Peter Neilson Pancreatic Cancer Grant Fund
This funding grant has been generously donated in memorial of Peter Neilson, a valued past Director of Simplicity Foundation and in this round, the CCR aims to directly encourage and boost research in the pancreatic cancer field across all disciplines, and to facilitate collaboration between researchers from the University of Auckland and their DHB and community colleagues.
|PI||Dr. Andrew McCann|
|Title||Capacity building pancreatic stereotactic ablative radiotherapy (SABR) as a bridge to future radiation /DNA-PK inhibitor phase IB clinical research.|
This project aims to engage with an Australasian group who set up trials which are ‘public good’ (not commercial). In this pivotal clinical trial, Andrew will be working with this group, called the Australasian Gastrointestinal Trials Group (AGITG) on a trial called MASTERPLAN.
This trial will bring a new kind of radiotherapy to Auckland City Hospital, called stereotactic ablative radiotherapy (SABR). This trial will be looking at how safe this therapy is with combined with chemotherapy in some particular kinds (in locally advanced (LAPC) or borderline resectable (BRPC)) of pancreatic ductal adenocardinoma (PDAC). This kind of trial is called an ‘early phase’ trial and generally involves small numbers of patients, to ensure the intervention is safe to use. Once this trial format is complete, the trial will move to an ‘efficacy’ phase, where larger numbers of patients are offered the intervention and the direct results of benefit are outlined. This treatment is not currently funded in New Zealand, so this trial creates an opportunity for New Zealanders to access this innovative treatment, while in combination with standard of care chemotherapy. This treatment will be used instead of conventional radiotherapy in the trial group. Compared to conventional radiotherapy, SABR is considerably shorter (1.5 weeks compared to 5 weeks of treatment) and is less toxic.
Introducing this technique in trial format will bring this new treatment to New Zealand in pancreatic cancer for the first time, but it will also ensure the introduction is safe, closely monitored, and benchmarked in order to meet external quality assurance standards (facilitated by the involvement of the Trans Tasman Radiation Oncology Group). TROG quality assurance will include credentialing of the end-to-end SABR pathway, as well as independent review of SABR treatment plan pre radiotherapy for each patient, and post treatment technical QA review. This will enable this pathway to be used in future.
The researchers have recently undertaken two trials in this technique in prostate cancer. In future, they wish to work with the Auckland Cancer Society Research Centre, a pillar of the Centre for Cancer Research, to develop a new chemotherapy drug to be used in combination with this radiotherapy treatment.
The introduction of pancreatic SABR will strengthen the te whare tapa whā model of care to help address disparities in Māori outcomes. Introducing a pancreatic SABR programme will create new opportunities for translational research. This research will create a technology platform which will support future trials and access to this treatment. In future we will be able to combine this treatment with a chemotherapy drug being developed at the University of Auckland.
Specifically, this study aims to:
1. To develop a te whare tapa whā model of care around the clinical implementation of pancreatic SABR.
2. To recruit 3 patients onto the Masterplan protocol. An application will be made to the NZ Gut Foundation (NZGF) to fund an additional 3 patients for total of six (preliminary approach to NZGF already made by Canterbury DHB); this should ensure at least 4 patients are treated on the SABR arm.
3. To compare radiosensitisation by lead DNA-PKi (SN39536) and corresponding HAP (SN39884) in a murine PDAC cell line (Panc-02) in vitro, and radiosensitisation of Panc-02 tumours and duodenum in mice. (this will begin work on a future study using a NZ developed chemotherapy drug in combination with the SABR).
The study design is a randomised control trial with randomisation 2:1, which means more patients will be on SABR than a regular 1:1 RCT. Both arms receive 6 x 2 week cycles of FOLFIRINOX chemotherapy (or an alternative if they cannot tolerate this chemotherapy regime). SABR (40 Gy in 5 fractions) is administered within 4 weeks of last chemotherapy cycle. Surgery is aimed to be performed 6 weeks after completion of chemotherapy +/- SABR. The option for patients of participating in tissue and blood sample collection (Te Ira Kāwai | Auckland Regional Biobank) for future biomarker research (conducted by AGITG) will be available.
A key outcome of this study will be to see if the SABR improves control of the cancer. The most important outcome will be to see if this is controlled 12 months after the treatment. The researchers will also consider the safety, surgical outcomes, how long peoples cancer stays impaired (not growing), rates of surgery, pathology, quality of life, and some kinds of survival measures (how long people live and how well, after treatment).
Li Family Cancer Research Fund
The purpose of the fund was to directly encourage cancer related research focusing on improving health outcomes while reducing inequalities for all New Zealanders by engaging strongly with the community at all levels.
One of the key aspects of Te Aka Mātauranga Matepukupuku (Te Aka) is to link and grow relationships between the Faculty of Medical and Health Sciences and the District Health Board research staff and, while not essential, the Li Family Cancer research fund is intended to encourage researchers from both organisations to work together by funding research collaborations.
A number of longstanding research relationships of this nature already exist and this fund will strengthen these relationships by providing additional grant funding. In addition, we would like to support new and emerging partnerships by providing seed grant funding to facilitate the development of new research collaborations related to translational research opportunities that should improve success in winning a variety of competitive national and international research grants, such as the Health Research Council project and programme grants.
The Li Family
2021 Funding Round Successful Applications
Applications are in three categories:
- Li Family project grant
These grants support partnerships, by providing funding to facilitate the development of new and existing translational research collaborations, which will lead to improved success in winning a variety of competitive international and national research grant applications. Where research relationships already exist, this Fund has the potential to further strengthen these relationships and research programmes by seed funding new initiatives. Funding for this category will be awarded for no more than 18 months. These projects will be reviewed, funded, and reported on similarly to our previous funding rounds.
- Li Family release time grant
This grant is to be used for ‘release time’ for a named investigator. This funding will be provided to offset salary costs, either in a block or distributed for a period of up to one year as fractional FTE (full time employment) (such as a day a week of release time from regular duties, or to increased part time FTE for a period). A portion of the grant may be used to facilitate hui (travel, koha, catering etc). This release time must be used to invest in building partnerships with a view to an enhanced research output and career leverage. Partnerships identified may include community partnerships, transdisciplinary research partnerships and/or partnerships with Māori leading to enhanced and authentic ability to produce innovative and competitive research outcomes addressing inequity or community-identified priorities in future. Use of ‘release time’ will be reported in an innovative way, detailing reflections and impacts of the enhanced relationships.
- Albet Trust bequest seed grants
These grants are awarded out of a generous bequest from the Albet Trust. This bequest has enabled Te Aka to seed fund two projects from applicants to the Li Family project grant round. These projects showed significant merit but did not meet the Li Family Funding threshold. This bequest enables these promising early-mid career cancer researchers to develop their research ideas into proposals which could be funded by larger contestable funding rounds (such as the Health Research Council or Marsden Fund), or could return to the Center for Cancer Research funding round in future.
Li Family Project Grants
|PI||Dr. Anna Serlachius|
|Title||Qualitative study exploring views of an online acceptance and commitment therapy (ACT) intervention for adolescent and young adult (AYA) cancer survivors|
|Summary||The study will gather feedback from rangatahi (Adolescent and Young Adult (AYA) aged 12-24 years) cancer survivors, their whānau and health professionals on the proposed online acceptance and commitment therapy intervention. This is the first stage of the development of this intervention. The aim is to gather views on the acceptability, feasibility, and suitability of the proposed intervention. The qualitative evidence gathered will be used to modify the intervention before conducting further research. By involving those who will be using this program, their voices will be included in the end design ensuring it is relevant to rangatahi in Aotearoa and has real significant impact in improving their outcomes. We are working in partnership with the AYA Cancer Network Aotearoa and National Hauora Coalition to ensure we are aligned with the needs of this unique population. There is very little research on developing supportive interventions for rangatahi cancer survivors, especially in Aotearoa. This is an opportunity to better understand their needs and co-design a tool to support their wellbeing.|
|Timeframe||January 2022 – June 2023|
|PI||Dr. Thomas Park|
|Title||Integrating tumour biology with machine-learning to decipher glioblastoma tumour heterogeneity and advance equitable diagnosis|
Glioblastoma (GBM) is the most common, debilitating, and fatal brain tumour in adults. Despite many advances in anticancer therapies, GBM still lacks any curative interventions, resulting in a median survival time of only 16 months.
We aim to develop a digitised method of accurately identifying distinct GBM tumour microenvironments (TMEs) and elucidate their biological features that could be exploited for personalised diagnosis and treatments.
The first objective will use machine learning to develop an image analysis algorithm. This algorithm aims to identify unique TME signatures from patient tumours –a “tumour fingerprint”, which can act as a stand-alone, rapid, and personalised GBM diagnostic system.
The second objective will consider the relevant cell populations and protein expression of the identified TMEs, using tissue and cells isolated from patient GBM specimens. Immunohistochemistry-based single-cell image analysis and flow cytometry will be utilised to uncover prognostically applicable TME-associated information, which will further advance our understanding of GBM biology and identify potential therapeutic targets.
In the future this will lead to research producing a multiscale predictive algorithm that can guide personalised treatment strategies and drug development for GBM. We believe our project will provide a widely accessible and equitable diagnostic system that delivers rapid, low-cost and personalised tumour diagnostics.
|Timeframe||January 2022 – May 2023|
|PI||Dr. Ben Lawrence|
|Title||Establishing a Northern Region Māori Lung Cancer Cohort to advance Māori health through precision oncology|
Lung cancer is the leading cause of cancer death for Māori, who suffer higher incidence and mortality than non-Māori. Inequity occurs at all parts of the cancer journey. This project employs patient and whānau voice early to create a Māori lung cancer cohort that is most likely to recruit and ultimately benefit Māori through collaboration. Specifically, this award will prepare for the cohort using wānanga, patient/whānau interview, Māori expert consultation and scientific workshops. This seeding project aims to:
1. Determine the feasibility of a prospective cohort of Māori lung cancer patients recruited from the clinical setting.
2. Establish and demonstrate patient engagement, a data management plan that meets obligations of Māori data sovereignty and a dissemination strategy to impact Māori health.
3. Formalise academic/clinician collaborations in four modules: patient experience, immunoprofile, genomics and tissue feasibility/biobanking.
These new understandings will provide the base for a large HRC application in 2023 lead by UoA.
|Timeframe||January 2022 – June 2023|
Li Family Release Time Grants
|PI||Dr. Annette Lasham|
|Title||Extending a multidisciplinary translational team to improve outcomes for New Zealand women with breast cancer|
Annette recently assembled a multidisciplinary team from across New Zealand that successfully competed for a prestigious programme grant from the Breast Cancer Foundation NZ to study young NZ women with breast cancer. The team includes biomedical scientists, bioinformaticians and statisticians, a medical oncologist and pathologist. She now plans to expand this translational research team to include people and groups with expertise outside of their own.
The overarching goal of our work is to perform research that will translate into improved and equitable outcomes for women with breast cancer in New Zealand. This ‘released time’ will be used to
Having this extended multidisciplinary team will enable us to generate results that are robust and relevant, to be able to make recommendations to health policy makers and lead to transformations in clinical practice.
|Timeframe||January – December 2022|
Albet Trust Bequest Seed Funding Grants
|PI||Dr. Hayley Reynolds|
|Title||Development of imaging biomarkers for accurate and informative assessment of treatment outcome following prostate radiotherapy: the Auckland ‘Sequential Imaging’ study (SI-BiRT)|
Below is the summary submitted for the Li Family Funding Round ($50,000). This is likely to be modified before the start date to ensure it can be delivered within the reduced budget.
Recently, ‘biologically targeted radiotherapy’ (BiRT) has been proposed to significantly improve treatment for prostate cancer by giving a personalised, non-uniform dose of radiation based on patients’ tumour location and biology identified from multiparametric MRI (mpMRI). Furthermore, mpMRI has shown potential to predict treatment response earlier and more precisely than current prostate specific antigen (PSA) blood testing allows.
In this study we aim identify new imaging biomarkers of treatment response by carrying out mpMRI before and after radiotherapy on patients being treated at Auckland City Hospital.
We also aim to investigate hypoxia in mpMRI and tissue samples, since hypoxia is known to contribute to treatment failure.
Changes in patients’ imaging data will be analysed using radiomics and machine learning methods and correlated with blood-based measures of treatment response (including PSA and measures of hypoxia), to identify biomarkers which may indicate early treatment response.
Overall, this project aims to identify novel biomarkers which could be used to adapt treatments in patients who are not responding to radiotherapy.
This study will be carried out in collaboration with the wider BiRT team based at the University of Sydney, with whom we aim to run larger clinical trials in future to validate imaging biomarkers identified in this study.
|Timeframe||March 2022 – September 2024|
|PI||Dr. Amy Lovell|
|Title||Changes in nutritional status in childhood cancer patients: A prospective cohort study|
Malnutrition (under-or over-nutrition) is common among paediatric cancer patients and impacts survival, treatment tolerance and quality of life. Evaluating nutritional status is an integral component of care during cancer treatment; however, it is not routinely undertaken in NZ. As a result, the factors influencing change in nutritional status during childhood cancer remain poorly understood, and malnutrition prevention is challenging to implement.
This research will determine the feasibility of measuring the change in nutrition-related blood, body measurements, and body composition in the first 12 months of treatment in a sample of newly diagnosed children <18 years with cancer at the Starship Blood and Cancer Centre (SBCC) in Auckland, NZ.
Data collection points will be at diagnosis, 3, 6, 9, and 12 months from diagnosis. Collected data will be classified into five domains; 1) anthropometrics; 2) biochemical data; 3) medical tests and procedures; 4) food/nutrition-related history; and 5) nutrition-focused physical findings.
Outcomes include determining the occurrence of micronutrient abnormalities and malnutrition, measuring changes to body composition and dietary intakes, and assessing the impact of nutritional status on clinical outcomes. The proposed collaboration between the University of Auckland, SBCC and the National Child Cancer Network will be the first to provide NZ-specific data in this area of nutritional science and guide better health outcomes.
|Timeframe||March 2022 – September 2023|
2020 Successful Recipients
Prof Cristin G Print – Cancer Molecular Screening and Therapeutics (MoST) – activating genomic-enabled cancer trials for New Zealand.
The key cancer focus of this research is provision of cancer research services, targeting inequity
This research seeks to integrate several existing cancer research enablers: a Biobank, genomic sequencing facility, a molecular tumour board, an early phase trials unit, a consensus tikanga and kaitiakitanga for Maori whanau to co-lead, and a strengthening view of patient-centred care in cancer services in the Health Systems area of the school of population health.
The groups will be linked by a master protocol to create a single streamlined research solution. The result will be a cancer testing and drug research platform that can realise the vision of an integrated academic cancer centre in Auckland. The master framework will facilitate molecular screening of 400 patients with next generation sequencing cancer panels (genetic testing). After this testing, patient will be able to be linked to a suite of clinical trials for biomarker-driven treatments, that is, treatments tailored or specific to that patient’s particular genetic markers.
|Timeframe||February 2021 to January 2023|
Assoc. Prof Adam V Patterson – Window of opportunity trial of Tarloxotinib combined with SBRT in advanced HPV negative head & neck cancer
They key cancer focus of this research is testing and development of new drugs which will work against HPV (human papillomavirus) negative head and neck cancer.
HPV is a group of viruses that are passed between people through various routes and can have an impact on abnormal cell growth which can lead to several kinds of cancer.
This drug has been developed by the Auckland Cancer Society Research Centre and has been tested in healthy people already.
This research undertakes an early trial of this medication in people with cancer, testing the drug on its own, and in combination with another common cancer treatment, radiation therapy, before patients go for surgery to remove their cancers.
The drug works by a complicated process of targeting a section in the middle of the tumour which has limited oxygen, killing the cells. Because the drug targets only a part of the tumour, the developers think there will be fewer side effects than other treatments.
|Timeframe||February 2021 to January 2023|
Prof Michael Findlay – THYmine2 – An observational study to assess the ability of the thymine loading test to prospectively categorise patients with gastrointestinal or breast cancer who cannot tolerate fluoropyrimidine treatment.
The key cancer focus of this research is cancer treatment for people with breast cancer and gastrointestinal cancer.
This research aims to develop a test which can be used to predict if a particular drug will have severe side effects for some people with cancer. The chemotherapy drug group (fluoropyrimidine drugs) can have serious side effects for the group of people that are not able to take it. This research seeks to show that a thymine test is a reliable way to identify people who might have this reaction in advance. This could help doctors adjust the dose of the drug they give to patients or find alternative treatments for people who the test identifies as not able to tolerate this drug.
The test being studied is a urine test which is easy to do and inexpensive, so it would be a simple thing to put into practice, should it prove effective. Two hundred patients will be enrolled into the trial, people how have gastrointestinal or breast cancer who are about to undergo chemotherapy using the drug group.
This trial will be undertaken at Auckland City Hospital, Canopy Cancer Care in Auckland, Dunedin Hospital, Christchurch Hospital and Tauranga Hospital.
|Timeframe||January 2021 to December 2021|
Assoc. Prof Michael B Jameson – The OSCAR Trial: Optimising Selenium status to prevent Colorectal Adenoma Recurrence.
The key cancer focus for this clinical trial is the use of selenium (type and dose) in the treatment of bowel cancer.
This trial will recruit patients from Counties Manukau DHB and Waikato DHB who are enrolled in the bowel screening programme. Patients will have already had removal of the bowel cancer precursor, polyps. Different doses and types of selenium will be tested in this group, to see which most helpful, and which option is more tolerable for people (has the least side effects, although few are expected). People will also be tested to see how much selenium they have in their blood before starting on selenium, to see if that makes a difference to their polyps reoccurring.
This trial will help inform a larger trial which will help determine whether the dose and type of selenium identified in this project are working to reduce reoccurring polyps. This future trial will recruit much larger numbers of people.
|Timeframe||February 2021 to March 2022|
Dr Cherie Blenkiron – A new approach to investigating cellular signalling within tumours: A focus on endometrial cancer and metabolic disease.
The key cancer focus of this research is endometrial cancer, a gynaecological cancer which is affected by weight and disorders relating to the metabolism. This cancer can be challenging to diagnose. This cancer has implications for Maori and Pacific women and may affect women before they have children. This is a study in two parts, running at the same time.
One part is research which will take place in the laboratory. This part will apply a new technique, first in the world, to the analysis of cancer tissues. This technique uses a new way to identify cancer biology and biomarkers (medical signs about things that happen in cells, in this case happening in the cancer cell) called extracellular vesical investigation. The team will use donated tissue from the Auckland Biobank.
Biomarkers are important because what happens in the cell can tell us the best way to stop the cancer spreading or progressing. In future, this will help us with both diagnosis of endometrial cancers and monitoring of people who already have endometrial cancer. This technique might also be useful in diagnosis and management of other cancers in due course.
The other part is establishment of a research network of cancer clinicians and researchers. This network will identify focus areas and areas of need for endometrial cancer patients in New Zealand. They will do this by:
· connecting researchers and clinicians with various areas of interest,
· establishing partnerships between researchers, and
· organising the research studies in this area by ensuring there is minimal overlap and that complementary studies are combined.
This will ensure we have efficient and useful research on this unique and important cancer.
|Timeframe||March 2021 to February 2022|