Review of the ANZGOG Annual Scientific Meeting 2018
The Annual Scientific Meeting (ASM) of the Australia New Zealand Gynaecological Oncology Group (ANZGOG) was held in Brisbane from 4 to 7 April, with the theme “Challenges in Precision Gynaecological Cancer in a Molecular Era”.
In this article, four members of ANZGOG share their highlights from the Meeting:
- Dr Paul Cohen, Director of Gynaecological Cancer Research at St John of God Subiaco Hospital in Perth, and Chair of the ASM Committee
- Associate Professor Pam Pollock, Principal Research Fellow at the Queensland University of Technology
- Anne Mellon, Clinical Nurse Consultant at John Hunter Hospital NSW
- Dr Amy Jamieson, Gynaecological Oncology Fellow at Westmead Hospital NSW
Dr Paul Cohen: opportunities Arising from the meeting
The ANZGOG Annual Scientific Meeting provides the ultimate opportunity for researchers, clinicians, nurses and clinical research officers with an interest in gynaecological cancer to hear about the extraordinary research being generated by ANZGOG and collaborators internationally, to build collaborations with international guests and their units overseas, and present new research concepts for review by relevant leaders.
We were extremely fortunate to hear from three internationally renowned clinician-researchers:
- Dr Martee Hensley, Medical Oncologist, at the Memorial Sloan Kettering Cancer Center in the USA
Dr Hensley’s talk highlighted the challenges of treating women with uterine sarcomas. She spoke of the opportunity to explore how molecular testing may improve diagnostic classification, yield prognostic information, and identify potential treatment targets for a subset of patients.
- Professor Michael Milosevic, Radiation Oncologist, at the Princess Margaret Cancer Centre in Canada
Professor Milosevic spoke about an exciting novel drug that in pre-clinical models of cervical cancer increases the efficacy of pelvic radiation therapy and simultaneously limits the toxicities of therapy. It is hoped that this drug will soon enter clinical trials.
- Associate Professor Jessica McAlpine, Gynaecologic Oncologist, at the University of British Colombia in Canada
Associate Professor McAlpine’s talk reviewed the need for, evolution of, and applications (tested and intended) for novel molecular classifiers in endometrial cancer and how these may improve outcomes for our patients.
One of the main outcomes of the Meeting will hopefully be more Australia and New Zealand centres becoming recruiting sites, which will lead to an increase in the numbers of women enrolled in clinical trials, and improved survival and wellbeing for women with gynaecological cancers.
Attending delegates told me that the meeting reminds us ‘why we do what we do’, and that they are energised and filled with enthusiasm for generating future study concepts.
Associate Professor Pam Pollock: Pure Science Symposium
The Pure Science Symposium showcased the high quality gynaecological research being performed in Australia. We had a diverse mix of speakers including those with strong research in other cancers but whose research has moved into a gynae cancer or has expanded to now include ovarian cancer.
We heard about several new compounds that show promise in preclinical models of ovarian cancer including the RNA polymerase I inhibitor (CX-5461) and its activity in homologous repair (HR) deficient ovarian cancer. Excitingly, this work forms the basis of a new Phase I/II trial in HR deficient ovarian and prostate cancers at the Peter Mac in 2018. There was also a presentation about the identification of a known drug clinically approved for use in auto-immune disease as a molecule capable of directly binding p53 leading to a conformational change and the reactivation of p53. Given that the vast majority of ovarian cancers carry mutated p53, this new p53 reactivating drug has great promise in ovarian cancer treatment and hopefully this presentation by a basic science researcher new to ovarian cancer will lead to a new ANZGOG clinical trial.
We also heard about the potential utility of circulating exosomes as an early diagnostic tool for ovarian cancer. Early diagnosis is a critical part of improving a woman’s chance of surviving ovarian cancer. The work presented was very exciting and we look forward to validation of these results in a larger cohort of patients. Dr Pradeep Tanwar gave us a great talk showing a link between increased VEGF levels and high BMI. Notably this work was performed using adipose tissue from women with low and high BMI, a mouse model that developed obesity due to hyperphagia (eating too much) as well as clinical specimens from low and high BMI women. The PI3K/AKT pathway was implicated in VEGFA driven tumour growth suggesting that agents that target this pathway could be a therapeutic option.
Overall, the pure science symposium presented new findings in early diagnosis of ovarian cancer using either blood-based assays or novel radiolabelled antibodies as well as new drugs and new drug combinations to treat molecular subsets of endometrial and ovarian cancer. The growing importance of the pure science symposium within the ANZGOG Annual Scientific Meeting was evident by the registration of over 100 attendees (both scientists and clinicians) and it remains an important and significant event to increase communication and collaborations between clinicians and scientists so that more effective treatments can be provided to our gynaecological patients.
Anne Mellon: A nursing perspective
I always come away from ANZGOG with inspiration for what we can achieve for our patients, and how we are fortunate in Australia to be at the forefront of cancer care and research for women diagnosed with gynaecological cancer, and this year did not disappoint. The international keynote speakers gave an insight into the challenges in gynaecological cancer in the molecular era, explaining how next generation sequencing, molecular classification and immune modulation can improve treatment and outcomes for women.
A session on immunotherapy discussed various trials utilising this new form of cancer treatment and how we will see improved progression free survival and overall survival in the future. An update on the HPV vaccine was presented, with the introduction of the nonavalent vaccine possibly seeing another change to the cervical screening program in the future. ANZGOG and OASIS trial updates were presented, showing the vast variety of research being undertaken in gynaecological cancer both nationally and internationally.
The quality and survivorship session utilised case studies to discuss issues we may face with both terminally ill and young patients. The multidisciplinary panel gave a varied perspective on these often difficult situations, and the authenticity of the cases allowed the audience to contemplate how they would have cared for these particular women. Presentations on supportive care, symptom burden and anxiety and depression illustrated the importance of thorough assessment of women to help manage these survivorship issues.
The nurses workshop this year focused on the theme of ovarian cancer, with presentations on diagnosis and treatment, current and future trials, and genetic testing. Psychological issues and the Survivors Teaching Students program were also presented. The group were honoured to hear from Liz Cotter, who is living with ovarian cancer, on her experience of diagnosis, treatment and survival. Despite there only being a small group at the nurses’ workshop, there was much discussion and sharing of ideas amongst those present.
I have returned from ANZGOG feeling energised from the vast amount of work that is occurring in gynaecological cancer and the promising future that lies ahead for the women in our care. I am also enthused by the reconnection with past colleagues and the new friendships formed in the community that is gynaecological cancer care in Australia.
Dr Amy Jamieson: The next generation of leaders
The theme of the ANZGOG ASM this year “Challenges in precision gynaecological cancer care in the molecular era” seems daunting as a junior gynaeoncology fellow. The reality is that immunotherapy and targeted cancer treatment is a rapidly evolving area in gynaecological cancer care and will likely continue to change the way we practice throughout our careers. This is the second ANZGOG ASM I have attended and I have, once again, come away feeling inspired by the content I have seen over the four day program.
The highlights included:
- Seeing our international guest speakers on Day Two share their exciting research in the molecular classifications of uterine sarcomas and endometrial cancers. This not only gives important prognostic information but will hopefully assist with tailoring adjuvant therapy for women with these cancers in the future.
- The breakfast debate on Day Three saw two gynaecologic cancer surgeons discussing the pros and cons of primary debulking surgery vs neoadjuvant chemotherapy for women with advanced ovarian cancer. This is a topical subject and both speakers gave a fantastic summary of the conflicting evidence that currently exists in the area.
It was exciting to be updated on many of the clinical trials ANZGOG is currently conducting, and those in development. It is a very valuable experience to see the huge amount of time, effort, and work that goes on behind the scenes in regards to clinical trials. It is also fantastic to see gynaeoncology surgeons, medical and radiation oncologists, and scientists, all collaborating with the aim to improve the lives of women with gynaecological cancers in Australia and New Zealand. I would highly recommend this meeting not only for the knowledge that I gained, but also for the opportunity to interact with such a diverse and dedicated group of people.
With thanks to the contributing writers and Ruth Gordon from ANZGOG. To learn more about ANZGOG visit www.anzgog.org.au.