Victorian Comprehensive Cancer Centre
Newsletter Summer 2012–23
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In this issue
A year of progress .................................................................................................................... 3
Key findings of the first VCCC research census ................................................................... 5
Education and training ............................................................................................................ 8
A new personalised medicine program ................................................................................ 10
Focus on ... .............................................................................................................................. 12
VCCC Project construction update ..................................................................................... 14
Q&A with ............................................................................................................................... 15
VCCC-sponsored projects in 2012 ....................................................................................... 18
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A year of progress
Professor Richard Larkins AO (Chairman)
Professor Jim Bishop AO (Executive Director)
An ambitious work program has seen us achieve many of 2012’s strategic objectives.
The VCCC’s robust Strategic framework 2009–2014 is providing some of the
building blocks for establishing programs that represent world’s best practice,
building collaborations between members, and integrating research ideas, clinical care
and education with ICT enablers.
Our key achievements for 2012 include the completion of capability censuses in both
research and education for 2008–10. These audits give us vital information about the
combined strength of the VCCC member organisations and reinforce the powerful
potential of effective collaborations. Overseen by the Cancer Research Advisory
Committee, the research census will be conducted again in March 2013 for 2010–11
and 2011–12, and will include an updated bibliography review to measure the impact
of our research. A clinical audit is underway to document clinical activity, as well as a
cancer-patient survival study.
Several one-off ‘return of value’ projects have been funded this year. These projects
directly benefit VCCC members by enabling integration of services and enhancing
capability, facilities and capacity.
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The VCCC Board recognises that genomic research is fundamental to the future of
cancer medicine, so they have created a program of research in personalised medicine
in genomics. This program will bring together and develop VCCC members working
in the area. The VCCC has recently awarded funding to the Australian Ovarian
Cancer Assortment Trial (ALLOCATE).
The VCCC program to develop education is also moving ahead, overseen by the
Cancer Education and Training Advisory Committee. A Master of Cancer Sciences
concept plan has been completed and The University of Melbourne is expected to
offer the program for semester one in 2014. In addition, ‘train the trainer’
opportunities have been made available to VCCC members’ staff.
Consistent with our focus on developing, retaining and recruiting cancer leaders, we
have made two significant appointments. Professor Graham Taylor has taken up the
position of Chair, Medical Genomics, and Professor Jon Emery from The University
of Western Australia has accepted the position of Chair, Primary Care Cancer
Research.
Looking ahead for 2013
In the first half of 2013, we look forward to the completion of a number of important
projects. These projects will help us measure our outcomes in the key areas of clinical
trials and patient experience. Two clinical trials projects are underway: a further
development of the Phase 1 and First Time in Human program and a project to
improve clinical trials accrual, both carried out for the VCCC by Cancer Trials
Australia. A patient experience survey across all VCCC clinical sites will be
performed collaboratively with the Western and Central Melbourne Integrated Cancer
Service and other members.
Four Herman Clinical Research Fellowships will be offered by The University of
Melbourne and the VCCC for 2013–14. Chairs of Leukemia Research, and Melanoma
and Skin Cancer Research are also being established. Further new academic posts are
planned for 2013 to increase the depth and focus of the VCCC cancer program.
We will announce an expert advisory panel in the coming months, with international
representation, which will be established to provide high-level strategic advice on
VCCC programs and initiatives.
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Key findings of the first VCCC research census
The VCCC’s first research census showed that members attracted around $77 million
in 2008–09 and more than $100 million in 2009–10 in research grant funding. This
means we are well positioned to lead the translation of research discoveries into key
aspects of the control of cancer. Haematology and breast cancer research has attracted
20 per cent of the funding, and more than 50 per cent of all grant funds are attributed
to cancer biology and aetiology research.
Conducted in late 2011, the census looked at 2008–2010 retrospectively, and analysed
cancer publication impact, workforce capacity and participation in clinical trials (from
2006 to 2010).
Research highlights
Publication statistics
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The VCCC has a higher relative citation impact (1.78) compared to other
Australian states (1.44) and the rest of the world (1.0).
•
More than 21% of all Australian papers include an author from the VCCC.
•
66% of all VCCC publications are authored by two or more VCCC members.
These VCCC collaborative papers have a higher impact than single organisation
publications.
•
Haematology’s large number of publications (20% of the total VCCC output) and
the highest number of publications in the top 10% of the world is evidence that
this research tumour stream is the VCCC’s strongest.
•
The highest impact papers in any Common Scientific Outline category are on the
causes of cancer, while most papers in the top 10% of the world are on treatment.
•
Publications on cancer prevention made up only 2% of the VCCC’s activity.
Research and clinical trial stats
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Around 1300 researchers constitute the VCCC cancer research effort.
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50% focus on cancer biology and the causes of cancer.
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18% are researching cancer treatments.
•
More than 200 PhD students make up more than 20% of the VCCC cancer
research workforce.
•
45% of all patients recruited to cancer clinical trials in Victoria participated in a
trial at a VCCC member organisation.
•
More than 60% of all trials open to accrual in Victoria are offered to patients at
VCCC member organisations.
The publication analysis suggests that collaborating with a VCCC member improves
the likelihood of attaining a higher citation impact. The distribution of early- and midcareer researchers compared to the large number of senior staff shows the importance
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of developing and supporting the future leaders in cancer research. The full report has
been distributed to VCCC researchers.
Research census 2013
The first research census has proven to be an excellent foundation to develop
collaborative research activity. In 2013, a second research census will focus on 2010–
2012. Using the two censuses will enable us to determine trends and help VCCC
member organisations develop programs.
The census will go ‘live’ around March 2013 as grant writing season draws to a close.
Again, groups of researchers will be approached to participate.
For more information on the research census or to make sure your group is counted,
please contact victorianccc-info@unimelb.edu.au.
Clinical audit
Professor Danny Liew is leading a team that is conducting a large-scale review of
clinical administrative data from the VCCC clinical members (Melbourne Health, The
Royal Women’s Hospital, Peter MacCallum Cancer Centre, the Royal Children’s
Hospital, Western Health and St Vincent’s Hospital Melbourne). Professor Liew is
the Chair in Clinical Epidemiology, The University of Melbourne, and Director,
Melbourne EpiCentre (Collaborative Centre for Clinical Epidemiology, Biostatistics
and Health Services Research) based at The Royal Melbourne Hospital.
The review is made possible largely by the efforts of the performance units within
each health service, who expertly collected and extracted the precise clinical and
costing data that was requested on cancer patients, going back to 2001.
‘By analysing the six hospitals’ patient data we’ll gain a better understanding of
patient activity in terms of number and type of patients, and clinical practice across
tumour streams and organisations at the VCCC. We will be able to identify the costs
involved for patients with different types of cancer at the VCCC’, said Professor
Liew.
The findings could then be used to build programs in areas such as screening, early
detection and survivorship. In addition, a complementary ‘on the ground’ project will
be conducted by an external group early in 2013 to capture the clinical activity that is
not picked up by hospital administrative data.
Clinical trials
Although the VCCC recruited 45% of the state’s patients to cancer clinical trials in
2010, the 2011 research census highlighted the need for better support and
infrastructure for these trials to improve participation. Clinical trials provide the latest
research treatments to patients and translate rapidly evidence-based research findings
into clinical practice.
Two projects have been established with Cancer Trials Australia (CTA). The first
project concerns support and harmonisation of clinical trials infrastructure and
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processes. This includes costs of conducting a trial, fees charged, ethics timelines, and
processes and barriers to accrual across the VCCC. Healthcare Management Advisors
was engaged by CTA to interview more than 80 people, analyse the results and
prepare recommendations on a series of pilot projects to address the findings. The
consultation included VCCC members, Cancer Council Victoria, the pharmaceutical
industry, clinical research organisations and a private human research ethics
committee. The recommendations will be reviewed by the VCCC Board.
The second project investigates how the VCCC can attract more early-phase cancer
clinical trials from industry, and help support the Phase 1 and First Time in Human
program better across the VCCC.
‘Supporting VCCC leading clinician–researchers in early-phase trials is key to
developing cancer clinical trials that introduce innovation, address the needs of the
VCCC patient population and answer the big questions in cancer treatment’, said
Marcus Clark, CEO of Cancer Trials Australia.
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Education and training
Australia’s first Master of Cancer Sciences
Health professionals who care for patients with cancer, or who are involved in canceroriented research and teaching, will have the unique opportunity to enrol in a Masters
of Cancer Sciences, starting in semester one 2014. Led by The University of
Melbourne, with assistance from the VCCC Masters subcommittee, the
contemporary, evidence-based program is designed to improve the outcomes and
quality of lives of patients with cancer. Four core subjects will be offered—cancer in
society, cancer care, cancer biology and cancer research—in addition to a series of
elective subjects to complete a diploma or masters-level qualification. A research
project, by thesis, is a component of the final phase of the program.
Train-the-trainer programs to support excellence in cancer education
Two award programs designed to develop expertise, scholarship and leadership skills
in teaching will be offered in 2013 by The University of Melbourne. The Graduate
Certificate in University Teaching and the Graduate Certificate in Clinical Teaching
both provide opportunities to support excellence in education and training. The
VCCC recently announced eight full fee-remission awards to assist members to
participate in the Graduate Certificate in Clinical Teaching in 2013. The successful
candidates are from the fields of nursing, oncology, psychiatry and haematology:
Dianne Clifton (St Vincent’s Hospital Melbourne), Sue-Anne McLachlan
(St Vincent’s Hospital Melbourne), Justin Dwyer (St Vincent’s Hospital), Nicole
Wong Doo (Peter Mac), Simone Sheridan (Peter Mac), Genni Newnham
(St Vincent’s Hospital Melbourne), Mei Ling Yeh (The Royal Children’s Hospital).
The Leaders in Cancer Program
The Leaders in Cancer Program was established to develop, attract and retain the next
generation of cancer professionals. The VCCC and The University of Melbourne
developed the initiative with the expectation it will involve and benefit all members.
It will create several new university chairs, clinical fellowships and a student support
program. Recent appointments include Professor Jon Emery as the new Chair of
Primary Care Cancer Research and Professor Graham Taylor as the new Chair of
Medical Genomics.
Fellowships
Applications for the VCCC Herman Clinical Fellowships for Cancer Research closed
recently. Funded by the VCCC and The University of Melbourne’s Herman Trust for
Cancer Research, four clinical research fellowships, each valued at $100,000 each
year for two years, will be awarded for 2013 to allow clinical researchers to carry out
translational cancer research in either a VCCC laboratory or clinical setting.
Student prizes
High-achieving students in the VCCC have been awarded prizes to support career
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development. The top prize to the highest ranked applicant ($10,000) is the ‘Picchi
Award for Excellence in Cancer Research’ and has been awarded to Dr Aung Ko Win
from The University of Melbourne School of Population Health. Other student
prizes, each worth $5000, have been awarded to Annette Lim (Peter Mac), Nikhil
Sapre (The Royal Melbourne Hospital), Connie Duong (Peter Mac), Anna Boltong
(Peter Mac) and Lorey Smith (Peter Mac). The prizes will provide funding so that
students can travel internationally to attend conferences or work collaboratively, as
well as be supported in their development towards research independence. A
ceremony will be held on 13 March 2013 to award recipients their prizes.
Picchi award winner – Dr Aung Ko Win
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A new personalised medicine program
The optimal use of genomics in clinical care, early detection and prevention will be a
unifying theme of the VCCC. VCCC Board member and WEHI Director Professor
Douglas Hilton will oversee the development of a plan for personalised medicine on
behalf of the VCCC Board. A simple, exciting and overarching narrative will be
developed that recognises the scope of current activity and provides insight into what
could be achieved in the future.
‘With a coherent, cooperative approach, and support from government and the
community, the VCCC members can build a leading international personalised
medicine centre’, said Professor Hilton.
Participants from the VCCC have already started the planning process with a
workshop, which was very constructive. Participants agreed unanimously that the
VCCC establish a ‘molecular tumour board’ to discuss the results of genomic
research and their application in care. There was broad consensus that the VCCC’s
impact on care and fundamental practice change will be a measure of its success as a
leader in the area.
In June 2012, the VCCC Board agreed to fund work to seed further collaborative
approaches to research and translation personalised medicine research. The VCCC
received eight applications, which were reviewed by an external panel. On behalf of
the panel, Professor Hilton commented that ‘all the projects were exciting and capable
of delivering real benefits to the community’. All projects were considered fundable
and the panel recommended that ways to progress each project be explored.
The challenges in personalised medicine are significant. ‘Internationally, centres at
the forefront of personalised medicine are investing many tens of millions of dollars
per annum to ensure the fruits of the genomic revolution are used to improve the lives
of cancer patients. We were able to fund one project to a modest degree. We have to
raise our sights much higher’, Professor Hilton noted.
The project selected for funding, the Australian Ovarian Cancer Assortment Trial
(ALLOCATE), will develop—using next generation sequencing—an assay
comprising a gene panel clinically relevant to ovarian cancer. Once validated, the
gene panel, which includes targets identified by VCCC researchers supporting the
rapid translation of local scientific discoveries into clinical trials, will then be used to
screen tumour samples obtained from Victorian women with advanced ovarian
cancer. The aim will be to find potential therapeutic targets to guide patient enrolment
into clinical trials of novel therapeutic agents that are matched to their tumour
biology. ALLOCATE will help develop online test requesting and a reporting system
for personalised medicine, and harmonised counselling and consent procedures. It
will also unite VCCC members by teaming researchers and clinicians to interpret the
complex datasets generated by next generation sequencing.
A number of other fundable, high-quality genomics proposals were submitted. The
VCCC program will look to facilitate the generation of new revenue streams from
other funders for these innovative projects.
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If you would like to be included on the genomics and personalised medicine distribution list,
please email Anne Rudolph (arudolph@unimelb.edu.au).
Congratulations to the collaborative ALLOCATE team, which includes investigators
from The University of Melbourne, Peter MacCallum Cancer Centre, The Royal
Women’s Hospital and The Royal Melbourne Hospital
Prof Paul Waring, Prof Michael Quinn, A/Prof Linda Mileshkin, A/Prof Clare Scott, Prof
Graham Taylor, Dr Jayesh Desai, Dr Ben Tran, Prof David Bowtell, A/Prof Anne Hamilton,
A/Prof Orla McNally, Prof Geoff Lindeman, Dr Gillian Mitchell, Prof Melissa Southey, Dr
Daniel Park, Olga Kondrashova, Dr Sebastian Lunke, A/Prof Barney Rudzki, Dr Matthew
Wakefield, Prof Stephen Fox, A/Prof David Thomas, Prof Fernando Martin-Sanchez, Prof
Andrew Lonie, Prof Richard Sinnott, Dr Jan Pyman, Dr Olle Ericsson, Robert Shueren, Dr
Kandavel Shanmugam, Dr Anne Thompson
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Focus on ...
Kathy Campbell, IM & ICT Project Director
Kathy Campbell commenced the role of Information Management and Information
Communications Technology (IM & ICT) Project Director for the VCCC in April
2012.
As project director, Kathy is responsible for leading the development and deployment
of the agreed IM & ICT program deliverables. Her vision for the program is ‘to
provide access to cancer information when and where needed to enable world-class
collaborative research and patient-centred care’.
Kathy views the VCCC IT solutions as ‘enablers’, so she will be working hard to
ensure the member organisations have the tools, information and environment
necessary for an effective collaboration.
Since Kathy’s appointment, the IM & ICT program has gained traction. She has
established the program’s foundations by recruiting a strong team, setting up a
governance structure, defining the program scope and developing a project
methodology. A number of projects—such as a current-state analysis and business
requirements for animal house management, multidisciplinary meetings, a solution to
support the new intensive care unit and a unique patient identifier—have been moving
forward under Kathy’s direction.
Kathy brings a wealth of experience to the VCCC; she has worked for healthcare
providers, consulting firms and vendors in both the public and private health sectors
of Australia and Canada. Her previous positions include a non-executive directorship
of a large not-for-profit health and community services provider, and chief
information officer of a group of five hospitals, and she has undertaken IT
organisational reviews, restructures and project management in health care. Kathy, a
Fellow of CPA Australia, also has more than 15 years’ experience in investment
banking and funds management.
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Outside of work, Kathy loves to travel—she has lived in 28 different houses,
11 towns and cities, 5 Australian states and 3 countries. She is also fond of eating and
drinking good food and coffee, going to the movies and keeping fit.
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VCCC Project construction update
The VCCC Project facilities construction is well underway. Those who pass by the
site have probably seen the colourful hoardings along the perimeter of the
construction area and the installation of gantries and site sheds. The gantries provide a
safe route for pedestrians when walking around the construction site, while the site
sheds provide amenities for construction staff.
Within the site itself, the second tower crane was erected recently. Other works this
summer include bulk excavation, which is due for completion in early 2013 (at which
time the hole will be about 25 metres deep) and concrete pours, including the
foundations and base walls of some lift cores.
To register for quarterly construction updates on the VCCC Project, please email
vcccproject@health.vic.gov.au.
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Q&A with ...
Professor Jon Emery, Australia’s first Chair of Primary Care
Cancer Research
In 2012, Professor Jon Emery was appointed Chair of Primary Care Cancer Research
to build a program focusing on research into prevention and risk assessment, timely
diagnosis, models of shared-care pathways and clinical trials in the community. He
will be attached to Western Health, The University of Melbourne and the VCCC.
Professor Emery is well recognised internationally for his research in primary care
and cancer with more than 100 peer-reviewed papers. He is currently a Winthrop
Professor of General Practice at the University of Western Australia, Senior Clinical
Research Associate at the University of Cambridge, and Director of the Cancer
Australia Primary Care Collaborative Cancer Clinical Trials Group (PC4). He is also
a practicing GP.
We asked Jon about his aspirations for the role.
What does this appointment mean to you professionally?
This really is my dream job. I’d always hoped my career path would lead to this type
of role. I began my academic career as a Cancer Research Campaign Research Fellow
working on cancer risk assessment and was later fortunate to receive a clinician
scientist award from Cancer Research UK. Both charities recognised the importance
of primary care in cancer control and they essentially helped create an academic
career pathway for me. Working at the VCCC is an extraordinary opportunity to build
on my previous experience and ensure that primary care’s role in cancer care is
recognised and maximised.
What are some of your top objectives for the VCCC in this area?
Primary care contributes to cancer control along the whole continuum, from
prevention, screening and symptomatic diagnosis, to survivorship and palliative care.
I aim to contribute to research, education and service development along the whole
continuum.
What do you think the VCCC can deliver that we haven’t achieved in the past?
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One of the significant advantages created by the VCCC is that it brings together basic
cancer scientists, epidemiologists, behavioural scientists and clinical researchers. This
creates opportunities to identify novel interventions which can be translated in the
community to improve cancer outcomes. For example, new cancer biomarkers require
validation in the clinical settings where they will be applied. Subsequent studies are
then needed which demonstrate their potential impact on clinical outcomes. This is
especially the case in terms of new markers of cancer risk or new cancer diagnostic
tests. The new NHMRC Centre of Research Excellence on colorectal cancer
prevention, led by Mark Jenkins, is an example of this approach.
How do you see the VCCC delivering for the community?
I think we need to engage with the primary care community and, of course more
broadly with the general Victorian community. We have a potentially important role
in developing new cancer preventive services in the community and improving cancer
diagnostic pathways by working with Medicare Locals and local practices. We also
need to be exploring new approaches to longer term follow up of cancer survivors that
engage with primary care and recognise the strengths that a generalist perspective
brings to survivorship care. While cancer survival figures in Australia are some of the
best in the world, there remain significant disparities within our community,
particularly for rural, Aboriginal, CALD [culturally and linguistically diverse] and
socioeconomically disadvantaged people. We have an important role to play in
working with these communities to try to reduce these disparities in cancer outcomes.
What do you see as the major benefits of practice-orientated translational research?
The majority of cancer prevention and initial cancer diagnosis occurs in general
practice. Research which translates innovations in these areas requires multiple
research-oriented practices, such as those in the Victorian Practice-based Research
Network, VicRen. Working with general practices in the early translational phase
means that new approaches to cancer prevention, diagnosis and survivorship are more
likely to be feasible, acceptable and effective.
What do you see as the major challenges for achieving better cancer outcomes in
the community?
Although cancer is the greatest cause of disease burden in Australia, from a general
practice perspective, it is just one of many important conditions that we manage. An
individual GP will see approximately eight new cases of cancer in a year, and he or
she will be caring for roughly 40 cancer survivors. Looking at it in this way, cancer
may not seem that relevant to many GPs. However, this ignores the many people who
present in general practice with symptoms suggestive of cancer, and the significant
role primary care can play in cancer prevention and screening. Another significant
challenge is the current workforce shortage in primary care. If primary care is to take
on expanded roles in cancer follow-up, this will require careful introduction of new
models with adequate support and, potentially, the development of new roles within
the whole primary care team.
Anything else you want to say?
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I am very excited by this new position in the VCCC. I already have some great
collaborators in Melbourne and I look forward to making more in this new role.
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VCCC-sponsored projects in 2012
Project
Lead organisation
Enhancing molecular pathology research
Peter Mac
Transition plan for the Victorian CCC
Animal Facility
Peter Mac
Improving facilities for collaborative
education opportunities
Melbourne Health
Clinical integration
Melbourne Health
Linking university strengths to VCCC
The University of Melbourne
Improving emergency department care
of cancer patients
St Vincent’s Hospital
Melbourne
Developing a joint psych-oncology
clinical research program
St Vincent’s Hospital
Melbourne
Establishing a Centre for Translational
Research in Breast Cancer
Walter and Eliza Hall Institute
Defining patient pathways across
tumour streams
The Royal Women’s Hospital
Enhancing epigenomics research
capability within VCCC
The Royal Children’s Hospital
Establishing an Electronic Clinical
Information System
The Royal Women’s Hospital
VCCC-sponsored and organised events in 2012
The first VCCC Breast Cancer Research Collaborative Symposium: Clinical
Translation, 17 July 2012, WEHI
VCCC Gynae-oncology Research Collaborative Endometrial and Cervical Cancer
Symposium, 16–17 August 2012, WEHI
VCCC Breast Cancer Symposium on Imaging, Screening and Mammographic
Density, 30 November 2012, WEHI
Events supported by VCCC in 2012
Metastasis 2012, 14th International Biennial Congress of the Metastasis Research
Society, 2–5 September 2012, Brisbane
The first Australian p53 Workshop, 19–21 September 2012, Peter Mac
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Upcoming events
The inaugural Victorian Psycho-Oncology Conference: Implementing Effective
Psycho-Oncology Interventions into Usual Care will be held on 14 June 2013. For
more information, contact Karen Lacey at karen.lacey@unimelb.edu.au.
The vision for the VCCC is to save lives through the integration of cancer research,
education and patient care. Through innovation and collaboration, the VCCC will
drive the next generation of improvements in prevention, detection and cancer
treatment.
Contact us
Victorian Comprehensive Cancer Centre
PO Box 2148, Royal Melbourne Hospital, Vic 3050
Level 3, 766 Elizabeth St, Melbourne, Vic 3000
t: +61 3 8344 8708 e: victorianccc-info@unimelb.edu.au
Victorian Comprehensive Cancer Centre Ltd trading as Victorian Comprehensive
Cancer Centre
The Victorian Comprehensive Cancer Centre, a joint venture between:
Peter Mac
Melbourne Health
The University of Melbourne
The Royal Women’s Hospital
Walter & Eliza Hall Institute of Medical Research
The Royal Children’s Hospital Melbourne
Western Health
St Vincent’s Hospital Melbourne
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