Cancer Continuum

Research directors
Overview
Research activities
Future directions
Participating centres/groups

Research directors

Scientific Director: 
Associate Professor Marie Ranson
marie_ranson@uow.edu.au

Medical Director: Professor Philip Clingan
philip_clingan@uow.edu.au

Overview

The latest figures from The Cancer Institute NSW indicate that the risk of being diagnosed with cancer is now one in two for males and one in three for females up to the age of 85 years. In 2006, more than 13,000 people died from cancer in NSW.

Overarching aims of the Cancer Continuum research theme are to improve our understanding of the biological processes underlying cancer, develop improved methods of detection and treatment for cancer, and apply what is known in the areas of cancer screening and cancer prevention. The theme also includes research into behavioural effects and interventions in reducing cancer risk.

The theme encompasses biologists, chemists, physicists, clinicians and radiologists, and behavioural and information technology scientists – based at the University of Wollongong, the Wollongong Hospital and private cancer clinics – all working together to address these issues.

Research activities

Novel anti-cancer drugs and formulations

• Development and preclinical testing of novel formulations that allow for the previously problematic simultaneous administration of commonly used chemotherapeutic drugs 5-Fluorouracil, folinic acid and oxaliplatin in a single injectable solution
• Evaluation of natural inhibitors and novel small molecule inhibitor of the urokinase plasminogen activation system for the prevention and treatment of metastatic cancer
• Isolation, structural elucidation, biological evaluation of natural product-based cytotoxic agents and kinase inhibitors
• Development of small molecule blockers to counter the effects of the extracellular chaperone clusterin to improve the efficacy of Taxol therapy
• Use of clusterin as an immune modulator to stimulate the immune response (especially the cytotoxic T-cell response) against cancer cell antigens  

Cell and molecular biology of cancer

• The role of the plasminogen activation system in the progression of cancer
• The regulation and importance of the translationally controlled tumour protein (TCTP) in cancer 
• Identification of the pathways and mechanisms underlying the relationship between schizophrenia and cancer incidence
• Identification of the pathways and mechanisms underlying the relationship between cancer and obesity (the current focus is on colorectal cancer
• Molecular mechanisms of tissue differentiation using ovarian dermoid tissue
• Cancer and purinergic signalling
• Cancer and thrombosis

Radiotherapy

• Real time dosimetry in brachytherapy, with the aim of improving the outcome of prostate cancer treatment 
• Development of microbeam radiation therapy (MRT) and dosimetry for synchrotron microbeams  
• Real time dosimetry for quality assurance in intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), image guided radiation therapy (IGRT) and tomotherapy
• Radiobiological optimisation of treatment delivery in radiation therapy of head and neck and prostate cancer 
• Advanced IMRT and adapative radiotherapy
• Advanced treatment planning in radiotherapy using imaging multi-modalities
• Proton therapy modelling and microdosimetry
• Magneto Radiotherapy  for MRI guided cancer treatment
• Experimental and simulational micro and nano-dosimetry for proton therapy and space medicine
• Monte Carlo modelling of radiation transport for radiation dosimetry and radiobiology

Nuclear medicine and imaging

• Small animals PET (positron emission tomography) scanners instrumentation
•  Real time imaging of radioactive seeds in seed permanent implant brachytherapy
•  Gamma probes radioisotopes tracking for intraoperative breast cancer and other cancer surgeries  

Social marketing and behavioural assessment to reduce cancer risk

• Impact of a social marketing initiative on increasing the percent of adolescents who engage in sun protection behaviours
• Cancer-related risk behaviours and behaviour change
• Perceptions of breast cancer risk, participating in breast cancer screening and delays in seeking treatment
• The level of understanding and acceptance of the revised NHRMC alcohol consumption guidelines

Clinical trials

Several Phase II and Phase III clinical trials are underway to evaluate combination chemotherapy and new small molecule agents such as angiogenesis inhibitors, TK1 inhibitors and monoclonal antibodies. Involvement in these trials is usually within the context of a participating site in a national or international trial. Current trials include the:

• ENTHUSE and COUGAR studies in prostate cancer
• BETH, BEATRICE, AVEREL, BALI 1 and ENZASTUARIN studies in breast cancer
• ACT1, FIGHT, APOMAB and GATE studies in lung cancer
• JZAF and SYMMETRY studies in melanoma
• XENOX B, FUTURE and SUTENT studies in colorectal cancer
• PANCRESTIC study in pancreatic cancer.

Future directions

Three research areas are likely to see significant expansion in the near future. The first of these is drug development. This will involve establishing a dedicated preclinical in vitro and in vivo testing facility that will expedite innovative cancer drug discovery and advance the identification of potential drug leads for further development.

A second area is dosimetry, which will involve expanding current work to develop more sensitive and effective dosimetry instruments for prostate and other cancers.

The third area is obesity and cancer.  While the current work in this area is focusing on colorectal cancer, it is expected that future research will focus on breast cancer as well as how bariatric surgery results in a reduction in cancer incidence.

Participating centres/groups

• Centre for Medical Bioscience (UOW)
• Centre for Medicinal Chemistry and Pharmacology (UOW)
• Centre for Medical Radiation Physics (UOW)
• Centre for Health Initiatives (UOW)
• Centre for Translational Neuroscience (UOW)
• Nuclear Medicine and Clinical Oncology (SESIAHS)
• Radiopharmaceutical Research Institute (ANSTO)
• Illawarra Cancer Care Centre
• St George Cancer Care Clinic
• Prostate Cancer Institute of NSW
• Southern Medical Day Care