Monash research sheds light on prostate cancer treatment

Associate Professor Arun Azad and the 

Prostate Cancer Therapeutics research group

Monash University research has revealed that prostate cancer patients with a particular biomarker may benefit from commonly used hormonal drugs, contrary to a landmark study published a few years ago.

Monash Health oncologist Associate Professor Arun Azad from the Prostate Cancer Therapeutics laboratory, School of Clinical Sciences at Monash Health (SCS) led the study that will change clinical practice and may improve outcomes for patients with metastatic castration-resistant prostate cancer. 

“A landmark study published in 2014 had suggested that men with a certain biomarker (known as AR-V7) do not respond to some of the commonly used hormonal drugs in prostate cancer,” Associate Professor Azad said.

AR-V7, a type of protein, is easily detected in the blood of men with prostate cancer.

“In our study, we’ve shown that patients with AR-V7 may in fact respond to the drugs abiraterone and enzalutamide, and should not necessarily be excluded from such therapies if they express this biomarker.”

The study, published last week in European Urology, supports a recent pivotal phase III clinical trial that made the same finding.

Associate Professor Azad said his group’s research shows that the presence of AR-V7 should not be used to guide treatment selection for men with advanced prostate cancer.

“This represents a major shift in our understanding of AR-V7 and its potential clinical utility as a biomarker,” he said. 

“This is a pertinent reminder that we should not ‘jump the gun’ with biomarker studies and make assumptions—or even worse, change our clinical practice—on the basis of a solitary study.” 

Associate Professor Azad’s research was supported by an NHMRC Project Grant on which he is the Chief Investigator. 

He thanks the patients and families who so generously supported this ongoing study, as well as his research team, clinical collaborators at Monash Health, Eastern Health and Chris O'Brien, Lifehouse.

Monash leads largest ever randomised controlled trial on ICU sedation

Professor Yahya Shehabi

The largest RCT on ICU sedation study, led by Monash University, recruited its 4000^th and final patient this week.

The clinical trial known as Sedation Practice in Intensive Care Evaluation (SPICE III) is led by Chief Investigator Professor Yahya Shehabi from the School of Clinical Sciences at Monash Health (SCS). SPICE III is funded by a NHMRC project grant.

Professor Shehabi reported that the final patient was recruited at Nepean Hospital in Sydney on February 7 at 2.23pm.

The SPICE III trial is investigating the use of dexmedetomidine as a light sedation in critically ill, ventilated ICU patients, using an innovative approach called Early Goal Directed Sedation.

“This approach has the potential to improve 90 day survival of critically ill patients who are ventilated for more than 24 hours,” Professor Shehabi said.

“The study also aims to evaluate institutional dependency and quality of life six months after discharge from ICU.”

Professor Shehabi said the delivery of early light sedation is likely to reduce ICU delirium and dependency on mechanical ventilation whilst in ICU.

“These outcomes are all patient-centred and have enormous implications for the quality of life for patients and their families. Improvements in these outcomes could translate to significant reduction in the societal burden of post ICU care syndromes with huge positive resource implication. 

The SPICE III trial has been conducted in 76 ICUs in nine countries including Australia, New Zealand, Malaysia, Saudi Arabia, United Kingdom, Scotland, Ireland, Italy and Switzerland.  It is managed by the Monash University Australian and New Zealand Intensive Care Research Centre.

“SPICE III will change the landscape of how critically ill patients are sedated in ICUs worldwide and will provide the highest level of evidence to inform future practice,” Professor Shehabi said.

The final results of SPICE III will be available at the end of 2018.

Competitive grant will support bone and muscle health research

Dr David Scott

Senior Research Fellow Dr David Scott from the School of Clinical Sciences at Monash Health (SCS) has been awarded a Rebecca L. Cooper Medical Research Foundation Project Grant to support his research into sarcopenia.

Sarcopenia is the degenerative loss of skeletal muscle mass and function.  It is estimated that 5–13% of elderly people aged 60–70 years are affected by sarcopenia, and this increases to 11–50% for those aged over 80. 

Dr Scott, an NHRMC Career Development Fellow in the Bone and Muscle Health Research Group, will use the $100,000 grant to undertake a randomised controlled trial comparing the effects of weight loss plus a bone-targeted exercise intervention versus weight loss alone in obese older adults with sarcopenia.

“We have demonstrated previously that obese older adults with sarcopenia have increased risk for falls, fractures and type 2 diabetes,” Dr Scott said.

“These individuals can undoubtedly benefit from weight loss interventions, but can experience significant losses of bone and muscle mass as a result.”

“We will determine whether a 12-week bone-targeted exercise intervention involving high-velocity resistance training and impact activities prevents decreases in bone and muscle mass during weight loss,” he said.

“We will also explore whether this type of exercise enhances the benefits of weight loss for improving insulin sensitivity in obese older adults with sarcopenia.”

Dr Scott’s application was the top-ranked grant in the geriatrics discipline.  He has also been invited to attend the Rebecca L. Cooper Medical Research Foundation dinner in Sydney next month.

Dr Scott acknowledges the ongoing support of Professor Peter Ebeling and the team in the Bone and Muscle Health Research Group.

Monash PhD candidate recognised for practice-changing research into prostate cancer

Dr Edmond Kwan

Monash University PhD candidate Dr Edmond Kwan is the recipient of the prestigious Conquer Cancer Foundation Merit Award in recognition of his research into prostate cancer.

A Monash Health medical oncologist, Dr Kwan is a PhD candidate in the School of Clinical Sciences at Monash Health (SCS).

“My PhD research explores the role of androgen receptor variants (AR-Vs) as a predictive and prognostic biomarker in advanced prostate cancer,” Dr Kwan said.

“AR-Vs are abnormal proteins that can be present in prostate cancer, and in recent years, have become detectable in blood tests that analyse circulating tumour cells.”

“These proteins are thought by many to represent one of the primary mechanisms by which advanced prostate cancer can develop resistance to newer drug therapies, such as abiraterone and enzalutamide,” Dr Kwan said.

“Some studies even suggest that patients with AR-Vs do not benefit from these therapies.”

Dr Kwan’s research group— the Prostate Cancer Therapeutics Laboratory—designed a blood test to accurately detect AR-Vs.  This test can be performed more routinely than tests involving circulating tumour cells.

“We found that a significant proportion of these patients with detectable AR-Vs in their blood still benefit from these effective therapies, and therefore we would recommend against clinicians using AR-Vs as a method of choosing ideal treatments for their patients,” Dr Kwan said.

Dr Kwan presented his research at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium last week in San Francisco.   The findings were also published in the high impact journal European Urology this week (read more HERE).

Dr Kwan said it is an absolute honour to be a recipient of a Conquer Cancer Foundation Merit Award.

“As an early career Oncologist embarking on the PhD pathway, I have a strong commitment to translational research that bridges the divide between basic science research and real-world benefits for patients I see in the clinic,” he said.

“It is extremely encouraging to receive such a highly-sought after award so early in my academic career, and no doubt this will go a long way in assisting my goal of securing an overseas fellowship position post-PhD to further strengthen my independent research skills.”

Dr Kwan acknowledges his PhD supervisors Associate Professor Arun Azad, Dr Sarah To and Professor Eva Segelov, and the rest of the Prostate Cancer Therapeutics Laboratory for all their assistance and hard work on the project.

“This award would not have been possible without their unwavering support,” Dr Kwan said. 

Afternoon tea to celebrate Professor David Kissane AC Award, 14 February

RSVP link here: https://my.monash.edu.au/news-and-events/bookings/mmcbs/register/230085/

Grand Rounds: “Gender Dysphoria: An introduction to current practice and the challenges associated with an atypical case”, 14 February

February 14, 12.30-1.30pm, Lecture Theatre 1, MMC

Presented by Dr Jaco Erasmus, Consultant Psychiatrist, Head of Gender Clinic

Gloria Leung PhD confirmation, "The development of recommendations for healthy eating and lifestyle in shift workers", 14 February

All staff and students are invited to Gloria Leung's PhD confirmation seminar.

14 February, 10am, BASE Facility, Level 1, 264 Ferntree Gully Rd, Notting Hill

Synopsis: Shift workers are at increased risks of cardiovascular disease and type-2 diabetes. Their night time eating habits may be a contributing factor, as it forces the body to metabolise food when they are supposed to be asleep. This thesis explores if manipulation of meal timing can reduce shift workers' metabolic disease risks. 

Supervisors: A/Prof Maxine Bonham, Dr Kate Huggins

Hudson Seminar: Regulatory Mechanisms of Transcriptional of Heterogeneity, 15 February

12-1pm, Thursday 15 February, Seminar rooms 1 and 2, TRF

Presented by Dr Kirsten McEwen, Fellow at Imperial College London

Kirsten McEwen is a Fellow at Imperial College London investigating heterogeneity in health and disease. Kirsten holds a PhD in epigenetics from the University of Cambridge and undertook her post-doc at the MRC London Institute of Medical Sciences. Upon award of an Imperial College Research Fellowship, Kirsten established her independent research
programme on transcriptional heterogeneity.

Her expertise lies in integrating interdisciplinary approaches to discover mechanistic causes of cellular phenotypes.

Digital Hospital: High Hopes, Sobering Reality, 1 March

Presented by Professor Anke Simon, Baden-Wuerttemberg Cooperative State University, Stuttgart, Germany

Free registration

Diabetes and Bone – New developments and the important role of sclerostin signalling, 2 March

Presented by Professor Lorenz C Hofbauer, University Medical Centre at Technical University Dresden

9.30-10.30am, Friday 2 March, MMC Surgery Seminar Room, Block E, Level 5

Professor Hofbauer studied medicine at the University of Munich and obtained his MD degree 1995 in the thyroid field. His interest in bone research was stimulated during a post-doctoral fellowship at the Mayo Clinic, Rochester, MN, USA under the mentorship of Drs. Larry Riggs and Sundeep Khosla from 1996 to 1999.

In 1999, Professor Hofbauer moved to Philipps-University of Marburg, Germany, where he established his own research group focusing on the RANKL/OPG biology in skeletal, malignant, and vascular diseases. In parallel, Professor Hofbauer completed his clinical education in internal medicine, endocrinology, and diabetes with board exams in 2003 and 2004. From 2004 to 2007 he was a DFG Heisenberg senior fellow and consultant in medicine.

In 2007, Professor Hofbauer became Head of the Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III at the University Medical Center at Technische Universität, Dresden, Germany having also completed subspecialty training and board certification in gastroenterology and geriatrics.

Since 2011, Professor Hofbauer obtained funding for DFG-Forschergruppe SKELMET on the pathogenesis of bone metastases, which entered into the second funding period in 2014.

In 2016, he was appointed Director of the Center for Healthy Aging at the Dresden University Medical Center with an interdisciplinary medical and scientific focus on maintaining lifelong mobility and autonomy. In 2018, he became Deputy Editor of the Journal of Bone and Mineral Research, the Journal with the highest impact factor in the discipline of bone and mineral disorders.

A call to action - translating research to improve chronic wound outcomes, 27 March

We have national and international experts in the field of pressure injury and venus leg ulcers who will present on novel and innovative interventions which can help improve chronic wound conditions.

Register by Monday 26 February to take advantage of early bird rates!

NHMRC Project Grants Applications - Minimum Data & Compliance due date - Wednesday 14 February

A reminder that time is running out to initiate your NHMRC Project Grant applications in RGMS. 

NHMRC Project Grants applications must be initiated and all minimum data must be completed in RGMS by 17.00 AEDT Wednesday 14th February 2018. Applications not initiated or not meeting minimum data after that time will not be eligible.   

• Minimum Data - due 17.00 AEDT Wednesday 14 February 2018

Minimum data for the Project Grant scheme consists of the following:

• General: Administering Institution, Application Title, Aboriginal/Torres Strait Islander Research (yes/no), and Synopsis
• A-RC: Research Classification: all sections
• B-GRPN: Grant Review Panel Nomination: all sections including Clinical Trial and Cohort Study.

Applications that fail to satisfy this requirement will not be accepted. Applicants are also reminded to complete the recommended fields as outlined above with correct information. Using placeholder text such as “text”, “synopsis” or “xx” etc. is not acceptable as minimum data.

The MRO will start checking minimum data for all Project Grants initiated in RGMS later this week. 

• Limits on Project Grant applications in 2018

The maximum number of applications any CI (CIA-CIJ) may submit in the 2018 Project Grant round for NHMRC funding is two. The maximum number of Project Grants a CI (CIA-CIJ) can hold is six.

For the purpose of determining eligibility for this round, the number of Project Grants an applicant holds is the number scheduled to continue from 1 January 2019. For example, if an applicant will hold five active Project Grants in 2019, only one Project Grant application may be submitted in 2018.

If you are a Program Grant holder, different rules apply - please contact the MRO to confirm your eligibility to apply for a Project Grant. 

• MRO Submission Process

The MRO submission process document is attached HERE for your information. The compliance & eligibility checking close date is Wednesday 14th February 2018. Requests for checks are made via Pure (please see attached HERE quick reference guide to Pure if required). We are already checking applications, so as soon as you have a near complete draft (including budget) in RGMS, please let us know via Pure.

Key dates:

Any questions?

If you have any questions about the NHMRC Project Grants, please contact the MHS Team. 

2018 MIME seed fund round, meeting on 19 March

Monash Institute of Medical Engineering (MIME) is preparing to launch its annual seed fund. The 2018 MIME Seed Fund will be launched through a series of affinity meetings with our partner hospitals.

Click on the link below to RSVP to attend the meeting.

Monday, 19 March MIME Monash Health Affinity Meeting 3.30 – 5.30 pm

The 2018 round of the MIME Seed Fund is designed to build on the collaborative framework of MIME established in recent years. There will be up to $500,000 available in the 2018 funding round. Applications may request up to $50,000 per project for medtech collaborative projects involving a MNHS clinician researcher and a Monash engineering or IT researcher. Cardiac themed proposals will be highly regarded and may attract a higher level of funding. Successful applicants of the 2016 MIME Seed Fund round are also invited to apply for top up funding as part of the 2018 round.

The funding will be directed to projects that can achieve a meaningful outcome within 12-18 months, e.g. proof-of-concept data or initial prototype. The seed funding is aimed at progressing a project to the point that the research team is well positioned to then secure external funding from industry or grants to progress the next phase of the R&D.

Like the previous rounds of the MIME Seed Fund, there will be two stages to the application process: an initial call to clinicians to define areas of unmet clinical need, followed by an invitation to all Monash staff to respond with proposed solutions. All Monash staff are eligible to participate in the multidisciplinary ‘solution' teams. Researchers from MIME partner institutions are also invited to participate as members of the collaborative teams.

Important Dates

Date	Item
19 March	MIME Monash Health Affinity Meeting
19 March 2018	Call to clinicians for unmet needs opens
3 April 2018	Call to clinicians for unmet needs closes
9 April 2018	Selected proposals announced on our website
11 April 2018	Call for solutions opens
26 April 2018	Call for solutions closes
4 - 15 June 2018	Panel interviews
1 July 2018	Announcement of successful candidates

For further details regarding the 2018 MIME Seed Fund please visit the MIME Seed Fund webpage https://www.monash.edu/mime/seed 

To RSVP to attend the MIME Monash Affinity Meeting or if you are a clinician researcher wishing to present please complete the attached Google form HERE or contact MIME’s Executive Officer Susan Newland susan.newland@monash.edu

2018 Prizes & Awards Calendar - March to April

Please refer to the attached Prizes & Awards Calendar (HERE) for opportunities closing in March and April 2018. 

Of particular note are the L'Oreal-UNESCO for Women in Science Australia & New Zealand Fellowship (opened on 26 January) and the Young Tall Poppy Science Awards (opening on 26 February), so it might be good to start thinking of suitable candidates now.

A comprehensive list of world-wide prestigious prizes and awards eligible to Australian researchers is also available at Research Professional.

If you are a Monash member of staff and intend to apply for any of the listed prizes or awards, please contact Mind Your Way, an academic consultancy engaged on the Monash Prizes & Awards Strategy on behalf of the Office of the Provost and Senior Vice-President. Only Monash staff are eligible to access Mind Your Way services paid by the Office of the Provost and Senior Vice-President. Adjuncts and affiliates wishing to engage Mind Your Way will have to enter into a contract and pay directly for services offered by Mind Your Way.

If, as part of the eligibility criteria, there are limits on numbers of applications that can be submitted by Monash, approval must be sought and obtained by the appropriate delegated individual.

Ergonomics & setting up your workstation properly

Ergonomic injuries can be debilitating, and are more common than you might think. Ergonomic Principles is a new online module available in myDevelopment to help you set up your office workstation correctly, to help prevent strain in the back, neck and shoulders. 

Ergonomic Principles is an interactive resource to help you review your current workstation set-up and work practices, and make changes as required. 

For further information please see the SCS intranet. 

Consensus Opinion on Diagnosis and Management of Thrombotic Microangiopathy in Australia and New Zealand

Jake Shortt et al. published in Nephrology.

Read article here.

Sharing the pain. Lessons from missed opportunities for healthcare improvement from patient complaints and litigation in the Australian health system

Euan Wallace et al. published in Australian Health Review.

Read article here.

No effect of saturated fatty acid chain length on meal induced thermogenesis in overweight men

Kay Nguo et al. published in Nutrition Research

Read article here.

The Use of Tissue Glue for Circumcision in Children: Systematic Review and Meta-Analysis

Maurizio Pacilli et al. published in Urology.

Read article here.

Regulatory T cells in renal disease

Maliha Alikhan et al. published in Clinical & Translational Immunology.

Read article here.

Lupus Low Disease Activity State (LLDAS) attainment discriminates responders in a systemic lupus erythematosus trial: post-hoc analysis of the Phase IIb MUSE trial of anifrolumab

Eric Morand et al. published in Annals of the Rheumatic Diseases.

Read article here.

Long-term Outcomes of Gastroenteropancreatic Neuroendocrine Tumors

Eva Segelov et al. published in Pancreas.

Read article here.

Expression of Androgen Receptor Splice Variant 7 or 9 in Whole Blood Does Not Predict Response to Androgen-Axis-targeting Agents in Metastatic Castration-resistant Prostate Cancer

Arun Azad et al. published in European Urology.

Read article here.

Systematic review of high-level mobility training in people with a neurological impairment

Tanja Spencer, Michael Fahey et al. published in Brain Injury.

Read article here.

A point-prevalence survey of alcohol-related presentations to Australasian emergency departments

Diana Egerton-Warburton et al. published in the Australian and New Zealand Journal of Public Health.

Read article here.

Corrigendum: Risk of colorectal cancer for carriers of a germ-line mutation in POLE or POLD1

Melissa Southey et al. published in Genetics in Medicine.

Read article here.

Uptake of maternal vaccinations by Indigenous women in Central Australia

Sushena Krishnaswamy et al. published in the Australian and New Zealand Journal of Public Health.

Read article here.

Strategies to implement maternal vaccination: A comparison between standing orders for midwife delivery, a hospital based maternal immunisation service and primary care

Sushena Krishnaswamy et al. published in Vaccine.

Read article here.

Successful treatment of Nerium oleander toxicity with titrated Digoxin Fab antibody dosing

Anselm Wong et al. published in Clinical Toxicology.

Read article here.

Extracellular Vesicles in Human Reproduction in Health and Disease

Lois Salamonsen et al. published in Endocrine Reviews.

Read article here.

Omega-3 Polyunsaturated Fatty Acid Supplementation to Prevent Arteriovenous Fistula and Graft Failure: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Kevan Polkinghorne et al. published in the American Journal of Kidney Disease.

Read article here.

Transformative effects of Aboriginal health placements for medical, nursing, and allied health students: A systematic review

Claire Palermo et al. published in Nursing & Health Sciences.

Read article here.

Prescription of antihypertensive medication at discharge influences survival following stroke

Joosup Kim et al. published in Neurology.

Read article here.