer Australia is assessing applications from organisations tendering for the contract to provide tailored lung cancer screening Australia-wide. The outcome of the tender process is expected in October 2020.
As a result of the VCCC’s coordination, Victoria is positioned to implement a tailored lung cancer screening program that will have direct benefits through earlier detection of lung cancer.
Outcomes-focused health services research
Health services research, whereby healthcare practice, services, costs and experiences are used to understand community requirements and outcomes, is critical to improving patient outcomes. However accessing crucial health data has proven to be difficult, as systems are siloed, governance creates barriers, or technology is out- of-date.
A goldmine of information and data
Connection and comparison of health data is a potential goldmine for health services research, enabling primary health care and hospital records, as well as registries, to be used for analysis and investigation. Effective linkages between health data sources will provide researchers with the opportunity to explore and consult, potentially providing answers or direction for key clinical questions.
The new VCCC Data-Driven Research Hub is making these connections, opening networks and unearthing the gold.
The Data Hub combines a data-sharing platform that uses University of Melbourne developed GRHANITE™ software to unlock primary care data with data-sharing systems and infrastructure provided by BioGrid enabling a dedicated secure research environment.
In addition, an expert Data Hub team provides project design advice to researchers ensuring the capabilities of the linked data are considered and key features such as overarching ethics processes, are used for all data sources.
Sophisticated analytical tools and techniques Through the University of Melbourne Cancer Health Services Research and the Cancer in Primary Care Research groups, the Data Hub also enables access and utility of the data. These groups work with clinicians and researchers to use analytical tools and techniques with the Data Hub, mitigating over-interpretation and helping to accurately focus and investigate important research questions.
The Data Hub is a research project incubator, providing approaches to collating data, advice on analytic methods and delivering outcomes-focused results for improving health services into the future.