As I sit back and reflect on my two terms as MOGA Chairman, which was a great honour bestowed upon me by my colleagues, I can’t help but feel somewhat satisfied.
The culmination for me was the 2014 Annual Scientific meeting in Sydney, which has just ended. The quality, enthusiasm, excitement and dedication from the large crowd in attendance reflect the values that MOGA has aspired to during my time as chairman. Those who attended the meeting will have been impressed by the quality and relevance of all the presentations from both national and international speakers, all talking to the theme of “Integrating Molecular and Immunologic Advances into Practice”.
We were fortunate to have Ramaswamy Govindan from St Louis talk on genetic profiling in lung cancer, James Gully from the NCI discuss immunotherapy in prostate cancer, Alison Stopek from Tucson talk about targeting the RANKL/RANK/OPGF pathway for breast cancer treatment and Klaus Pantel from Cologne discuss circulating tumour cells. The program was augmented by many of our own members, recognised both nationally and internationally for their contribution to medical oncology.
Another objective of MOGA over the last few years has been to extend our influence to South-East Asia. It has been achieved through two main areas. The first is the expansion of the Australia & Asia Pacific Clinical Oncology Research Development (ACORD) Workshop to allow 72 trainees to participate, representing not only Australia, but also India, Nepal, Malaysia, China, Thailand, Singapore, Japan, United Kingdom, Taiwan, Iran, Bangladesh, Philippines, Pakistan, United States of America, Korea, and New Zealand.The program was founded by a previous MOGA Chairman, Bogda Koczwara, and is coordinated by the ever enthusiastic Martin Stockler.
The second area for expansion has been to explore partnerships with other Asian-Pacific Medical Oncology Societies, and develop the “Asian Pacific Perspectives” session at the Annual Scientific Meeting. This year we heard about Medical Oncology in Japan from Yuichiro Ohe, in Korea from Hyun Choel Chung, in Singapore from Ravi Kanesvaran, and New Zealand from Ben Lawrence. I have had the privilege of being invited to the Japanese Medical Oncology Society meeting for the last two years, an excellent scientific forum with over 6,000 participants, and later this year with attend the Korean Association of Clinical Oncology meeting in Seoul. In discussions with these groups, and the Chinese Society of Clinical Oncology, everyone is keen for a closer association and to develop an independent Asian-Pacific oncology collaboration. To remain a viable organisation, we will need to embrace the spirit of collaboration and expansion.
One of the great pleasures of the 2014 MOGA ASM was seeing Geoff Lindeman receive the MOGA/Novartis Oncology Cancer Achievement Award. Geoff joins the “who’s who” of Australian medical oncology and was a very worthy and humble recipient. Geoff is Joint Head of the Stem Cells and Cancer Division at the Walter and Eliza Hall Institute of Medical Research and Clinical Director of the ACRF Centre for Therapeutic Target Discovery. He is also a medical oncologist and Head of the Familial Cancer Centre at The Royal Melbourne Hospital. He holds an appointment as Professorial Fellow in the Department of Medicine at the University of Melbourne. His laboratory is studying molecular regulators of normal breast development and cancer, with a particular focus on breast stem cells, the breast epithelial cell hierarchy and cancer. A groundbreaking discovery in 2006 on the generation of a functional mammary gland from a single stem cell has had an extraordinary impact on the breast cancer, mammary gland biology, and stem cell fields. His research efforts are focused on the characterisation of markers and regulators that could serve as novel therapeutic targets in breast cancer. His clinical activities centre on hereditary breast cancer and translational cancer research.
One major task I initiated during my sojourn was to tackle the issues surrounding access to cancer drugs for our patients. This has involved a process of engaging and developing relations with the Therapeutics Goods Administration, the Pharmaceutical Benefits Advisory Committee and the Department of Health & Ageing. Through persistence and a modicum of diplomacy, we have been able to make real inroads in many areas that directly affect our members’ ability to treat their patients. Working with the TGA, we have been able to address the issue of drug shortages and drug indications, and for those who heard John Skerritt talk at the Annual Scientific Meeting, there is real hope of development of an accelerated cancer drug approval process.
Through significant collaboration with the PBAC, and especially their chair, Suzanne Hill, we have been able to establish the PBAC Oncology Working Group, which meets four times each year to discuss a range of issues, including advice regarding new submissions. This important group has been able to have a number of older cytotoxic agents derestricted, including gemcitabine, oxaliplatin, irinotecan, and in the near future the taxanes. In doing so, it removes significant administrative burden from our members. We have accelerated the approval of a number of new drugs, such as aberaterone, ipilumumab and cabazetaxel, and have been instrumental in having tamoxifen submitted for breast cancer prevention. We continue to work with them to a process of adaptive licensing, which will hopefully allow much earlier access to effective new anti-cancer drugs. I plan to stay on as chairman of the PBAC Advisory committee for the next two years.
We continue to work with the Department of Health & Ageing on the issue of reducing administrative burden for our members. We have been in discussion regarding the need for rationalisation of the authority prescription system and there is now an Authority Review Reference Group which has been charged by the Health Minister with the task of sorting this out by the end of 2013 for cancer drugs. Furthermore there have been some real moves forward with regard to creation of electronic prescriptions from drug charts in private sector hospitals and the need for a national database to augment the move to adaptive drug licensing.
Trainee education has always been a key objective of MOGA and remains a strong focus. At the Annual Scientific Meeting there was once again a Communications Skills Workshop for the trainees and a trainee education program. We also ran another RACP Supervisors’ Training Program. All members are also invited to the Annual Scientific Workshop and Best of ASCO. MOGA continues to provide the College with the Adult Medical Oncology Training Curriculum.
Our next project is to develop a workforce initiative, particularly to help and direct newly qualified graduates into potential jobs, and to plan for future trainees numbers. This will be led by the new MOGA Chairperson, Rosie Harrup, and Zarnie Lwin, the newly elected MOGA treasurer. Our aim is to map out the current medical oncology services, both public and private, in Australia, and look for potential areas for expansion. Another exciting development of MOGA to help the trainees who have entered the workforce is the Young Oncologists Group of Australia (YOGA), established by George Au-Yeung, Deme Karikios, and Hui-li Wong. With these and other enthusiastic young oncologists at the helm, our profession is in good hands.
Finally, none of the achievements of my term in office would have been possible without a hardworking executive and our executive officer Kay Francis, and her team of Daniel Evans and Brigette Rousseau . The foundation for the current organisation was firmly in place when I took over, thanks to the dedicated and innovative chairpersons that came before me. The future is bright for MOGA and medical oncology in Australia, as long as all continue to participate.
Gary Richardson is the Director of Oncology Clinics Victoria, Director of Cabrini Academic Haematology & Oncology Services and an Associate Professor of Medicine at Monash University. He is the immediate past president of the Private Cancer Physicians of Australia, past Chairman of the Medical Oncology Group of Australia and Chair of Foundation 49.