Celebrating our two-year anniversary
Today, 1 May 2020, we celebrate two-years of activity of the Cancer Health Services Research group, established as one of the strategic research programs in the Victorian Comprehensive Cancer Centre (VCCC). While we pay respect to many colleagues who are committed to work and manage with this difficult COVID-19 period, it is also good to celebrate progress and to share the success of collaboration.
Photo: Since this group photo was taken on 4 February 2020, we have welcomed Riccarda Peters, Sophie O’Haire and Grace Chazan.
In the two years of our existence, we have developed successful partnerships and collaborations with many clinical and non-clinical research groups across the VCCC partners. Our team now has 14 research and professional staff and we are expecting a few more colleagues on different externally funded projects. In two years, we have curated a very talented multidisciplinary team with backgrounds in statistics and data science, public health, simulation modelling and health economics as well as honorary staff with advanced clinical and molecular biology degrees.
There have been many highlights in the two years, with some of our key achievements included below.
The VCCC data-driven research hub has become the platform for all our work on data and clinical registries. We have developed strong research collaborations with the data custodians and their teams managing several clinical registries, including primary care (NPS medicines insight), prostate cancer (ePAD), colorectal cancer (TRACC), melanoma (MRV), pancreatic cancer (PURPLE) and lung cancer (TMC). We have developed the tools to map treatment patterns and studied the effect of different drug treatment sequences on outcomes.
Currently, we expand our work to study the health economic impact of cancer treatment and the use of linked data to study the cancer care continuum. This facilitates new projects investigating the effects of diagnostic delays on cancer outcomes. An exciting new program of work, to be led by a new staff member, is the use of linked data to map disparities in health service utilisation in colorectal cancer survivors.
Our initial work on registries has leveraged many other projects. Such as with the Thoracic Malignancies Cohort, where a stunning multi-disciplinary collaboration has emerged with the Peter MacCallum Cancer Centre (PMCC) lung cancer team, investigating treatment patterns for lung cancer patients with different mutational profiles and, more recently, work to investigate changes in clinical management as part of COVID-19. A similar opportunity arises for the MRV registry, with collaborations across Victoria.
We also leverage both registries and linked datasets to study immunotherapy-related toxicities and their impact on health services. The PRECEPT project is another example, where we use real-world registry data to develop a decision model to analyse if new biomarkers such as ctDNA can support treatment decisions in localised prostate cancer. Similar work is being proposed for guiding adjuvant treatment decisions in colorectal cancer. PRECEPT also is the first project to integrate patient preferences, which emerged from our work with the VCCC consumer and engagement committee. Patient preference research likely will become a new focus for us, because of increasing interest from the familiar cancer centre and an involvement in studies on immunotherapy in kidney cancer.
Very exciting is our involvement in the University of Melbourne Centre for Cancer Research (UMCCR) Precision Oncology program and the work with the Peter MacCallum Cancer Centre (PMCC) department of pathology. We are in the final stages of launching a health economics and cancer genomics platform as part of the Illumina – University of Melbourne partnership. This platform aims to leverage projects studying the health economics and service implications of comprehensive genomic profiling in cancer management.
Our work is to provide the health economic evidence for genomic testing to be accessible and available for all cancer patients, such as in the work for iPREDICT. Two other projects have already started; one with the haematology group at PMCC, establishing the evidence base for complex genomic testing in chronic lymphocytic leukaemia (CLL) and acute lymphoblastic leukaemia (ALL) blood cancers. And a second project is to be launched evaluating the use of ctDNA liquid biopsies to facilitate access to molecular testing for all Victorians reducing potential disparities.
Many projects rely on data and on clinical and health economic evidence. Therefore, “our” ‘clinical trial metrics team’ is managing a dedicated portfolio of projects to map clinical trial participation in Victoria, to analyse disparities in access to cancer clinical trials and to develop rigorous methodology, based on multi-criteria decision analysis, to determine the value of trials to support clinical trial units managing a portfolio. But we also look into new ways to use real-world and clinical registry data to inform and simulate clinical trials, such as the use of synthetic control groups for single-arm clinical trials.
Those who make it all possible
We are most thankful to our funders, who initiated and supported us throughout the two years. Obviously, the VCCC and the University of Melbourne, who had the vision to start this group and provided the resources to make this all happen. Melbourne Genomics Health Alliance for providing the resources to tap into the world of genomics and blood cancers, MOVEMBER for funding the PRECEPT project and the Department of Health and Human Services for funding a program of work on disparities in cancer survivorship with the Cancer Survivorship Centre at PMCC.
While writing an update like this, you finally come to the point where you have to decide if it is appropriate to acknowledge people. While many people have been critical in the development of this group, naming them all would be a Herculean task and will likely be full of omissions. We therefore conclude with acknowledging the VCCC staff and leadership, the MSPGH leadership, the UMCCR executive and support team, the Gibbs team in the Personalised Oncology division at the Walter and Eliza Hall Institute, the MSPGH Health Economics unit, the MSPGH Biostatistics/Epidemiology units and the many fantastic collaborators in Peter MacCallum Cancer Centre and other VCCC alliance partners. It’s been a great adventure to work with you all.
The Cancer Health Services Research group was established as part of the VCCC strategy to develop capacity in data-driven cancer health services research, and is embedded in the Centre for Health Policy in the University of Melbourne School of Population and Global Health (MSPGH). The group is an active member of the University of Melbourne Centre for Cancer Research (UMCCR) and based on level 13 in the VCCC building.