Academic Department
Szalmuk Family Department of Medical Oncology - Projects

Main Areas of Research

Targeted therapies
These are drugs with a focused mechanism that specifically acts on well-defined targets or biological pathways that, when inactivated, causes regression or destruction of the malignant process. Examples of this type of targeted therapy include hormonal-based therapies in breast and prostate cancer; small-molecule inhibitors of the epidermal growth factor receptor pathway in lung, breast, and colorectal cancers; blockers of invasion and metastasis enabling proteins and enzymes; antiangiogenesis agents; proapoptotic drugs; and proteasome inhibitors.

Cancer Genetics
Genetic information, including information from family history and from DNA-based testing, provides a means to identify people who have an increased risk of cancer. Identifying a person with an increased risk of cancer can, through clinical management strategies to reduce risk (e.g., tamoxifen for breast cancer, colonoscopy for colon cancer) or through intrinsic benefits of the information itself (e.g., no genetic predisposition), improve that person's health outcome or quality of life. Intrinsic benefits may include better informed choice about family planning, retirement, and other life decisions. Methods of genetic risk assessment include assessment of family history and genetic testing. Current research focuses on identification of high-risk patients and appropriate screening for them.

Supportive Therapies
These are agents that alleviate or prevent development of symptoms related to cancer, or alleviate the toxic side-effects of chemotherapy. An example of the former would be zolendronic acid, an agent that prevents progressive bone destruction caused by cancer invading the skeleton. From the latter, agents such as granulocyte colony-stimulating factor would be a good example. Long-acting forms of this medication reduce the risk of infection associated with myelosuppressive drugs.

Translation of Research In To Practice

The successful introduction of small growth regulating molecules into clinical practice is one instance of translation of research into practice. For example, an new agent lapitinib, which has been trialed at Cabrini Hospital was found when combined with capecitabine to delay the progression of breast cancer for nearly twice as long as did treatment with capecitabine alone in patients with advanced breast cancer that had progressed following treatment with trastuzumab (Herceptin®). In separate clinical trials, two new targeted drugs - sunitinib (Sutent®) and temsirolimus - have shown positive results in patients with advanced kidney cancer, offering new standards of care, according to findings presented at the 2006 meeting of the American Society of Clinical Oncology.

Two studies using agents trialed at Cabrini showed benefit for patients with multiple myeloma. Elderly patients with multiple myeloma who were treated with the drug thalidomide in addition to standard chemotherapy lived 15 to 21 months longer on average than patients who received either high doses of a standard drug followed by a stem cell transplant or standard chemotherapy alone. Combining lenalidomide with dexamethasone delayed the progression of advanced multiple myeloma for more than twice as long as did dexamethasone alone in patients whose disease had come back or stopped responding to other treatments.

Finally longer follow-up data from a large international phase III trial of post-menopausal women with breast cancer carried out bat Cabrini Hospital who switched to the drug exemestane (Aromasin®) after several years on tamoxifen confirm a delay in disease progression and also show a survival advantage, compared to women who stayed on tamoxifen.

Collaborative Research Groups

Oncology research trials are usually part of a collaborative effort. Our current collaboration partners are:

National Cancer Institute
American Association for Cancer Research
American Society of Clinical Oncology
Clinical Oncology Society of Australia
Medical Oncology Group of Australia
Gynaecology Oncology Group
Australia & New Zealand Gynaecological Oncology Group
Australasian Leukaemia &Lymphoma Group
Australia & New Zealand Breast Cancer Trials Group
Breast Cancer International Research Group
International Association for the Study of Lung Cancer
Thoracic Society of Australia
Haematology Society of Australia
International Society of Gynaecologic Oncology
Australasian Gastro-Intestinal Trials Group

Recent Publications

Marc Peeters, Eric Van Cutsem, Salvatore Sienna, Yves Humblet, Alain Hendlisz, Bart Neyns, Jean Luc Canon, Jean Luc Van Leathem, Joan Maurel, Gary Richardson, The Panitumumab study team (Amgen; Abgenix). A Phase 3, Multicentre, Randomized Controlled Trial Of Panitumumab Plus Best Supportive Care Vs BSC Alone In Patients With Refractory Metastatic Colorectal Cancer. New Engl J Med (submitted)
Marc Peeters,Eric Van Cutsem,Salvatore Sienna, Yves Humblet, Alain Hendlisz, Bart Neyns, Jean Luc Canon, Jean Luc Van Leathem, Joan Maurel, Gary Richardson, The Panitumumab study team (Amgen; Abgenix). Treatment Effect on Progression-Free Survival (PFS), Objective Response Rates (ORR), and Survival By Skin Rash Severity: Exploratory Results from a Phase 3, Randomized Controlled Trial of Panitumumab vs. Best Supportive Care (BSC). J Clin Oncol (submitted)
Ruddle JB, Harper CA, Honemann D, Seymour JF, Prince HM. A denileukin diftitox (Ontak) associated retinopathy? Br J Ophthalmol. 2006 Aug;90(8):1070-1.
Cachin F, Prince HM, Hogg A, Ware RE, Hicks RJ. Powerful prognostic stratification by [18F]fluorodeoxyglucose positron emission tomography in patients with metastatic breast cancer treated with high-dose chemotherapy. J Clin Oncol. 2006 1;24(19):3026-31.
Tam CS, Wolf M, Prince HM, Januszewicz EH, Westerman D, Lin KI, Carney D, Seymour JF. Fludarabine, cyclophosphamide, and rituximab for the treatment of patients with chronic lymphocytic leukemia or indolent non-Hodgkin lymphoma.
Cancer. 2006 Jun 1;106(11):2412-20.
Robinson HE, Maxwell EL, Prince HM, O'Reilly MA, Jakobovits A. Cefotetan-induced life-threatening haemolysis. Med J Aust. 2006 Mar 6;184(5):251.
Ng AP, Lade S, Rutherford T, McCormack C, Prince HM, Westerman DA. Primary cutaneous CD4+/CD56+ hematodermic neoplasm (blastic NK-cell lymphoma): a report of five cases. Haematologica. 2006 Jan;91(1):143-4.
Gandhi MK, Lambley E, Burrows J, Dua U, Elliott S, Shaw PJ, Prince HM, Wolf M, Clarke K, Underhill C, Mills T, Mollee P, Gill D, Marlton P, Seymour JF, Khanna R. Plasma Epstein-Barr virus (EBV) DNA is a biomarker for EBV-positive Hodgkin's lymphoma. Clin Cancer Res. 2006 Jan 15;12(2):460-4.
Thompson M, Wall DM, Hicks RJ, Prince HM. In vivo tracking for cell therapies.
Q J Nucl Med Mol Imaging. 2005 Dec;49(4):339-48.
Westwood JA, Smyth MJ, Teng MW, Moeller M, Trapani JA, Scott AM, Smyth FE, Cartwright GA, Power BE, Honemann D, Prince HM, Darcy PK, Kershaw MH. Adoptive transfer of T cells modified with a humanized chimeric receptor gene inhibits growth of Lewis-Y-expressing tumors in mice. Proc Natl Acad Sci U S A. 2005 Dec 27;102(52):19051-6.
Anderson KC, Prince HM. Lenalidomide and thalidomide: an evolving paradigm for the management of multiple myeloma. Semin Hematol. 2005 Oct;42(4 Suppl 4):S1-2.
Gibbs SD, O'Grady J, Seymour JF, Prince HM. Bisphosphonate-induced osteonecrosis of the jaw requires early detection and intervention. Med J Aust. 2005 Nov 21;183(10):549-50.
Mileshkin LR, Seymour JF, Wolf MM, Gates P, Januszewicz EH, Joyce P, Prince HM. Cardiovascular toxicity is increased, but manageable, during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for patients aged 60 years and older. Leuk Lymphoma. 2005 Nov;46(11):1575-9.
Tam CS, Wolf MM, Westerman D, Januszewicz EH, Prince HM, Seymour JF. Fludarabine combination therapy is highly effective in first-line and salvage treatment of patients with Waldenstrom's macroglobulinemia. Clin Lymphoma Myeloma. 2005 Sep;6(2):136-9. Early B-cell chronic lymphocytic leukemia presenting as cutaneous lesions with a normal peripheral blood lymphocyte count. J Am Acad Dermatol. 2005 Sep;53(3):535-6.
Prince HM, Mileshkin L, Roberts A, Ganju V, Underhill C, Catalano J, Bell R, Seymour JF, Westerman D, Simmons PJ, Lillie K, Milner AD, Iulio JD, Zeldis JB, Ramsay R. A multicenter phase II trial of thalidomide and celecoxib for patients with relapsed and refractory multiple myeloma. Clin Cancer Res. 2005 Aug 1;11(15):5504-14.
Mileshkin L, Prince HM. The adverse prognostic impact of advanced age in multiple myeloma. Leuk Lymphoma. 2005 Jul;46(7):951-66.
Seshadri T, Prince HM, Bell DR, Coughlin PB, James PP, Richardson GE, Chern B, Briggs P, Norman J, Olver IN, Karapetis C, Stewart J; Australian Cancer Anaemia Study Group. The Australian Cancer Anaemia Survey: a snapshot of anaemia in adult patients with cancer. Med J Aust. 2005 May 2;182(9):453-7.
McMurrick P, Dorien S, Shapiro J.Bowel cancer - guide for the GP. Aust Fam Physician. 2006 Apr;35(4):192-7.
Lim L, Gibbs P, Yip D, Shapiro JD, Dowling R, Smith D, Little A, Bailey W, Liechtenstein M. Prospective study of treatment with selective internal radiation therapy spheres in patients with unresectable primary or secondary hepatic malignancies. Intern Med J. 2005;35(4):222-7.