UNSW Sydney and the Garvan Institute of Medical Research researchers will lead the program, thanks to a $3.75 million grant from the Cancer Institute NSW

A national clinical trial program will test promising new targeted therapies for pancreatic cancer, one of the deadliest forms of cancers of which more than 3000 cases are diagnosed annually in Australia.

The clinical trial program (MoST–P), led by researchers and clinicians at UNSW and the Garvan Institute, will provide patients with access to either targeted therapies matched to the genomic signature of their individual tumour, or targeted to the tumour environment.

UNSW Dean of Medicine & Health, Professor Vlado Perkovic said the grant could lead to better outcomes for pancreatic cancer patients and more personalised approaches to treatment.

“Our researchers constantly challenge existing knowledge on cancer and are at the forefront of advances in cancer research. The trial announced today is an exciting development in pancreatic cancer research and offers hope for the future for people affected by this terrible disease,” Prof. Perkovic said.

The trial is supported by a $3.75 million Cancer Institute NSW Translational Program Grant and is scheduled to begin later this year. UNSW Professor David Goldstein, Director of the Translational Cancer Research Network, is chief investigator of the trial.

“For the first time, this proposal brings together scientists, clinicians and the community, within a proven national program to achieve meaningful outcomes for Australians affected by pancreatic cancer. It is a tangible dividend of the years of funded research by focused pancreatic research groups within the UNSW pancreatic research hub,” Prof. Goldstein said.

Investigator Professor David Thomas from the Garvan Institute said: “NSW has a critical mass of excellence in pancreatic cancer. This trial is a really exciting bench to bedside translation of our research findings for pancreatic cancer patients, and gives us new options to target the surrounding tissue and improve drug response for patients with this disease.”

New approach to treating pancreatic cancer

Pancreatic tumours often show no obvious signs or symptoms in the early stages of disease, and by the time most cases are diagnosed, the cancer has already begun to spread outside the pancreas and is often inoperable.

Through the trial, researchers will treat pancreatic cancer patients by using genetic information or targeting the tumour environment, known as the stroma.

The research team is working with Garvan’s successful Molecular Screening and Therapeutics (MoST) trials program, where the genome of pancreatic cancer patients’ tumour is sequenced and matched to available treatments, at a number of different sites throughout Australia.

If no matched treatment is available, patients will be placed in one of two novel trials testing the efficacy of therapies targeting the stroma, which in pancreatic cancers can form an impenetrable barrier to treatment. These two treatments, RXC004 (trial led by the Garvan Institute in collaboration with biotech Redx) and sulfasalazine (trial led by UNSW), have both been shown to target the scar tissue around pancreatic cancers and prevent tumour growth in experimental models.

“The two pancreatic cancer sub-studies aim to tackle what is currently a critical barrier to existing treatments: the scar tissue barrier around pancreatic tumours,” said investigator Associate Professor Marina Pajic from the Garvan Institute. “Our approach in this trial is a real step towards personalised medicine and pancreatic cancer, involving co-targeting of the cancer genome and specific signals from the stroma targeting.”

World-leading collaboration

This trial will integrate the research and clinical expertise of the Australian Pancreatic Cancer Genome Initiative (APGI), the Australian Pancreatic Cancer Matrix Atlas (APMA) and the UNSW Sydney pancreatic cancer hub, with the national clinical framework of the MoST clinical trials program.

“New South Wales has been internationally acknowledged as a research leader in pancreatic cancer,” said investigator UNSW Associate Professor Phoebe Phillips.

“This clinical trial will employ a systematic mechanism to bring the laboratory findings to patients, in a meaningful timeframe, to improve treatment. As a scientist, I am really proud that we have taken basic scientific findings previously supported by NHMRC and PanKind (The Australian Pancreatic Cancer Foundation) into the clinical setting.”

Investigator Professor Paul Timpson from the Garvan Institute said: “This crucial clinical trial will leverage the MoST clinical trial framework to improve outcomes for this aggressive cancer. We expect to demonstrate the value of understanding the tumour and scar tissue profile of pancreatic tumours for treating pancreatic cancers in real time.

“Our deep analysis of samples involved in this trial will guide new targeted drug therapies worthy of larger clinical trial testing, which we hope will ultimately improve and personalise treatments for all patients.”

The research team working on the trial includes UNSW A/Prof. Phoebe Phillips; Prof. David Thomas, A/Prof. Marina Pajic and Prof. Paul Timpson from the Garvan Institute; Dr Katrin Sjoquist from University of Sydney; and Dr Lorraine Chantrill and Professor Anthony Gill from NSW Health.

The trial is part of a larger vision and collaboration for pancreatic cancer research. The Pancreatic Cancer Research Hub brought together the best minds from NSW health districts, hospitals, universities and research institutes with a mission to improve pancreatic cancer patient survival.  A partnership between the Hub and the MoST trial has led to the research program which is being funded.

Cancer Institute NSW Fellowships

Six UNSW Medicine & Health researchers have been awarded Cancer Institute NSW Fellowship grants:

• Dr Catherine Caldon from UNSW Medicine & Health and the Garvan Institute of Medical Research received a $150,000 Career Development Fellowship to investigate endocrine tolerant cells in late recurring breast cancer.
• Dr Robert Weatheritt from UNSW Medicine & Health and the Garvan Institute of Medical Research received a $498,995 Career Development Fellowship to investigate P-bodies as a novel mechanism driving triple negative breast cancer.
• Dr Ursula Sansom-Daly from UNSW Medicine & Health received a $300,000 Early Career Fellowship for a project investigating ways to safeguard the mental health of adolescents and young adults with cancer and the professionals who care for them.
• Dr Ksenia Skvortsova from UNSW Medicine & Health received a $488,660 Early Career Fellowship to investigate rescuing tumour-suppressor gene activity to cure follicular lymphoma.
• Dr Christina Signorelli from UNSW Medicine & Health received a $599,835 Early Career Fellowship for a project looking at ways to improve the quality of life and Australian survivors of childhood cancer.
• Dr Emmy Fleuren from UNSW Medicine & Health received a $569,071 Early Career Fellowship for a project to enhance precision medicine for paediatric sarcoma patients through phosphoproteomics.