Victoria Sharp had survived two bouts of breast cancer, melanoma and ovarian cancer when she received the news no one wants to hear. The ovarian cancer had returned and spread extensively.
“For me, that was utterly devastating,” Victoria recalls. “When you are told it’s inoperable, that’s when you know your life is on the edge.”
Victoria, who was treated by oncologists from the Peter MacCallum Cancer Centre, was offered the opportunity of another round of chemotherapy but she was also offered an alternative treatment. Because she had previously undergone genetic testing which identified a mutation in the BRCA2 gene associated with breast and ovarian cancer, as well as genomic testing of her tumour, she was found to be an eligible candidate for a clinical trial.
She said the decision was hugely difficult because going on the trial meant passing up another opportunity for chemotherapy. Ultimately she went ahead with the trial – a collaboration between Peter Mac, Alfred Health, Olivia Newton John Cancer Centre and pharmaceutical company BeiGene – which tested the safety and efficacy of a drug, pamiparib.
“With the knowledge of my genetic status, the support of my treating oncologist, and access to clinical trials, we were able to match my cancer with an effective treatment targeted to my genomic status,” Victoria said.
Victoria was on the trial for five years, taking a daily oral dose of pamiparib. The tumour began to diminish over time and by the end of the trial, in 2022, there were no signs of the cancer. One year later, there are still no tumours. “There’s no doubt in my mind that that drug worked,” Victoria said.
The BRCA gene mutation has had a huge impact on Victoria’s family. Her mother succumbed to breast cancer and so did her sister, at age 32. “When I was 12 and my mum was sick, I thought, ‘they will have a cure by the time I grow up’. Well, they didn’t. But these new developments are so promising. I am thrilled to see where things are heading in the fields of genomics and precision oncology.”
The Victorian Precision Oncology Summit 2023
Victoria’s promising outcome from precision oncology is the type of experience the organisers of the Victorian Precision Oncology Summit want to deliver for more people statewide with cancer. She shared her lived experience at the Summit, coordinated by the VCCC Alliance and Monash Partners Comprehensive Cancer Consortium (MPCCC) on Friday, 28 April in Melbourne. The event, which was attended by more than 200 experts in the field, focused on equity of access to this method – testing the DNA composition of tumours to identify treatments tailored to the patient’s individual cancer.
Dr Kortnye Smith, medical oncologist at Peter MacCallum Cancer Centre, who also has a role with the VCCC Alliance, said precision oncology is looking more carefully at the DNA of the tumour to provide clinicians with all the information, not just some of the information. “We can use that information to help make the right clinical decision about treatment. It can improve the patient’s survival and prevent exposure to toxic treatments that aren’t going to work, or give more lines of treatment.
“The current issues are that there are significant inequities depending on where and with whom you are getting tested, and which patients are getting offered this test and that’s really what we are hoping to overcome with this summit. You have to be on a research trial, or pay for it, which costs about $3000. Those are the only two ways you can access it at the moment in Victoria.”
Other speakers included international guest, Professor Olivier Michielin, Head of the Centre for Precision Oncology, Lausanne University Hospital, Switzerland; Professor David Thomas, CEO of Omico – the Australian Genomic Cancer Medicine Centre; and Dr Kortnye Smith, a medical oncologist and researcher at Peter MacCallum Cancer Centre and VCCC Alliance. Among the attendees will be Tim Richardson, the Victorian Parliamentary Secretary for Health Infrastructure.
This inaugural summit focused on equity of access to molecular testing, attracting professionals working in cancer genomics from multiple disciplines and perspectives, to identify potential opportunities to synchronise activities for the benefit of Victorian cancer patients.
Speakers
Professor Olivier Michielin
Head, Centre for Precision Oncology, Lausanne University Hospital,
Switzerland
Professor Olivier Michielin obtained a Masters of Physics in 1991 at the Swiss Federal Institute of Technology and a Medical Degree from the University of Lausanne in 1997. He pursued his PhD training under the supervision of Jean-Charles Cerottini (Ludwig Institute) and Martin Karplus (Harvard and Strasbourg Universities, Chemistry Nobel Prize Laureate 2013). He was appointed Group Leader of the Swiss Institute of Bioinformatics in 2002 and became an Assistant Professor and Privat Docent at the Medical Faculty of Lausanne in 2004 and 2005, respectively.
In parallel, he has trained as a medical oncologist and obtained his board certification in 2007 at the Department of oncology of the Lausanne University Hospital (CHUV) where he is currently heading the melanoma clinic. He was appointed Associate Professor in 2010 and full Professor in 2019. Prof Olivier Michielin is mainly focused on translational oncology, developing new molecularly defined therapeutic approaches based on original bioinformatics techniques developed in his laboratory, as well as melanoma clinical trials at the Lausanne University Hospital. In 2016, Prof. Olivier Michielin was appointed Head of the Center for Precision Oncology within the Department of Oncology.
Dr Kortnye Smith, Medical Oncologist, Peter MacCallum Cancer Centre
Dr Kortnye Smith is a medical oncologist and researcher at Peter MacCallum Cancer Centre and Eastern Health. After completing her medical oncology training, she pursued a two-year fellowship at Peter MacCallum Cancer Centre and Melbourne Genomics Health Alliance where she investigated pathways for the integration of complex genomic sequencing into cancer therapy.
Currently she works predominantly in lung cancer and melanoma as well as focusing on her passion of improving patient equity by coordinating the Oncology in the Home program across the Eastern suburbs of Melbourne. Her research focuses on the implementation of new models of care and educational to facilitate access to genomics across Victoria.
Professor David Thomas, CEO, Omico: the Australian Genomic Cancer Medicin Centre
Professor David Thomas is a medical oncologist and researcher with a focus on the impact of genomics on cancer medicine and public health. He is currently the Chief Executive Officer of Omico: the Australian Genomic Cancer Medicine Centre, a nationwide network of research and treatment centres enabling research in precision medicine.
He established a national infrastructure for clinical research into sarcomas and has played a significant role in the development of adolescent and young adult oncology. Despite an active clinical role, David has published more than 250 research papers including senior or lead author papers in Science, Cancer Cell, Cancer Discovery, Molecular Cell, Journal of Cell Biology, Cancer Cell, Journal of Clinical Investigation, Journal of Clinical Oncology, Lancet Oncology, and JAMA Oncology. His work has. directly led to changed clinical practice, including regulatory approvals for denosumab in giant cell tumour of bone, and whole-body MRI for patients with Li-Fraumeni Syndrome.
Source: VCCC Alliance
