Clinical trial with genomics focus may offer fresh hope for blood cancer patients in Western Australia

Monday, July 4  2022

A clinical trial research program currently available in Queensland and South Australia, will now be available in Western Australia offering local patients with advanced blood cancer access to genomic screening of their individual disease, potentially leading to accessing precision medicines.

Led by Dr Carolyn Grove, Clinical and Laboratory Haematologist at Sir Charles Gairdner Hospital, Linear Clinical Research and PathWest, the Blood Cancer Genomics Trial – Molecular Screening and Therapeutics in Leukaemia and Lymphoma (MoST-LLy) – leverages the experience, infrastructure and novel clinical trial design powering the Molecular Screening and Therapeutics (MoST) Program which is pioneering the way that solid tumours could be treated with precision medicine.

MoST-LLy represents the first time this platform has been used to screen and treat people living with blood cancer in Australia having first become available in Queensland in July 2021, then subsequently South Australia and now Western Australia.

“Ongoing research has increased our understanding of the genetic complexity of blood cancers which in turn has paved the way for new precision medicine-based therapies. This clinical trial harnesses the power of genomic profiling and will provide more Western Australian patients with access to new targeted treatment for their blood cancer,” said Dr Grove.

High-grade lymphomas and acute leukaemias are aggressive blood cancers with few treatment options available to patients living with relapsed or refractory (resistant to treatment) disease. This research program aims to match patients’ tumour profile with available and promising treatments. This could be a standard treatment, a treatment offered by MoST-LLy, or a treatment offered by another clinical trial.

The program also researches biomarkers of response or resistance to treatments to further develop precision-based therapy options, providing a new model of rapid clinical translation and access to novel treatments for high-risk blood cancers in Australia. Findings may change the management of advanced blood cancers and improve patient outcomes.

The program is a collaboration between the Royal Brisbane and Women’s Hospital, Royal Adelaide Hospital, QIMR Berghofer Medical Research Institute, SA Pathology, Garvan Institute of Medical Research, Omico (the Australian Genomic Cancer Medicine Centre), NHMRC Clinical Trials Centre at the University of Sydney and now Linear Clinical Research in Western Australia.

The pilot $1.8 million program in Queensland and South Australia is co-funded by the Leukaemia Foundation and Tour de Cure and will allow for the screening and enrolment of 240 patients. The program is also supported by the Australian Government, the NSW Office of Health and Medical Research, and pharmaceutical partners[1].

The program has recently been awarded an additional $2.7 million through the Australian Government’s Medical Research Future Fund (MRFF), which will be used to expand the pilot project to 240 more patients and sites in 2022 and beyond, including Western Australia.

A fundraising effort from long term Leukaemia Foundation supporter Tim Goyder and his networks also facilitated the expansion of the Blood Cancer Genomics Trial into Western Australia. Although well and not currently receiving treatment, Tim was diagnosed with chronic myeloid leukaemia over two decades ago and believes Western Australians should have better access to trials such as this.

“I feel very strongly about access to research and trials here in Australia, particularly for fellow Western Australians. As someone who has lived with and survived blood cancer, I think it’s incredibly positive to see this potentially life-changing research now being undertaken here in Perth. I am hopeful this research can lead to better outcomes and survival rates for people living with blood cancer,” said Tim.

With more than 50 Australians diagnosed with blood cancer every day and blood cancers combined now ranking as the second largest cause of cancer-related death in the country[2], Leukaemia Foundation CEO Chris Tanti said the importance of improving access to genomic screening and clinical trials could not be overstated.

“If we are to have any hope of reducing blood cancer mortality in this country, we must shift our focus away from treating blood cancer subtypes with a ‘one size fits all’ approach and towards targeted therapies. Genomic testing illuminates the best treatment path for each individual patient, and the potential for delivering precision medicine tailored to them may result in improved survival, less side effects than some traditional treatment options, less time spent in treatment and greater quality of life,” he said.

“This research program will provide a new model of rapid clinical translation and access to novel treatments for high-risk blood cancers in Australia. Importantly, findings through this program may improve patient outcomes and ultimately change the management of advanced blood cancers.

“Together, genomic screening, clinical trials and precision medicine have the power to revolutionise the way we treat blood cancer in Australia and bolster the national blood cancer community’s concerted work to achieve zero lives lost to this complex set of diseases by 2035.”

Professor David Joske, Clinical Haematologist at Sir Charles Gairdner Hospital, Founder and CEO of Solaris Cancer Care and Blood Cancer Taskforce member echoed Chris’s comment.

“Having access to Genomics in WA will shorten the lead time to accessing a whole treasure trove of new therapies, some only available in clinical trials, which means less anxiety, and better and quicker results for our fellow Western Australians. This study is a vital step to ensure blood cancer treatments in WA remain at the cutting edge of new technologies and understanding of cancer,” Professor Joske said.

Interested Western Australian patients should discuss this trial with their haematologist. Further information on the trial is available through the Leukaemia Foundation website.

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Genomic screening and precision medicine in blood cancer 

• There are over 120 different types of blood cancer and research shows that even within each of these groups, there are many sub-groups with unique genetic mutations that affect both disease development and treatment options.
• Genomic screening has revolutionised understanding of blood cancers and paved the way to a new generation of new precision medicines, where treatments are targeted based on an individual’s blood cancer genomic profile. Until recently it has been almost impossible to target treatments to a person’s unique genetic makeup, resulting in a ‘one size fits all’ approach to treatment.
• Access to accurate and timely diagnostics is fundamental to treatment, care and survival for people living with blood cancer. Early and accurate diagnosis is critical to understanding what type of blood cancer an individual has, and to understanding what treatment pathway will offer the best survival and quality of life outcomes.
• Genomic profiling is required for accurate subtype diagnosis and the subsequent treatment of blood cancer patients. Through genomic profiling, clinicians can more precisely match patients to targeted therapies. These efforts are critical to the expansion of precision medicine and the realisation of curative therapies.
• Despite blood cancers being at the forefront of genetic characterisation and precision medicine, genetic testing is not standard of care in Australia and less than 30% of Australians facing blood cancer undergo a genomic screen to inform their diagnosis and treatment pathway.[3]
• The National Strategic Action Plan for Blood Cancer includes recommendations around genetic screening, including developing guidelines for diagnostics and reviewing Australia’s capacity to meet these guidelines, as well as recommendations to enable access to novel and specialised therapies, including actions to improve equitable access to these therapies and making precision medicine the standard of care.

Blood cancer clinical trials 

• Research has shown that the systematic enrolment of patients in clinical trials is one of the single most important actions to reduce the number of lives lost to blood cancer, however despite the demonstrated benefits of clinical trials, patient participation in blood cancer clinical trials in Australia remains low.
• Patients on clinical trials are shown to have improved outcomes, and that access remains the greatest obstacle to beating blood cancer. Less than 20% of Australians living with blood cancer today report having the opportunity to participate in a clinical trial, and only 1 in 5 Australians with blood cancer who want to enrol in a clinical trial have access to one.[4]
• The National Strategic Action Plan for Blood Cancer includes recommendations to increase access to clinical trials, including through improving discussion of clinical trial options with patients and increasing access in regional and remote areas, such as through a national approach to prioritising tele-trials.

[1] This research was conducted with support from AstraZeneca Pty Ltd and BeiGene Ltd.

[2] Cancer data in Australia, Summary – Australian Institute of Health and Welfare (aihw.gov.au)

[3] State-of-the-Nation-Blood-Cancer-in-Australia_Leukaemia-Foundation.pdf

[4] State-of-the-Nation-Blood-Cancer-in-Australia_Leukaemia-Foundation.pdf