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The UC Cancer Research Fund

Dr Rao in the University of Canberra laboratory

One in three Australian men and one in four Australian women will be directly affected by cancer before the age of 75. Cancer remains one if the leading causes of death in Australia despite a 30% improvement in survival over the last two decades.

Cancer will affect almost every Australian in their lifetime, either directly or through the diagnosis of friends or family.

    There are two core aspects to our research:

  1. The development of a blood test that allows for personalised treatment and will increase the chances of positive treatment outcomes.
  2. The development of new treatments that stop cancer recurrence (metastatic disease), initially in breast cancer and then in other aggressive cancers.

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Metastasis, or metastatic disease, is the spread of cancer from one part of the body to another organ or part of the body. Metastasis is associated with over 90% of cancer deaths.

You can find more detailed information about metastatic disease on the National Cancer Institute website.

Current cancer treatments target the cancer tumour mass, however they have no impact on cancer stem cells.  Even after successful cancer treatment, cancer stem cells remain dormant. Metastatic disease occurs when the cancer stem calls reactivate, enter the blood stream and travel to other parts of the body, leading to secondary cancers. These secondary cancers are usually more aggressive and often found occur in areas of the body where treatment options are limited or not available. Too often death follows within a short time frame.

Cancer Stem Cells  and cancer cells with only Chemotherapy Drug administered

Metastatic cancer blood test

Our research team has developed a blood test that detects cancer stem cells in the blood stream — a sign that cancer has metastasised. Further development of the blood test to the point that it is ready for use in the clinical setting will produce four key benefits for cancer patients.

  1. Early intervention when cancer metastasises

Early treatment response is critical for stopping the spread of metastatic cancer.

Our blood test can detect 1 CSC in 7.5ml of blood providing the earliest possible indication that the disease has progressed to the metastatic stage. Currently, metastatic progression of the disease is diagnosed through invasive tissue biopsy and can only be diagnosed well after the progression of the disease has occurred.

Once available to patients the test will allow treatment intervention significantly earlier, allowing more time for treatment before the cancer progresses.

  1. Guiding treatment decisions for more effective outcomes

Once metastatic cancer is detected our researchers are able to analysis the cancer stem cell biomarkers and predict how the cancer will respond to treatment.

Often oncologists have a range of treatment options available to them. Each treatment option will work for a percentage of patients but an oncologist has no way of knowing which treatment will be most effective for an individual patient. This can lead to multiple treatments being required before a successful outcome is achieved. Patients have to endure the side effects of multiple treatments, have reduced quality of life and loose time. If their cancer is aggressive it may be time they simply do not have.

By predicting which treatment option will be effective patients will receive the most effective treatment as their first treatment.

  1. Adapting treatment to changes in the cancer

When patients are initially diagnosed with breast cancer a tissue biopsy assesses the hormone status of the cancer. The hormone status influence how the cancer grows and subsequently the treatment options available to the patient. Breast cancer can be HER2-positive or HER2-negative. A patient with HER2-positive breast cancer can only receive HER2-positive treatments.

However, a patient’s HER2 status can change thereby changing the treatment options available to a patient.

Our blood test can determine the HER2 status of breast cancer without the need for a tissue biopsy. This will allow for ongoing monitoring over the progression of the disease. If the HER2 status of a HER-negative patient changes to HER2-positive, for example, their treatment can quickly be altered to a HER2-positive treatment option.

The blood test will therefore reduce the number of patients undergoing ineffective treatment.

  1. Predicting response to immunotherapy

Immunotherapy is a promising growth area for cancer treatment. Immunotherapy works by strengthening the body’s defence mechanism so that the body can attack the cancer. Immunotherapy is emerging as a preferable form of cancer treatment as side effects are often less severe and immunotherapy may be more successful in preventing cancer recurrence.

Currently immunotherapy is successful in 15 – 40% of patients, depending on the type of cancer. The lower likelihood of success often causes oncologists to employ an immunotherapy treatment only after other treatments have failed. Our blood test predicts when immunotherapy is the preferable option for a patient. This will allow immunotherapy to be employed more often for those patients it is most likely to be successful for.

University of Canberra researcher Professor Sudha Rao and her team are on the brink of significant advancements in this area.

The team has identified an approach that blocks stem cell proteins in breast cancer. The approach may be able to be administered with current chemotherapy drugs to simultaneously attack the tumour and block the stem cells.

Novel treatment approach

The major cause of metastatic disease and recurrence of cancer are special cells called cancer stem cells (CSC) which are located within the cancer tumour. The cancer stem cells have the same features as normal stem cells however they are resistant to all current standard care drugs, chemotherapy, and radiation.

Our research team is the first team worldwide to discover two nuclear proteins that are critical for the identification of breast cancer stem cells.

Following this discovery the team identified a drug combination that block the proteins. When used in combination with existing chemotherapy drugs the resulting therapy attacks both the cancer cells, and cancer stem cells.

Chemo and CSC Drug infographic

Below you can see how the treatment compares to other treatment methods in pre-human trials.

Research to date suggests this approach will result in:

  • a lower dose of chemotherapy drugs needing to be used;
  • reduced treatment side effects due to lower dosages;
  • minimal chance of metastatic disease; and
  • no more cancer in the original area.

Clinical trials for this new breast cancer treatment are on-going. The treatment utilises an existing and pre-approved drug (currently used in the treatment of depression). This significantly shortens the trial period as the side effects of the drug are already known. New drugs take considerably longer to trial and gain approval to use. The new treatment could be available in as little as a few years.

Professor Rao believes that the same approach could be applicable to other aggressive cancers, including pancreatic and ovarian cancer. In the next phase of their research the team hopes to identify other existing and approved therapies that can be used to block stem cell proteins in other forms of cancer – with a particular focus on aggressive cancers.