Funded projects

Printing of the revised edition of The Palliative Care Handbook.

The Palliative Care Handbook is a guide for clinical management and symptom control and an invaluable resource for healthcare professionals throughout New Zealand. This easy to use guide gives uncomplicated explanations of how to manage general and complex symptoms in patients with palliative needs. The Handbook is provided free of charge to healthcare professionals – predominantly doctors and medical students in all areas where palliative care happens; it gives confidence to those who use it and therefore improved patient and whanau experiences and outcomes. Around 80% of people using hospice services have terminal cancer. Providing education, resources and guidance in current best practice is essential to delivering the highest standard of care possible to patients, families and whanau.

Can stimulation of human antigen presenting cells with TLR ligands improve their capacity to initiate a T-lymphocyte response to a vaccine targeting cancer.

We can exploit the natural behaviour of the human immune system when designing vaccines to treat cancer. Antigen presenting cells (APCs) are the sentinel cells of the human immune system and orchestrate tailored immune responses to invading viruses or bacteria. The aim of this project is to identify the best receptors on human APCs to target with a cancer vaccine. The molecules that bind to these receptors can then be included in a vaccine. So when the vaccine is administered it will instruct the patients APCs to initiate an immune response that will kill the cancer cells.

Control of epigenetics and HIF-1 by hydroxylases.

Cancer cells often outgrow their blood supply, causing a deficit in oxygen, known as tumour hypoxia. This hypoxia causes cancer cells to resist treatments and metastasise, leading to poor patient outcomes. Exactly how hypoxic cancer cells can do this is of great interest, and one major mechanism is through the activity of a family of particular enzymes called hydroxylases. This project aims to examine the activity of these hydroxylases and how they function, so that we can understand how cancer cells behave under hypoxia, and how we can overcome hypoxia-mediated tumour progression.

Circulating tumour DNA as a Predictive and Sensitive Biomarker in Metastatic Breast Cancer.

This research explores the use of two techniques to monitor tumour responses to chemotherapy; measurement of tumour-derived DNA found circulating in the bloodstream, and changes in functional imaging that reflect the metabolic activity of the tumour. Side-effects of chemotherapy for metastatic breast cancer can hamper a patient's quality of life. Therefore, accurate and timely assessment of treatment effectiveness is crucial. These techniques can signal the effects of treatment at a cellular level before any changes are seen in tumour size and may provide earlier and more sensitive indications of response, helping women avoid ineffective and potentially toxic therapy.

ACCeRT: Auckland's Cancer Cachexia evaluating Resistance Training study.

Cachexia is a debilitating condition affecting cancer patients overall physical and mental health. It involves loss of body fat and muscle that leads to the stereotypical appearance of an advanced cancer patient. It largely affects lung, pancreatic and bowel cancer patients. It has a profound effect on patients' personal relationships, social and community interactions. Patients find it hard to ‘kick a ball around with the grandchildren' and miss out on ‘meeting friends at a social club'. This study looks at the combination of a new approach with established methods to help stabilise this process in New Zealand lung cancer patients.

To attend the Keystone Symposia ‘Immune Evolution in Cancer' from March 9th to March 16^th 2014 in Whistler, Canada

To attend the Keystone Symposia ‘Immune Evolution in Cancer' from March 9th to March 16^th 2014 in Whistler, Canada

To attend the International Forum on Quality and Safety in Healthcare (Paris, France, 8th - 11th April 2014)

To attend the International Society of Biological and Environmental Repositories (ISBER) 2014 Annual Meeting, May 20- 24, 2014, Orlando, Florida USA.

To attend the Trans-Tasman Radiation Oncology Group (TROG) Cancer Research - 26th Annual Scientific Meeting 2014, to be held in Sunshine Coast, Australia from the 1st-4th April, 2014

To attend the 2014 Australia New Zealand Gynaecological Oncology Group (ANZGOG) Annual Scientific Meeting in Canberra, Australia from 26 - 30 March 2014.

The potential impact of primary HPV testing on cervical cancer in New Zealand

Cervical cancer remains an important public health problem in New Zealand. Human papillomavirus (HPV) is the essential cause. Screening for high-risk HPV types (with appropriate subsequent treatment) could prevent nearly all cervical cancers. HPV testing is being considered as the main screening test, rather than Pap smears, for cervical cancer in many countries. Before introducing a new screening methodology, it is important to estimate any decrease in disease incidence that may result. Through a case-control study using routinely collected data, we will estimate the proportion of current cases of cervical cancer that could be prevented by introducing HPV testing. tissue.

The role of ascorbate in controlling hypoxia factors in renal cell carcinoma

Kidney cancer is a lethal disease with few treatment options. The most aggressive type of kidney cancer allows tumours to accumulate the pro-survival factor HIF. We have shown that lower HIF-levels and higher vitamin C levels were detected in tumours from colorectal cancer patients with better survival. This study will determine whether the same is true for kidney cancer. Vitamin C and HIF-activity will be measured in banked kidney tumour samples. Our findings will raise awareness of the need for optimal vitamin C levels in a healthy diet, and pave the way for clinical trials of vitamin C in cancer.

Tumour selective delivery of PARP inhibitors cancer

Inhibitors of the DNA repair enzyme PARP-1 are a new class of anticancer agent. They are being clinically trialled for tumours with DNA repair defects (e.g. mutations in BRCA genes) and to potentiate the activity of DNA damaging agents. Unfortunately, normal tissue toxicity limits their combination with these cytotoxins. We aim to develop prodrugs of PARP inhibitors to mask their activity in normal tissue and release the active PARP inhibitor selectively within areas of low oxygen (hypoxia) in solid tumours. This novel approach will increase the efficacy of these agents in combination with cytotoxins and expand their therapeutic potential.

Inhibiting Immune Checkpoints to Improve Immunotherapy for Brain Cancer

Cancer immunotherapies, which use a patient's own immune system to fight tumour cells, are now entering the clinic and have shown impressive efficacy against a number of cancers. One approach uses therapeutic vaccines, which work to educate the immune system and boost the number of tumour-destroying immune cells, while another is to remove the molecular brakes that constrain anti-tumour immune responses. We aim to test whether these two approaches can synergize to create a more effective cancer therapy, and propose to test this using our vaccine in a preclinical model of brain cancer.