Genetic risk factors identified for prostate cancer

Monash University’s Precision Medicine research group has discovered multiple new genetic risk factors that make men susceptible to aggressive prostate cancer that will contribute to future prevention of the disease.  Read full story here.

Monash-led clinical trial shows promise for prostate cancer patients

Associate Professor Arun Azad

A world-first clinical trial aimed at improving immunotherapy responses in patients with advanced prostate cancer has started at the Monash HealthTranslation Precinct.

The trial, which has already seen positive results, is being led by Monash Health oncologist AssociateProfessor Arun Azad from the Prostate Cancer Therapeutics laboratory, School of Clinical Sciences at Monash Health (SCS). 

“The first patient on trial has responded to therapy after just six weeks, which is pretty remarkable,” Associate Professor Azad said. 

The investigator-initiated trial is known as ICE-PAC (Immune checkpoint inhibition + stereotactic radiation in advanced prostate cancer), and is supported with funding from Merck Serono, the manufacturer of Avelumab—the drug being used in the trial.

Associate Professor Azad said immunotherapy has transformed the management of many malignancies—although not prostate cancer (yet)—by re-activating anti-tumour immune responses against cancer cells.

“However, these drugs do not work in all patients and in particular in advanced prostate cancer, seem to have limited activity at best,” Associate Professor Azad said.

“One way to boost their efficacy might be pre-treating with high-dose, precision radiotherapy (also known as stereotactic radiation) to metastatic disease.”

“This stereotactic radiation causes death of cancer cells, which releases tumour antigens (proteins) that stimulate immunity and can enhance the effect of immunotherapy drugs such as Avelumab.”  ​

​Associate Professor Azad said the patients being recruited to this study are heavily pre-treated having progressed on standard chemotherapy and hormonal therapy.

“They have limited treatment options and sadly in some cases limited prognosis. So we badly need effective new treatment options for them,” Associate Professor Azad said.

Collaborators on the study include Associate Professor Shankar Siva and Dr Ben Tran from Peter MacCullum Cancer Centre and Dr Carmel Pezaro, Eastern Health.

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The researcher team will recruit a total of 25 patients. Three patients are on the trial now with another two about to commence. ​

Monash Health recruits first patient in Australia to prostate cancer clinical trial

Associate Professor Arun Azad

The first Australian to be recruited to a new prostate cancer clinical trial is a Monash Health patient.

Led by Associate Professor Arun Azad, Head of Medical Oncology Clinical Trials at the Monash Health Translation Precinct (MHTP), the PROfound trial examines the benefit of a new drug, olaparib, that targets the PARP gene (a gene involved in repairing DNA) in advanced prostate cancer.

“PARP inhibitors work by inhibiting a key DNA damage repair pathway in prostate cancer cells,” Associate Professor Azad said.

“Approximately 20% of advanced prostate cancer patients harbour a DNA repair gene mutation that makes them very sensitive to the effects of PARP inhibitors.”

The same mutations can be present in breast and ovarian cancer, for which olaparib is already approved and in the clinic.

“We know that advanced prostate cancer patients with a DNA repair gene mutation have really bad outcomes,” Associate Professor Azad said.

“However, the use of PARP inhibitors allows us to take advantage of these mutations for the benefit of patients. We hope that these drugs will eventually become available in the clinic for advanced prostate cancer patients, pending the success of trials such as PROfound.”

The PROfound clinical trial is being conducted at the state-of-the-art Clinical Trial Centre at the Monash Health Translation Precinct.   

Associate Professor Azad is a Senior Research Fellow at Monash University and Consultant Medical Oncologist at Monash Health.

NHMRC scholarships will benefit research into prostate cancer and lupus

Dr Melissa Northcott

Two Monash Health doctors have received competitive National Health & Medical Research Council (NHMRC) scholarships to undertake postgraduate research at Monash University.

Medical Oncology Fellow Dr Edmond Kwan and Rheumatology Registrar Dr Melissa Northcott will start their PhD programs at the School of Clinical Sciences at Monash Health (SCS) next year, with the support of the scholarships each valued at $125,000 over three years.

Currently a Medical Oncology Clinical Fellow at the Peter MacCallum Cancer Centre, Dr Kwan will commence at Monash Health and Monash University in February.

Dr Edmond Kwan

Dr Kwan hopes his research project will pave the way for the future development of new effective drug therapies to improve the outcomes of prostate cancer

patients.

“In men with metastatic castration-resistant prostate cancer, we have previously identified an association between treatment outcomes with the androgen receptor inhibitor enzalutamide and aberrations detectable in plasma cell-free DNA and whole-blood RNA,,” said Dr Kwan.

“Using serial blood samples, we aim to identify genomic and molecular changes linked to treatment outcomes on enzalutamide, and identify potential mechanisms and predictors of drug resistance.”

Dr Kwan said he is very excited about coming to the Monash Health Translation Precinct to undertake his PhD, and believes the MHTP will provide an amazing opportunity to produce high quality clinical translational research.

Dr Kwan’s PhD will be supervised by Associate Professor Arun Azad from the Department of Medicine at SCS and Consultant Medical Oncologist at Monash Health.

Under the supervision of Dr Sarah Jones and Head of SCS and Director of Rheumatology at Monash Health Professor Eric Morand, Dr Northcott will investigate the role of a protein named GILZ in patients with systemic lupus erythematosus (SLE).

“Lupus is an autoimmune condition which causes inflammation in many different organs and can lead to considerable suffering and even death in some patients, many of whom are young,” said Dr Northcott.

“Currently there is inadequate treatments for many patients with this condition and GILZ is thought to reduce inflammation and may be a future treatment target.”

Dr Northcott thanks Professor Eric Morand and Dr Sarah Jones for their help with her NHMRC application while Dr Kwan is grateful for the significant support of Associate Professor Azad.