NZSO Dwyer

Professor Terry Dwyer

Terry is a non-communicable disease epidemiologist with extensive experience in the conduct of cohort and case control studies.

He was previously Director of the Murdoch Children’s Research Institute at the Royal Children’s Hospital, Melbourne, coordinating research projects including those on cancer, heart disease, multiple sclerosis, childhood asthma, and diabetes.

His work has focussed on infant and child health. His team's research on Sudden Infant Death Syndrome and sleeping position was recognised by the NHMRC, Australia, as one of the most important contributions to medical research by Australia in the 20th Century.

He is currently playing a leading role in two large global cohort collaborations. The first involves a collaboration of birth cohorts in more than ten countries to obtain prospective evidence on the causes of childhood cancer.

The second study is focused on following around 40,000 subjects who were first measured at school age and are now moving into their fourth and fifth decades. This study seeks to estimate the separate effect of childhood physical and lifestyle characteristics on risk of major adult diseases such as type 2 diabetes and cardiovascular disease.

In his work Terry has developed skills in the development of environmental and lifestyle measures, in genetic measures, and the analysis of gene-environment interactions, particularly in the setting of cohort studies, including those set in early life.

Bruce Cain Memorial Lecture: Addressing the gaps in evidence for prevention of rarer cancers and cancers with long lead times

Prospective cohort data has been central to gaining an understanding of preventable causes of major diseases of humans including the common cancers. It played a part in confirming the role of smoking in lung cancer and in defining the role of serum cholesterol and blood pressure in cardiovascular diseases. Prospective evidence has been less available for rarer cancers, particularly those occurring in childhood. There has also been a lack of prospective data to investigate the role of exposures that might be important in aetiology decades before cancers occur in adults.

For rare cancers huge prospective studies are required to provide the necessary power to detect associations of importance. Cohort studies with measurement of exposures of interest from early life are often small and also face power limitations. Nonetheless, platforms with sufficient numbers of participants obtained through global collaborations are now being assembled and are able to start addressing key questions.

It is now approximately seventy years since the early cohort studies that proved to be so influential were initiated. Is there anything that can be learnt from the game changing experience of the COVID-19 pandemic that might help us accelerate production of knowledge for cancer prevention, and what part might New Zealand play in future global initiatives.

NZSO Kinross

Mr James Kinross

Mr Kinross is a consultant colorectal surgeon, at St. Mary's Hospital London. His clinical interests are in minimally invasive and laparoscopic surgery for the treatment of colorectal cancer. He also has an interest in surgical nutrition and modulation of the gut microbiota by pro and prebiotics for improved operative outcomes.

He was trained in Northwest London, and he was an NIHR Clinical Lecturer in Surgery and an Ethicon Laparoscopic Fellow in Colorectal Surgery. He was awarded a Royal College of Surgeons of England training fellowship during his PhD. He is a visiting Professor at the Royal College of Surgeons of Ireland.

He performs translational research into computational and systems biology in surgery. Specifically, he is involved in clinical trials using intra-operative mass spectrometry (known as Real-time Electrospray Ionisation Mass Spectrometry or REIMS) for improving precision in the surgical treatment of colorectal cancer.

Dr Kinross also studies the role of the gut microbiome in the aetiology of colon cancer, Crohn's disease and obesity. This is because intestinal inflammation is a common pathway across all conditions. The aim is to develop novel biomarkers for the early detection of bowel cancer, and to develop novel therapies for its treatment based on a deeper understanding of how the microbiota that reside in the gut influence tumour biology and the response of cancer to treatment.

Finally, he has a separate interest in the educational application of virtual worlds and gaming technologies for surgical and medical education. He works as part of a team that is building next generation, immersive simulators for use in major incidents and trauma training.

Leveraging the gut microbiome for improving clinical outcomes in colorectal cancer

The gut microbiome represents a novel therapeutic target for the prevention and treatment of colorectal cancer. However, the mechanisms through which microbiota regulate tumour response, drug efficacy and toxicity remain poorly defined.

This talk will provide an overview of current approaches attempting to mine the gut microbiome for therapeutic benefit, and it will focus specifically on the role of gut microbial co-metabolism as a translational target for cancer therapy.

Specifically, it will address how metabonomics provides functional insight into the role played by the gut microbiome in cancer initiation and progression and it will outline how future oncology trials can be optimised for functional analysis of microbiome-cancer interactions.

NZSO Rizos pic

Professor Helen Rizos

Professor Rizos is a leading person in Melanoma and Immunotherapy and she is a key member of the Melanoma Institute of Australia (MIA). She holds a NHMRC Senior Research Fellowship as

a principal investigator and she has a very active and translational research program.

She is a cancer cell biologist with an international reputation in the field of melanoma senescence, tumour suppressor proteins and oncoproteins. Her work combines genetic analyses of melanoma tumours with functional molecular and cell biology in order to understand the role and regulation of genes and cellular pathways that influence the development and therapeutic response of melanoma.

Professor Rizos moved to Macquarie University in 2014 with her research team and Professor Kefford. Her research will continue to focus on melanoma cell biology and Macquarie University has all the required facilities and infrastructure. In 2017, Professor Rizos and her team won the Wildfire Highly Cited Publication Award from Cancer Institute NSW's Premier Awards for Outstanding Cancer Research.

Predictive biomarkers for immune checkpoint inhibitors in melanoma

The last five years has seen remarkable improvements in the survival of patients with advanced melanoma due to the use of immune checkpoint inhibitors. These inhibitors target the cytotoxic T-lymphocyte antigen 4 (CTLA-4; ipilimumab) and programmed death-1 (PD-1; nivolumab and pembrolizumab) receptors to promote T cell-mediated anti-tumor activity and durable responses.

Despite the impressive activity of these immune checkpoint inhibitors, 40-60% of melanoma patients will not respond to initial treatment and a subset of responding patients will ultimately develop resistance. Further, for patients treated with the combination of PD-1 and CTLA-4 inhibitors over 50% will develop grade III/IV immune-related adverse events.

There is therefore an urgent need to identify biomarkers that accurately predict for treatment response, and guide the selection of novel combination therapies for patients who acquire resistance. There is also a requirement to accurately predict whether response will be associated with significant adverse events.

In this presentation, the current state of biomarkers that predict response to immunotherapies, including circulating markers will be discussed.

NZSO Sabe pic

Professor Sabe Sabesan

Professor Sabesan BMBS PhD FRACP is the director of medical oncology at the Townsville Cancer Centre, Townsville University hospital in Queensland, Australia. He has designed, implemented and evaluated various teleoncology models for consultation, chemotherapy administration, training and clinical trial across the state and Australia. His program was rated “High” for Impact, Engagement and Path to Engagement by the Australian Research Council in 2019. His team’s research has informed the development of COSA Practice Guidelines for teleoncology, Queensland Remote Chemotherapy Supervision model and the Australasian Teletrial Model and contributed to the Canadian Rural Clinical Trial Framework.

Teletrial model for enhancing clinical trial access and recruitment

Cancer community faces ongoing issues with equity of access to clinical trials for rural patients and lower rate of recruitment of patients with rare cancers even within metropolitan settings.

Teletrial model uses telehealth to link smaller and larger centres and rural centres and allows patients to take part in some or all aspects of trials closer to home. Australasian Teletrial Model developed by COSA outlines the governance for safety and quality of the model and standard operating procedures articulate the operational requirements.

NZSO Di photo

Photograph by Virginia McMillan courtesy of New Zealand Doctor

Professor Diana Sarfati

Professor Diana Sarfati (MBChB, MPH, PhD, FNZCPHM) is Chief Executive for Cancer Control. As a public health physician, cancer epidemiologist and health services researcher, Diana brings a commitment to improving equity and cancer outcomes through evidence-based, person-centred care and using strong collective expertise.

Diana was appointed as Head of the Department of Public Health in 2014, and was the Director of the Cancer and Chronic Conditions (C3) research group at University of Otago, Wellington. She has led a large body of research relating to disparities in cancer outcomes. This work has resulted in the identification of key patient and health system factors that influence cancer survival. It has been used extensively by health policy makers, clinicians and other researchers to develop policies and practices that aim to reduce inequities in cancer outcomes

Diana is currently a member of the International Advisory Committee to Lancet Oncology, the Advisory Committee to International Agency for Research on Cancer’s (IARC) Pacific cancer hub, IARC’s international expert group on social inequalities in cancer, the Academic Advisory Committee on the International Cancer Benchmarking Project, and she led a Lancet Oncology series on cancer in small island developing states. Diana is a former member of the National Cancer Programme Leadership Board, the National Screening Advisory Group, the National Ethics Advisory Committee, the Bowel Cancer Taskforce and the National Bowel Cancer Screening Advisory Committee.

Overview of subject:

Te Aho o Te Kahu, the Cancer Control Agency became a legal entity on 1 Dec 2019. It’s purpose is to lead and unite efforts to deliver better cancer outcomes to New Zealanders. We are equity-led, knowledge-driven, person and whānau centred, and outcomes focused. Our work programme is broad and ambitious. We have a strong focus on supporting clinical quality improvement and consistency around the country with the aim of eliminating inequity. Our work is underpinned by strong clinical governance and engagement, which was critical in our ability to respond to the COVID crisis to provide clear guidance relating to cancer diagnosis and treatment during that period. We are also working closely with clinicians and others to strengthen our approach to supporting access to clinical trials. In this presentation, I will outline the structure, function and purpose of the Agency and outline some of the priority work that is currently underway to assist both the clinical and research cancer environment.