October marked an important milestone for the Newcastle and Hunter community as a Phase 2 clinical trial for people with advanced pancreatic cancer, the ACCENT trial, commenced patient recruitment at Calvary Mater Newcastle.

Calvary Mater Newcastle is the first hospital in a regional area to become a site for this trial. With clinical trial investigator Dr Howard Chan, Staff Specialist Medical Oncology, together with clinical researchers from Calvary Mater Newcastle looking forward to recruiting local patients into the trial program.

ACCENT is testing the efficacy of a therapeutic known as narmafotinib, which targets a protein called Focal Adhesion Kinase (FAK), one of the factors that controls the formation of fibrotic tissue in the body – a process called fibrosis.

Fibrosis is important for providing both structural integrity to many organs in the body and in healing after injury. However, when fibrosis is uncontrolled, it can result in a build-up of stiff scar tissue that can prevent organs in the body from functioning properly, causing disease. Many cancers also form a fibrotic tissue shield to protect them from the immune system, which can then hinder the ability for a drug to treat cancer.

narmafotinib has been shown to act on FAK, offering potential for it to both treat and prevent fibrotic diseases, as well as to make cancers that were previously resistant to treatment responsive to drugs.

This milestone signals a new hope for people with pancreatic cancer – a devastating illness with a five-year survival rate of just 5 per cent, and below 3 per cent if the cancer has already metastasised.

“Reaching a Phase 2 clinical trial milestone for narmafotinib represents an important achievement for Australia’s medical research and biotechnology sector, signalling the translation of a novel therapy – discovered and developed by Australian scientists – into a tangible and potentially life-saving treatment for people fighting pancreatic cancer,” said Amplia CEO and MD, Dr Chris Burns.

“With collaboration in our DNA, Amplia is delighted to be working with Calvary Mater Newcastle to welcome local patients into the trial program.”

Often when we think of patients who have received a cancer diagnosis and are undergoing treatment, we think of the physical impacts. Though, we must also remember the emotional and psychological toll that comes with it.

That’s where Kerrie Clover comes in.

As a Research Manager and a Senior Clinical Psychologist for Psycho-Oncology, Kerrie splits her time between the world of research and clinical work where she helps people cope with the effects of cancer. From adjusting to a cancer diagnosis or progression, to helping get them through treatment, and looking at life after treatment.

“Often people are going along well in their life, and when something like cancer comes along, it has the ability to de-rail them,” she said.

During her 20 years at the Mater, Kerrie has worked on some incredible projects. This includes determining the best questionnaires to use in cancer services for measuring depression and anxiety symptoms, and research around anxiety caused by radiation therapy for head and neck cancer patients, who are required to wear a protective, rigid, close-fitting mask during treatment.

“Our research trial involved the patient wearing a pulse oximeter on their finger and feeding that back to them so they could hear their own pulse, and then getting them to try and lower their pulse with some specialised techniques.”

“Our clinical work definitely influences what and how we research.”

Most recently, Kerrie is collaborating with the Radiation Therapy Department to look at how best to help patients prepare for deep inspiration breath hold – a technique that patients receiving treatment to their chest area may have to undertake.

“When patients have treatment to the chest area, they might be asked to use this breath hold technique to reduce the chances of treating any nearby areas they want to miss, like the heart.

“We’ve found it can be quite tricky to master for many people, so our research is looking at how we might be able to improve this.”

According to Kerrie, working in the psycho-oncology service is extremely rewarding, as it means helping people when they need it most, and coming up with ways to increase patient comfort, adjustment and ultimately patient outcomes.

The work of Senior Aboriginal Health Worker and Project Officer, Julianne ‘Julie’ Rose, was recently honoured at the National Palliative Care Awards in Sydney, taking home the award for Outstanding Achievement in Aboriginal and Torres Strait Islander Palliative Care.

Julie, who has over 30 years’ experience working in the health sector with Awabakal and Hunter New England Local Health District, joined the Mater to co-design a model of care for Aboriginal people in the Greater Newcastle area.

The project, entitled Miromullia which means ‘continue to take care of’ in Awabakal language, involved hours of yarning and research to find out what Aboriginal communities want from palliative care services.

“I started from scratch, going out to grassroots community and homes, chatting to bereaved families and others that have used our services about their experiences and stories,” Julie said.

“I also yarned with health professionals that work with Aboriginal people in the health space – from GPs, nurses, allied health workers and Aboriginal Health Workers, to our own Mater palliative care staff. We’re now in the process of putting it all together to identify how we can achieve what our community would like to see.”

In regards to the project, Julie explains that the Aboriginal-led research framework is something that can be adopted across other areas of health.

“What we have done here at the Mater could work for other services. It’s a very authentic way of engaging with Aboriginal people and it’s meaningful,” she said.

“I also have a big responsibility to champion this work for my community, and I feel a sense of pride about that,” she said.

As she approaches the final stages of the project, Julie is looking forward to going back out to community to present the findings.

“The community gave all their time and were open in sharing with me, so it will be great to show them what we’ve found.”

Congratulations Julie on this fantastic achievement!

Congratulations to the Mater’s Department of Radiation Oncology Principal Medical Physics Specialist, Prof Joerg Lehmann, who was recently awarded funding from the NSW Regional Cancer Research Network.

The funding will go towards a research project aiming to improve the quality and utilisation of breast cancer treatment across the state, through accurate monitoring of the patient position during radiotherapy under breath hold.

Working alongside Prof Lehmann on the project is a core team of radiation oncology experts, including Radiation Oncologist, Dr Jane Ludbrook, Medical Physicist, Prof Peter Greer, and University of Newcastle Medical Physicist, Jose Antonio Baeza.

According to Prof Lehmann, this work will allow the team to optimise their software in a clinical environment and increase the accuracy of radiation treatment, limiting the risk of avoidable radiation to the heart.

“By more precisely monitoring the patient’s position during breast radiotherapy we aim to reduce the side effects of treatment and raise cure rates.” Prof Lehmann said.

Not only will this improve patient outcomes, but the precise nature of the treatment may also allow doctors to reduce the number of treatment sessions required for a patient. For breast therapy, this could mean reducing treatment sessions from 20 to 5.

“Creating a more convenient service, improving access to radiotherapy and reducing travel time is something we are working towards for our patients.”

As a stepping stone into the world of research and clinical trials, a number of fifth year medical students are participating in major international studies here at Calvary Mater Newcastle.

As part of a medical degree, students are given the opportunity to participate in research programs from their third year onwards. Currently at the Mater, there are around 15 medical students participating in three international data collection studies for the surgery department.

These studies, led by groups based out of Europe with hospitals from around the world participating, include; the GECKO study (Global Evaluation of Cholecystectomy Knowledge and Outcomes), which is a prospective, multi-site observational study on emergency and elective cholecystectomies; the HIPPO study (Hernias, Pathway and Planetary Outcomes for Inguinal Hernia Surgery), which is a global cohort project; and the APOLLO study, which is an international snapshot on the acute presentation of colorectal cancer.

Shane Zhang, medical student and an assistant in medicine, has been working alongside Colorectal Surgeon, Professor Stephen Smith, and Senior Staff Specialist for Surgical Outpatient Services, Dr Adeeb Majid, in setting up these programs.

“Research is important to improve patient outcomes in the long run. Ideally, we want to treat patients using the best possible methods. In order to do this, we have to rely on evidence and evidence is built on research,” he said.

“Being involved in research programs is a great exercise for medical students in terms of knowing more about research, why research matters and how research is performed.”

Research Governance Officer, Melissa Gavenlock, has been liaising with the students and believes that getting involved in research at data collection level is a great entry point.

“It’s a really good way of introducing medical students to research. They should feel like they are contributing to global health knowledge and initiatives,” she said.

“They get to learn and be enthusiastic about research and clinical trials and it adds that extra layer to their medical training, making for more engaged and enthusiastic medical professionals.

“Studies have shown that hospitals that research have better health outcomes,” she said.

As for Shane, he wants to get involved in research as much as he can.

“As a future clinician, it allows me to stay on top of new guidelines and new forms of evidence and also have a chance of contributing to that evidence.”

We once again say a huge congratulations to Dr Katie McGill, Calvary Mater Newcastle Research Manager in Suicide Prevention, on her latest success. Katie was co-winner of the University of Newcastle 2022 Higher Degree by Research (HDR) Research Excellence Award for her work on suicide prevention.

The University of Newcastle, under the auspices of Graduate Research, award the annual HDR Excellence Awards, across four categories (Research Excellence, Community Engagement, Industry Engagement and Leadership Excellence). These awards are open to all HDR students enrolled at the University in any Faculty and on any campus.

The award recognises and celebrates outstanding early career researchers and research supervisors, and the important role they play in research achievements. The accolade is awarded to an outstanding HDR student in recognition of excellence in their research activities over the past 12 months.

Dr Ralph Gourlay, Director of Medical Services, said, “I understand that this was related to Katie’s work at the Mater on suicide prevention in demonstrating the benefits and uses of a clinical case register for all deliberate self-poisoning patients. This is a fabulous contribution and we are extremely proud of Katie. I hope she also enjoyed ‘a bit of the glow’ of being recognised through this prestigious award.”

Katie said, “I’m absolutely thrilled, and humbled, to receive this award. It is so encouraging to receive an award like this as an early career researcher, particularly when all the nominations were so worthy. It is also a lovely way to finish off what has been a very demanding few years.

“This award is also a tribute to all of those who have helped make the research program possible, not the least being Calvary Mater Newcastle, and I couldn’t have asked for a better mentor or supervisor than Greg Carter. I look forward to continuing the work to make sure that the care and support we provide to people who are suicidal or who self-harm is the best it possibly can be.”

Well done Katie.

Tumour DNA technology provides effective pathway to colon cancer treatment

Congratulations to the Calvary Mater Newcastle Medical Oncology team, who provided a prominent leadership role in a successful cancer clinical trial that was published in one of the world’s leading medical journals, the New England Journal of Medicine.

The DYNAMIC trial was the first completed randomised clinical trial of circulating tumour DNA technology. It aimed to improve the treatment of patients who had been diagnosed with early stages of colon cancer and in return improve their quality of life.

Dr Fiona Day, Lead of the trial at Calvary Mater Newcastle and Senior Staff Specialist Medical Oncology, explains a standard treatment for patients with stage two or three colon cancer is surgery followed by chemotherapy to reduce the chances of the cancer’s reoccurrence. However, through this trial they were able to differentiate and tailor treatment for patients based on the results of a super sensitive blood test, performed on the patients four to seven weeks post-operative, which detects a tiny trace of the cancer’s DNA in the blood. Through the results of this microscopic blood test, the treating doctor is then able to tailor treatment – have chemotherapy after surgery, or just have the operation alone.

“The results of the trial have been dramatic, almost halving the number of people needing to take chemotherapy. Those patients who needed intensive treatment received it and those who didn’t benefited from bypassing chemotherapy, meaning no unnecessary side effects and inconvenience,” said Dr Day.

Calvary Mater Newcastle was one of 23 sites that participated in this Australian wide trial that recruited 455 participants. Our Mater team are to be congratulated on being one of the highest recruiting sites despite the hurdles of not performing this surgery on site and the extremely tight timelines for eligibility for the trial. Fiona comments, “Recruiting participants to this trial was a real team effort across the Mater and our colorectal surgery colleagues across the District.”

Dr Day concludes, “The favourable results of this trial are a great step forward in improving the lives of people facing colon cancer and how we treat them.”

International Association for Suicide Prevention – Early Career Researcher Award Winners

Calvary Mater Newcastle and the University of Newcastle were well-represented at the International Association for Suicide Prevention- Asia Pacific (IASP) conference, at Broadbeach Queensland in May 2022, scooping up two of the three Early Career Researcher prizes.

During the Early Career Researcher pre-conference workshop, participants were given five minutes to describe their research during a round of ‘Lightning Presentations’.

The awards were judged by an expert international panel including Prof Ian Hickie (Brain and Mind Centre, University of Sydney) and Dr Kylie King (Monash University, Victoria).

Dr Katie McGill, Calvary Mater Newcastle Research Manager in Suicide Prevention and PhD candidate, University of Newcastle, was awarded the ‘Best Lightning Talk’ for her summary on the role and value of clinical case registers for hospital-treated self-harm in improving patient care.

Ms Cynthia Coombe, a proud Worimi descendant and PhD candidate, University of Newcastle, won the hearts of the audience, winning the People’s Choice award for her talk about how she is seeking to better understand the care provided to Aboriginal people who come to hospital after intentional self-poisoning.

Cynthia echoed the voices of Awabakal and Worimi Elders and colleagues Margaret Whitson, Aboriginal Hospital Liaison Officer, Calvary Mater Newcastle, and Leonie Garvey, Greater Newcastle Sector Aboriginal Health Unit Manager, as she received the award in the hope that the work will have a ripple effect for First Nations communities, with the research translating into positive change in current clinical practise.

Professor Greg Carter, Director Consultation-Liaison Psychiatry, is the PhD supervisor of both candidates, and both women’s research has only been possible because of the unique dataset and case register held at Calvary Mater Newcastle.

Greg said, “Winning two of the three Early Researcher presentation awards at IASP was a deserved honour for Dr McGill and Ms Coombe. It was also a measure of the success of Newcastle based research programs.

“There was extensive competition from other PhD students, particularly from a number of Australian Universities and from a small number of international participants, who presented some excellent suicide prevention projects.”

Staff at Calvary Mater Newcastle are leading the way in helping oncology patients quit smoking through participation in the Care to Quit trial, led by Professor Christine Paul from the University of Newcastle.

The enthusiastic Calvary Mater Newcastle Care to Quit leadership team consists of Dr Fiona Day, Dr Tin Quah, Gillian Blanchard, Laura Healey, Emily Sykes, Leanna Pugliese and Ashley Powell. Wasting no time, the Mater team recruited the first patients to Care to Quit after it opened in June.

Smoking tobacco has harmful effects on almost all parts of the body. After being diagnosed with cancer, patients who continue to smoke have higher post-operative complications, longer hospital stays and more radiotherapy complications.

Conversely, patients who stop smoking at a cancer diagnosis improve their chances of survival, among many other benefits. Despite this, not all patients treated at cancer centres are screened for current smoking or referred to smoking cessation services.

The Care to Quit trial is a National Health and Medical Research Council (NHMRC) funded stepped wedge randomised clinical trial to implement best-practice smoking cessation care for people with cancer. It will be run over three years at nine cancer treatment centres in Australia.

At the Mater, patients will be invited to participate when attending Medical Oncology, Radiation Oncology, Surgical and Haematology outpatient clinic appointments. Participating is simple, involving two scheduled phone interviews. The trial aim is to see an improvement in the smoking quit rate among patients recruited after their treating staff are provided with a six month ‘intervention’ period of support and education in providing smoking cessation care.

The Mater team have helped develop important educational resources for the trial. Role play videos demonstrating smoking cessation advice provided to ‘patients’ (played by actors) have been filmed in the Medical Centre and in the Radiation Oncology treatment area and will be used at all participating cancer centres.

“I believe we are at a watershed moment for addressing this important aspect of supportive care in oncology,” said Dr Fiona Day. “We now realise that continued smoking after a cancer diagnosis can have an impact similar to having versus not having some cancer treatments. So now it’s time to resource and upskill our health services to meet this need, and gathering clinical trial evidence via the Care to Quit trial will aid that process.”

A huge congratulations to Research Manager for Suicide Prevention (and PhD student) at Calvary Mater Newcastle, Katie McGill.

Katie recently won her heat of the 2021 University of Newcastle’s Three Minute Thesis (3MT) competition.

The competition is held annually at the University of Newcastle for higher degree research candidates, spread across the four schools: Nursing and Midwifery, Health Sciences, Medicine and Public Health, and Biomedical Science and Pharmacy.

This year there were 22 candidates vying for a spot in the final.

In just three minutes, using only a static slide, participants present their research – what they’re doing, how they’re doing it, and why.

Katie’s thesis was entitled, “Using health service data to inform suicide prevention policy, planning and practice”, representing the School of Medicine and Public Health.

Of her win, Katie said,

“I’m so excited to go through to the University of Newcastle’s 3MT Competition final as the winner and representative of the School of Medicine and Public Health.

“Most of my family, friends and colleagues know I’m doing a PhD, but they have no idea what I’m doing, or why. This was a chance to see if I could explain my research in a way that would connect with everyday people, in a timeframe that probably equals our usual attention span!

“Improving outcomes for people who are suicidal is something that matters. Being able to work with Calvary Mater Newcastle and others in the field has made my work possible and it’s great to be able to let others know about it in this way.”

Ralph Gourlay, Director of Medical Services said, “This is a fantastic achievement of which I am personally inspired and impressed by Katie’s win.”

The winner from each school will progress to the University of Newcastle’s 3MT final on Wednesday 25 August 2021. Good luck Katie.

To view Katie’s thesis go to https://vimeo.com/570816553