Colorectal Cancer

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In collaboration with medical oncologists Dr Connie Diakos, Associate Professor Nick Pavlakis, Professor Stephen Clarke and others, our bowel cancer research is aimed at improving treatment of colorectal (or bowel) cancer.

Over the past 10 years, with the introduction of new chemotherapy agents and targeted therapies for colorectal cancer, people are living longer and better lives.  These drugs however carry the risks of considerable side-effects and financial costs. Bill Walsh Lab projects in colorectal cancer focus on identifying markers that can predict patient outcome to therapy or classify their prognosis, as well improving treatment in these patients using new technologies.

Colorectal cancer is the 3rd most commonly diagnosed cancer in NSW

Colorectal cancer is the 2nd most common cause of cancer-related death

1 in 13 people will be diagnosed with colorectal cancer by 85 years of age

Bowel Cancer Clinician Researcher: Dr Connie Diakos

Dr Connie Diakos is a clinician scientist and medical oncology involved in the treatment of gastrointestinal, neuroendocrine tumours, breast and gynaecological cancers at Royal North Shore Hospital and the Northern Cancer Institute. She has an extensive research background, having completed a PhD examining the mechanism of action of platinum anti-cancer drugs. Her work now centres around inflammation, being a hallmark of cancer, and its relation to the immune response.

Projects

1. 1. The Role of Inflammation in Colorectal Cancer

Dr Connie Diakos, Dr Joseph Chan, Dr Kellie Charles (Dept of Pharmacology, University of Sydney), Prof Stephen Clarke

Our research is focused on:
•    identifying new biomarkers for colorectal cancer and determining their utility in predicting the recurrence of cancer or response to chemotherapy
•    investigating the role of inflammation in colorectal cancer

An important challenge in treating patients with colorectal cancer is identifying those with early disease more likely to have their cancer recur and derive benefit from chemotherapy, and those with advanced disease more likely to develop severe side-effects. Current means of predicting treatment response are imperfect. In this age of personalised medicine, biomarkers to predict response or side-effects are therefore sought to guide the selection of better-tolerated drugs or early implementation of supportive therapies.

We are focusing on the search for blood-based biomarkers as these are easily obtained and allow for simple, inexpensive and repeated testing. These markers are reflective of cancer-specific and cancer-related processes and will present the opportunity for new cancer treatments as they will provide targets for therapy.

2. Identifying prognostic protein markers in colorectal cancer tumour

Dr Sarah Hayes, Dr Connie Diakos, Prof Stephen Clarke, A/Prof Viive Howell

One strategy to improve colorectal cancer patient outcome is to identify those patients that will benefit from further treatment beyond surgery or will require intensive post-treatment monitoring. There is currently an unmet need for highly sensitive and specific prognostic biomarkers that are capable of identifying patients whose cancer is highly likely to recur, progress, and/or spread despite therapy. Using powerful mass spectrometry, we have identified 21 key prognostic proteins in frozen tissue from colorectal cancer patients that may have utility for classifying patient prognosis up to three years post-surgery. Our current work involves validating our findings in tumours from a large number of colorectal cancer patients that received surgery here at Royal North Shore Hospital. Our research may assist our medical oncologists individualise treatment for a patient following surgery.

Funding: Philanthropic support from the Peter Pickles Foundation

3. Exploring a novel nanotechnology strategy for the neo-adjuvant treatment of colorectal cancer by photodynamic therapy and ionising radiation

Dr Wei Deng, A/Prof Viive Howell, A/Prof Ewa Goldys, Prof Alexander Engel

By combining two clinically accepts therapies, photodynamic therapy and ionising radiation we plan to develop a novel treatment strategy for colorectal cancer. This project will produce gold-labelled nanoparticles for enhance photodynamic therapy in deep tissue in a xenograft in vivo model. Once approved for human therapy this may reduce the radiation-induced mortality and/or increase treatment efficacy.

Funding: Ramsay Research and Teaching Award

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