Research Report

PATIENT CENTRED RESEARCH DRIVEN CANCER CARE

Research Report

2017 & 2018

Artist: Julia Westwood A place“ that burns on discovery.

- Professor Chris” O'Brien AO Foreword

Clinical excellence underpinned by research. At any one time, there are more than 100 This has always been at the heart of the vision clinical trials being undertaken by or in for Chris O'Brien Lifehouse. collaboration with our researchers and clinicians. The comprehensive cancer centre model is internationally accepted as the organisational Research courses through every department setting most likely to generate clinical and of Chris O'Brien Lifehouse, from medical research advantage. It is defined by integrated oncology and radiation oncology, to surgery, co-location of services, contribution to nursing, and complementary therapies. education and research output. Not only does Chris O'Brien Lifehouse In 2007, Professor Chris O'Brien AO said, "With emphasise continual interaction between a modern comprehensive cancer centre where clinicians and researchers to drive standards clinical care and research are integrated, and of care forward, in many cases the treating where treatment is underpinned and, indeed, clinician and researcher are one and the driven by research, we are entering a new same, eliminating the gap between lab and era." clinic altogether.

We now live in that era. This report summarises research highlights from our programs and departments for years Today, Chris O'Brien 2017 and 2018. Lifehouse is the largest Never to be forgotten are the people behind this data: real patients and families. The cancer clinical trials ultimate benchmarks by which we measure unit in NSW. ourselves are how their lives are improved. CHRIS O'BRIEN LIFEHOUSE 6 20 Introduction Research Highlights

8 Message from the CEO 22 Medical Oncology

10 Message from the 24 Head and Neck Director of Research 28 Radiation Oncology 12 Research Snapshots 31 Gynaecological 13 Collaborative Network Oncology

14 Research Committee 33 Breast

15 In Focus 35 Neurosurgery

37 Uro-Oncology

38 Supportive Care and Integrative Medicine

40 Affiliates

4 RESEARCH REPORT 2017 & 2018 44 70 Publications Grants

46 Medical Oncology 72 Medical Oncology

59 Head and Neck 74 Head and Neck

63 Radiation Oncology 75 Radiation Oncology

66 Gynaecological 75 Gynaecological Oncology Oncology

67 Breast 76 Breast

67 Uro-Oncology 76 Supportive Care and Integrative Medicine 68 Supportive Care and Integrative Medicine Contents

Introduction CHRIS O'BRIEN LIFEHOUSE

Message from the CEO Eileen Hannagan

Looking back at the clinical trials that came The third point is impact. Chris O'Brien across my desk for approval throughout 2017 Lifehouse has participated in — and led and 2018, research at Chris O'Brien Lifehouse — research that has changed practice and has evolved in three critical ways. changed lives.

The first is sheer quantity. Our clinical trials program has rapidly expanded. The most Our medical oncologists recent data from Cancer Institute NSW's have presented globally Cancer Clinical Trials Portal shows Chris O'Brien Lifehouse has the most cancer clinical and had stakes in some trials in NSW. of the most exciting

This is a testament to the energy and developments in cancer dedication of our clinicians, researchers and treatment in recent leaders. It also shows that while we may be a young organisation (2018 marked five years years. of operation), we have become a valuable contributor to the Australian cancer network. In a hugely significant development,Professor An evidence-based approach is essential as Michael Boyer AM, our Chief Clinical Officer, we continue to build in both substance and was a co-author in a global study that has reputation. made immunotherapy part of standard care in lung cancer treatment. The second way our research has evolved is in breadth and scope, as various departments Associate Professor Peter Grimison, one of have grown their research programs and our senior medical oncologists, is leading output. There are more strong studies the world's largest and most definitive coming out of our Radiation Oncology and trial of medicinal cannabis' feasibility, surgical departments such as Head and effectiveness and consequences in alleviating Neck. This can partly be attributed to the the debilitating side-effects of chemotherapy. investments in technology that we have made in the last few years. Our departments of Uro- So, what lies ahead for Chris O'Brien Oncology and Neurosurgery have started Lifehouse research? In order to achieve their own programs and we look forward to significant impact, we must continue to their results in future years. reach beyond our own circles and work actively and collaboratively with partners.

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We are committed to strengthening our relationships and networks throughout the precinct, the country and internationally. Research is pivotal to the Chris O'Brien Lifehouse vision. From the design of the building, to the way departments are organised, to the professional development and mentoring of staff, we are determined to break partitions wherever possible, in order to encourage relationships, propagate ideas, and give science the opportunity to flourish.

'A core part of our mission is finding the answers that will make it easier to treat, and cure, people with cancer tomorrow. It is just part of what we do.' - Professor Michael Boyer AM, Chief Clinical Officer

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Message from the Director of Research Professor Lisa Horvath

Chris O'Brien Lifehouse celebrated a major presentations, more than 70 grants and 62 milestone in November 2018: five years of research students (undergraduate, Masters operation. As the clinical service grows and and PhD). diversifies, so too does the research program. Two new departments — Uro-Oncology and This should be read as a collaborative Neuro-Oncology — have launched research report. Chris O'Brien Lifehouse researchers programs in the last year. have many roles, often numerous affiliations and do their research as part of networks. This Research Report, covering 2017 and 2018, demonstrates the depth of research The annual Chris O'Brien Lifehouse Research within the cancer centre and its collaborative Symposia are attracting a range of speakers network with over 250 publications, more and poster presenters from within Lifehouse than 200 national and international and our collaborative network across the

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spectrum of cancer treatment including The research has spanned clinical trials surgery, medical oncology, radiation oncology (phase 1-3), biomarkers, supportive cancer, and molecular pathology. surgical techniques, quality of life and cancer outcomes. In 2018, the symposium celebrated the 40- year career of Professor Martin Tattersall, who has influenced many areas of cancer Collaboration remains therapy across sarcoma, breast cancer, ovari- the cornerstone of an cancer and cancer survivorship. Chris O'Brien Lifehouse We also held our first Lifehouse Concept De- research. velopment workshop in conjunction with the NHMRC Clinical Trials Centre with more than Our Head and Neck Cancer Research Group 20 concept participants including doctors, continues to expand their network nationally nurses and allied health researchers. and internationally to address this uncommon cancer. Chris O'Brien Lifehouse is now part of A key aspect of the Chris O'Brien Lifehouse brain cancer research alliances and sarcoma research agenda is patient-focused research, research networks. especially that which changes clinical practice. The national cancer co-operative clinical trials groups remain important research partners Our researchers have across genito-urinary cancers (ANZUP), breast been part of a wide cancer (BCT), gynae cancers (ANZGOG), sarcoma (ASSG), brain cancer (COGNO), gastro- range of practice- intestinal cancers (AGITG), lung cancer (ALTG) changing studies. and radiation therapy (TROG).

The NSW Early Phase Clinical Trials Alliance These include immunotherapy in metastatic (NECTA) was established three years ago with lung cancer, extracorporeal radiotherapy Chris O'Brien Lifehouse, The Kinghorn Can- for sarcomas, improved patient decision- cer Centre and Scientia Clinical Research and making in cancer therapy, pre-operative aimed to grow the early phase clinical trial dietary improvements for surgery and portfolio in NSW. NECTA now has 6 active sites techniques to address fear of cancer across metropolitan and regional NSW with recurrence. more than 50 active Phase 1 trials across the network.

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Research Snapshots

Number of Phase 1-3 studies across cancer tumour streams (2017-18)

Phase 1

Phase 2

Phase 3

Number of participants on Number of participants clinical trials across cancer by Phase tumour streams (2018) 600

400

Phase 1

Phase 2 200 Phase 3

Other

2017 2018

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Collaborative Network

Royal Prince RPA Institute of Alfred Hospital Academic University of ResearcShurgery Sydney* Institutes*

RPA Institute Pharma / of Academic Biotec Surgery

National Cancer Sydney Consortia* Catalyst

Other Cancer Sydney Health Centres* Partners

* Collaborative networks include: University of Sydney: NHMRC Clinical Trial Centre, Sydney Cancer Centre, Prince of Wales Hospital - Nelune Cancer Nursing Research Unit, The Psycho-oncology Co- Comprehensive Cancer Centre, Coffs Harbour Health operative Research Group (PoCoG), The Centre for Medical Campus, Mid North Coast Cancer Institute (MNCCI), Psychology & Evidence-Based Decision-Making (CeMPED), John Hunter Hospital, Calvary Mater Newcastle, Peter Surgical Outcomes Research Centre (SOuRCe). MacCallum Cancer Centre, The Royal Melbourne Hospital, Research Institutes: Garvan Institute of Medical Research, Monash Health, Princess Alexandra Hospital Brisbane. The Centenary Institute, Asbestos Diseases Research Internationally, Dana-Farber Cancer Institute Boston, Institute (ADRI), Charles Perkins Centre, The ANZAC University of Southern California (USC). Research Institute, Melanoma Institute of Australia, The National Cancer Consortia: Australasian Gastro-Intestinal Institute for Glycomics, The South Australian Health and Trials Group (AGITG), Australia and New Zealand Breast Medical Research Institute (SAHMRI). Cancer Trials Group (ANZBCTG), Australian and New Other Cancer Centres and Hospitals: Concord Zealand Urogenital and Prostate Cancer Trials Group Repatriation General Hospital - Concord Cancer Centre, St (ANZUP), Australia New Zealand Gynaecological Oncology Vincent's Hospital Sydney - The Kinghorn Cancer Centre, Group (ANZGOG), Australasian Sarcoma Study Group Westmead Hospital - The Crown Princess Mary Cancer (ASSG), Trans-Tasman Radiation Oncology Group (TROG). Centre Westmead, Royal North Shore Hospital - Northern

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Research Committee

Rebecca Davies, Board Director, Chris O'Brien Lifehouse Lisa Horvath, Director of Research, Chris O'Brien Lifehouse (Chair) Michael Boyer, Clinical Director, Chris O'Brien Lifehouse Christopher Milross, Director of Radiation Oncology, Chris O'Brien Lifehouse Jonathan Carter, Director of Gynae Oncology, Chris O'Brien Lifehouse Sam Saidi, Gynae Oncology, Chris O'Brien Lifehouse Jonathan Clark, Head and Neck Surgery, Chris O'Brien Lifehouse Michael Elliott, Head and Neck Surgery, Chris O'Brien Lifehouse Sanjay Warrier, Breast Surgery, Chris O'Brien Lifehouse Christopher Young, Head of Colorectal Surgery, Royal Prince Alfred Hospital Paul Stalley, Program Director Surgery/ Head of Sarcoma, Sydney Local Health District Charbel Sandroussi, Director of Clinical Research, RPA Institute of Academic Surgery Paul Bannon, Head of Cardiothoracic Research, Royal Prince Alfred Hospital Stephen Larsen, Institute of Haematology Research Unit, Royal Prince Alfred Hospital John Boulas, Head of Urology Department, Royal Prince Alfred Hospital James Kench, Head of Department, Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital John Simes, Director, NHMRC Clinical Trials Centre Martin Stockler, Co-Director, Cancer NHMRC CTC Kate White, Chair, Cancer Nursing Research Unit Phyllis Butow, Co-Director, CeMPED The University of Sydney Michael Solomon, Co-Chair, RPA Institute of Academic Surgery Julie Charlton, Research Governance Manager, Chris O'Brien Lifehouse Jacquie Harvey, Business Manager, Clinical Trials, Chris O'Brien Lifehouse Brindha Shivalingham, Director of Neurosurgery, The Chris O'Brien Lifehouse Natalka Suchowerska, Head of Physics Research and Education, Chris O'Brien Lifehouse Toni Lindsay, Allied Health Manager, Chris O'Brien Lifehouse Steven Kao, Thoracic Oncology Research lead, Chris O'Brien Lifehouse Jane Young, Research Director, RPA Institute of Academic Surgery David Gattas, Research Lead ICU, Chris O'Brien Lifehouse Lyndal Trevena, The University of Sydney Professor of Primary Health Care Bev Noble, Partnership Advisory Council, Chris O'Brien Lifehouse Sarah Charlton Li, Research Program Manager, Chris O'Brien Lifehouse Trevor Tejada-Berges, Gynae Oncology, Chris O'Brien Lifehouse MacDonald Christie, Associate Dean (Research), Sydney Medical School and NHMRC Senior Principal Research Fellow Martin Butson, Principal Medical Physics Specialist, Chris O'Brien Lifehouse Leanne Hodgkiss, Trusts and Foundations, Chris O'Brien Lifehouse Henry Woo, Director of Urology and Head of Robotics, Chris O'Brien Lifehouse Carsten Palme, Director of Head and Neck Surgery, Chris O'Brien Lifehouse

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In Focus Meet Our Researchers

Associate Professor nausea drugs but for a small group of patients, Peter Grimison they persist. The medicinal cannabis trial is aimed at Associate Professor Peter Grimison is a senior testing whether it is feasible and effective medical oncologist. His clinical work focuses on to administer medicinal cannabis for these testicular cancer, sarcoma and upper gastro- patients, and what side effects, if any, it intestinal cancers. He is a leader in producing may cause. Professor Grimison says this trial is high-quality research through clinical trials, an opportunity to create reliable evidence especially in matters of patient quality of life in an area of acute community demand. Up and cost-effectiveness of treatment. until now, this area has had limited scientific understanding. MEDICINAL CANNABIS TRIAL Nausea and vomiting are notorious side- "Presently, doctors in Australia can prescribe effects of chemotherapy. For many, these medicinal cannabis, but without sufficient ev- symptoms are alleviated with advanced anti- idence and understanding of its side effects,

Associate Professor Peter Grimison (right).

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there is still a reluctance to do so," Professor Centre at University of Sydney, co-located at Grimison said. Chris O'Brien Lifehouse, Professor Grimison is testing the delivery of standard chemotherapy "My hope is that this study will provide the treatment in a different way. kind of evidence which will allow doctors to make that decision, and also to know whether "It's an important trial in a number of ways," the treatment will be cost-effective." he said. "It is recruiting from four different countries; it's recruiting in both adults and "The way we are administering the cannabis children; and it's recruiting in men and wom- treatment is quite novel. Traditionally, pa- en." tients who buy cannabis for medicinal needs will smoke it, or more recently use a vaporiz- "Most trials will focus on only one of these er or an oil. These methods are not practical groups, but germ cell tumours cross over. in a chemotherapy suite, so we are trialling a They are present in males, females, young and unique oral capsule. If we can show that the old. Not only will the phase 3 accelerated BEP capsule is safe and effective, then it will hope- study allow us to test the drug schedule in all fully be easier for patients and doctors to use." of these groups, but it allows us to form the kind of cross-national collaborations which will This will be the largest enable us to do better research in the future." and most definitive trial of its kind in the world. Nurse Practitioner Justine Oates The first part of the trial is currently recruiting across 11 cancer centres in NSW, including Nurse Practitioner Justine Oates works Chris O'Brien Lifehouse. alongside Nurse Practitioner Sarah Davies in the Head and Neck service of Chris O'Brien GERM CELL TUMOURS Lifehouse. They are leaders in promoting an Professor Grimison's areas of interest extend to evidence-based approach to nursing, using testicular cancer and related cancers known a research framework to evolve practice and as germ cell tumours. improve patient quality of life.

Testicular cancer is a disease that dispropor- In an example of research underpinning tionately affects young men aged between 15 nursing and patient care, Nurse Practitioner and 40 years old. Most people with testicular Oates led a retrospective review of head and cancer are cured, but a small number are not. neck microvascular free flap surgical -out comes. "We are interested in improving treatment for this group," Professor Grimison said. The study was initiated after the clinical governance board noted head and neck Working with the Australian and New Zealand surgical patients represented a large Urogenital and Prostate Cancer Trials Group proportion of patients who returned to theatre (ANZUP), based at the NHMRC Clinical Trials postoperatively.

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Nurse Practitioner Justine Oates.

'We wanted to find out areas. The volume of complex surgeries was extremely large; incidence of microvascular if there was something free flap failure was below international we could improve here.' benchmarks; the response time to re- exploration was impressive at less than 3.5 "Or are there systems in place that aren't hours, 24/7. working to the best of their ability?" Ms Oates said. "They're really positive outcomes for high volume, high complexity patients with high "A retrospective review over a two-year period co-morbidities," Ms Oates said. from 2017 to 2018 was conducted involving a comprehensive assessment of each case, "Through this study, we recognised the need responsiveness to the deteriorating patient for a formal guideline for critical information and evaluation of outcomes to further identify and escalation of free flap management. causal factors, current clinical practice and So while there were clear communication opportunities for improvement." pathways for the escalation of a deteriorating patient, we're now formalising a pathway for The study showed positive outcomes in all escalation management."

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In Focus Patient Impact

Tony Porter asked him about it, and he helped to find the trial," Mr Porter said. "The tumour on my neck Tony Porter's perspective on clinical trials and was gone after about three treatments. I now the opportunity to take part in them is deeply have scans every three months, and every scan personal, saying "it means the world" to him. has shown that the tumours have shrunk."

Mr Porter was active and healthy — a keen Mr Porter continues fortnightly treatment, cyclist, boxing class instructor, even a triathlon overseen by oncologist Dr Vivek Bhadri, who is and Iron Man competitor — when he was the study's principal investigator since Profes- diagnosed with melanoma. sor Tattersall's retirement.

He underwent treatment and it was believed "I'm appreciative of the opportunity to be on to be successful until a routine scan in 2017 a trial," Mr Porter said. showed what had first presented as melanoma was in fact a rare form of soft tissue sarcoma. Mr Porter had five tumours throughout his 'It means the world, body — in his neck, lungs and hamstring. because I probably

"I had trouble walking upstairs, I was coughing wouldn't be here up blood… I was in a fair bit of trouble," he without it.' said. Despite chemotherapy treatment, the cancer continued to grow.

"They gave me three options. Two of them were more chemo, and the third was a clinical Flavio Roncolato trial. I took that option." In December 2018, Flavio Roncolato was to Mr Porter enrolled in a trial for INCMGA00012 undergo a parotidectomy to remove a pea- — a type of immunotherapy. The drug is a sized lump under the corner of his jaw. PD-1 inhibitor, which increases the body's immune reaction to the cancer. Surgery of the parotid gland is particularly complicated because the facial nerve courses "I had read a fair bit about immunotherapy. through the gland. Nearly half of all patients The very first day I met Professor Tattersall, I who undergo a parotidectomy experience

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Above, Tony Porter. Right, Flavio Roncolato.

moderate to severe nerve dysfunction [could] eat, I had very little pain – in fact, it was afterwards. more a slight discomfort," Mr Roncolato said. "I think that having clinical trials of any sort Mr Roncolato's surgeon, Professor Jonathan in a hospital just shows that the facility that Clark AM, suggested that Mr Roncolato take you're at is probably pushing boundaries, and part in a trial aimed at reducing the risk the doctors who want to push those bounda- of infection and problems with swelling, ries are generally the better doctors." numbness, and loss of movement.

"It was Professor Clark who suggested the 'In my mind, that's clinical trial, and I said yeah, no problem. It what you would expect can't hurt, just do it," Mr Roncolato said. of a good researcher During surgery, Professor Clark coated Mr – they're out there Roncolato's exposed facial nerve with a solution of corticosteroid dexamethasone in a looking for the next slow release hyaluronic acid gel. best thing.'

"Considering what they did in surgery, my "They're not just sitting there saying 'well this recovery [was] great," Mr Roncolato said. "I is the way we've always done it'."

Research Highlights CHRIS O'BRIEN LIFEHOUSE

Departments Medical Oncology

Department List Summary By Numbers

Prof Lisa Horvath MBBS FRACP PhD (Director of Medical Oncology) 165* publications A/Prof Philip Beale MBBS FRACP PhD A/Prof Jane Beith MBBS FRACP PhD 59 presentations Dr Vivek Bhadri MBBS FRACP PhD Prof Michael Boyer AM MBBS FRACP PhD 7 students A/Prof Peter Grimison MBBS FRACP PhD 39 grants Dr Michelle Harrison BSc (Med) MBBS FRACP Dr Mun Hui MBBS FRACP PhD Dr Steven Kao MBBS FRACP PhD * Includes co-publications with other Chris O'Brien Lifehouse departments Dr Jenny Lee MBBS FRACP Dr Yeh Chen Lee MBBS BMedSci FRACP Prof Martin Stockler MBBS FRACP MSc (Clin Dr Kate Mahon MBBS FRACP PhD Epi) A/Prof Catriona McNeil MBBS FRACP PhD Prof Martin Tattersall AO MBBS FRACP PhD Dr Hao-Wen Sim MBBS(Hons) BMedSci FRACP Prof David Thomas MBBS FRACP PhD Prof John Simes BSc (Med) MBBS FRACP SM Dr Alison Zhang MBBS FRACP MD

Highlights

The Medical Oncology department has novel TargomiR, a miRNA drug developed in excelled in research over the last two years Australia to target malignant mesothelioma with more than 160 publications across a (Lancet Oncology). wide range of research areas including clinical trials, biomarkers, cancer biology, health The study of TargomiR represents a highly economics and quality of life. successful collaboration between the Asbestos Diseases Research Institute (University of The members of our department have Sydney), industry (Engeneic) and clinicians recruited patients to more than 100 clinical (Chris O'Brien Lifehouse, Concord Hospital trials (Phase 1-3 trials) and contributed to 41 and Royal North Shore Hospital). clinical trial publications in the same period. These include first-in-human studies of a Among the Phase 3 studies, our team have been novel EGFR inhibitor to treat CNS metastases involved in studies that have contributed to from lung cancer, a MET inhibitor and the the registration of immunotherapy agents

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as standard of care in melanoma and non- in which it was confirmed that a blood marker, small cell lung cancer. Professor Michael mGTSP1, predicts outcomes after Docetaxel Boyer AM was a co-author in a global chemotherapy in men with metastatic study that identified the immunotherapy, castrate resistant prostate cancer. This marker Pembrolizumab, added to chemotherapy may accelerate future clinical trials of new improves survival in patients with newly therapies and be useful in the clinic to guide diagnosed non-small cell lung cancer (New treatment decisions. This paper was the England Journal of Medicine). subject of an editorial in the journal European Urology.

This study has resulted Postgraduate students are essential to the in immunotherapy with progress of research. They produce high- quality research and become part of the next chemotherapy as a new generation of clinician scientists who bridge standard of care for the gap between the lab and the clinic. lung cancer. Two of our new consultants (Dr Mun Hui and Dr Alison Zhang) have completed their PhD In addition, we have contributed to studies over the last two years and produced randomised trials of exercise in advanced outstanding papers as part of this. Dr Mun lung cancer and psychosocial interventions Hui has been studying aggressive triple to address patients' fear of cancer negative breast cancer and published a recurrence. Associate Professor Jane Beith was study identifying Hedgehog signaling as a key part of a collaborative team that completed a driver of cross-talk between cancer cells and randomised controlled trial of ConquerFear, stromal cells driving chemoresistance (Nature a psychological intervention to treat the fear Communications). of cancer recurrence. The anxiety and distress associated with fear of cancer recurrence is a substantial problem for patients and this is This raises exciting one of the first psycho-oncology treatments possibilities for to improve patients' quality of life (Psycho- oncology). therapeutic strategies in advanced breast Several of the members of the Medical Oncology department are clinician scientists cancer. with research interests crossing biomarkers and cancer biology. More than 20 papers Dr Alison Zhang published a prospective have been published on new biomarkers multicentre phase 3 validation study of to potentially direct cancer therapy in the AZGP1, a tissue biomarker which can future. predict outcomes after surgery for localised prostate cancer (Annals of Oncology). These included two Phase 3 studies of This study provides robust evidence for the new biomarkers to guide treatment of incorporation of this biomarker into clinical prostate cancer. Dr Kate Mahon led a study practice.

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Head and Neck

Department List Summary By Numbers

A/Prof Carsten Palme MBBS FRACS (Director) Prof Jonathan Clark MBBS (Hons 1) BSc (Med) 59* publications MBiostat FRACS (Head of Research) Dr James Wykes Sci (Med) MBBS (Hons) FRACS 28 presentations (Head of Fellowship program) Dr David Leinkram MBBS, FRACDS (OMS) BDSc 20 students Dr Hubert Low MBBS BSc (Med) (Hons) FRACS A/Prof Sydney Ch'ng MBBS FRACS PhD 27 grants Dr Anthony Clifford MBBS FRACS Dr Kerwin Shannon MBBS FRACS * Includes co-publications with other Chris O'Brien Lifehouse departments A/Prof Michael Elliott MBBS MPhil FRACS Dr Bruce Ashford MBBS FRACS BDSc (Hons) Dr Ilias Kotranakis MBBS (Hons) FRACS Nurse Practitioner Sarah Davies NP, RN, BN (UTS) MN (NP) (Sydney) Dr Arjuna Ananda MBBS FRACS Nurse Practitioner Justine Oates NP, RN Dr Raewyn Campbell FRACS BMed (Hons) BAppSc(Physio) Grad Dip (Ex Sport Sc) Dr Lydia Lim BDS (Hons) FRACDS MDSc FRACDS (OMS) Dr Glen Croxson MBBS FRACS Dr John McGuinness BDS(Hons) FDS RCS A/Prof Alexander Saxby MB BChir MA (Hons) MBChB FRCS(ORL-HNS) FRACS (Cantab.) FRACS Dr Daniel Novakovic MBBS FRACS MPH Dr Phaethon Karagiannis MBBS MPH A/Prof Mark Schrifter BDS MDSc M SND RCSEd A/Prof Jonathan Kong FRACS FRCS MBBS M Oral M RCSEd FFD RCSI FRACDS AMusA Dr Jasvir Singh BDS MBBS D ClinDen (OMS) A/Prof Payal Mukherjee MBBS FRACS MS FRACDS (OMS) Dr Eileen Tan-Gore MBBS MDSc FRACDS Dr Sue-Ching Yeoh BDS (Hons) MDSc FRACDS FRACDS FOMAA FICD

Highlights

The last two years have been highly productive Our current research priorities are advanced for the Sydney Head and Neck Cancer Institute and metastatic cutaneous squamous cell (SHNCI), which is the research organisation of carcinoma, investigating the rising incidence the Head and Neck service at Chris O'Brien of oral cancer (particularly in young patients Lifehouse. who have never smoked), aggressive salivary

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gland cancers, reconstructive approaches to cancer cells. They observed an enrichment assist patients with advanced facial cancers of SOX9 at drug-induced H3K27ac sites, and facial paralysis, and patient education for suggesting tumour evolution could be driven head and neck cancer. by stem cell-switch-mediated epigenetic plasticity. Importantly, JQ1 mediated The Head and Neck service at Chris O'Brien inhibition of BRD4 could reverse drug-induced Lifehouse performs the largest number of adaptation. These results provide insights head and neck cancer surgeries in NSW, into the modes of therapy-induced cellular with more resections than the next two plasticity and underscore the use of epigenetic busiest hospitals combined. (See Graph A). inhibitors in targeting tumour progression.

This high volume of Cutaneous squamous cell carcinoma is a common cancer that most often occurs in patients generates the head and neck. Its underlying genetic invaluable data. We hold mechanisms are poorly understood. Through targeted sequencing of 48 clinically relevant the largest head and genes, researchers gained insights into neck patient research somatic mutations in non-metastatic high- database and biobank risk head and neck cutaneous squamous cell carcinoma. in Australia, with more than 14,000 registered This has led to the patients. identification of potential therapeutic targets. This data has contributed to important developments in research. In particular, alterations in FGFR2 and NOTCH1, which may have roles in local and In a study of somatic mutations in salivary distant disease progression. duct carcinoma (a rare, highly aggressive cancer with limited therapeutic options for Working with the Department of Radiation disseminated disease), multiple mutations Oncology on a multi-institutional survey, were identified, some of which are responsive researchers aimed to characterise the to drugs while others are resistant to experiences and unmet needs of patients treatments currently under investigation. with head and neck cancer with regard These findings emphasise the need to develop to information and support provision. complementary biomarker and treatment While patients were largely satisfied with the strategies for salivary duct carcinomas. information received about disease process, prognosis and treatment, they reported Chemo-resistance is one of the major causes receiving only minimal information related of cancer-related deaths. Using single-cell to stress and anxiety, including such topics transcriptomics, researchers investigated as psychological well-being, patient support divergent modes of chemo-resistance in groups, and psychosexual health. Verbal

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communication needs to be reinforced by This research has the accessible, well-constructed, written and multimedia resources appropriate to the potential to shape patient's educational level. health policy to

Researchers have completed the design, ensure more equitable development, data collection and analysis in outcomes for patients an important study of patient and health system barriers to early diagnosis of head with head and neck and neck cancer in Australia. The study cancers. examines geographical variation in pathways to treatment for head and neck patients Publication is due in 2019. in NSW and investigates patient and carer perceptions of facilitators and barriers.

Graph A: Annual average resections, by NSW public and private hospitals, head and neck cancer, 2016-2017

Chris O'Brien Lifehouse

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Radiation Oncology

Department List Summary By Numbers

A/Prof Christopher Milross MBBS MD FRANZCR FRACMA FAICD (Director of Radiation 44* publications Oncology) Dr Leily Gholemrezai MBBS FRANZCR 11 presentations A/Prof Angela Hong MBBS MMed PhD FRANZCR 13 students Dr Nitya Patanjali MBBS FRANZCR Dr Mo Mo Tin MBBS FRANZCR 4 grants Dr Regina Tse MBBS MClinEpi FRANZCR Dr Georgia Harris BSc MBBS MPH FRANZCR * Includes co-publications with other Dr Ee Siang Choong MBBS FRANZCR Chris O'Brien Lifehouse departments Dr Kavita Morarji MBBS FRANZCR Dr Sandy Sampaio MBBS FRANZCR Medical Physics Dr Eric Khoo MB ChB FRANZCR Elizabeth Claridge Mackonis BSc (Hons) Dr Carol Haddad MBBS FRANZCR MMedPhys Dr Samara Alzaidi BEng (Hons) GradDip VectorLab (Medical Physics) PhD A/Prof Natalka Suchowerska PhD MAppSc BSc Johnny Morales BSc (Hons) MSc (Medical FACPSEM Physics) Linda Rogers B Med Sc Dr Martin Butson BSc (Hons) PhD DScBSc Dr Ana Esteves BSc PhD (Hons) PhD DSc Prof David R McKenzie PhD BSc FAIP Dr Robin Hill BSc (Hons) MSc (Medical Physics) (collaborator from University of Sydney) PhD

Highlights

Researchers in the Radiation Oncology carried out across four institutions, patients department at Chris O'Brien Lifehouse have who had received treatment for head and neck had a productive two years, participating in cancer were surveyed to find a relationship several practice-changing studies as both lead between decision-making preferences and researchers and collaborators. psychological distress.

In a study initiated by our researchers and Researchers found that while patients do

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experience paternalistic decision-making, While the combination of surgery and most patients would prefer an active or shared postoperative radiotherapy was shown to approach to making decisions, especially if give excellent results, researchers found that they are tertiary educated or female. However, additional weekly carboplatin (chemotherapy) psychological distress is more likely in patients brought no added benefit. who are actively involved, younger, and female. The upshot is that clinicians should be aware of this potential and refer active- These findings eliminate decision makers for psychosocial support. an unnecessary

In a significant collaboration with Royal treatment burden for Prince Alfred Hospital, researchers undertook patients. a retrospective review of patients treated with extracorporeally irradiated allografts for primary and secondary bone cancers, VectorLAB at Chris O'Brien Lifehouse studying mid- and long-term survivorship and combines medicine, physics, biology and functional and radiographic outcomes. chemistry in order to solve some of the most urgent problems in cancer. Comprised The study looked at patients treated with of a diverse team of specialist scientists extracorporeally irradiated allografts for bone and clinicians, VectorLAB aims to translate tumours between 1996 and 2014, examining advances in science and technology to help the clinical, functional and radiological people with cancer. outcomes for patients. It demonstrated that extracorporeal irradiation is a versatile In 2018, VectorLAB acquired a customised reconstructive technique for dealing with 3D printer from the startup company AON3D large defects after resection of bone tumours in Montreal. Georgio Katsifis, a postgraduate with good functional and radiographic student from the School of Physics at outcomes. Functional outcomes as measured University of Sydney, took up the challenge to by Musculoskeletal Tumor Society (MSTS) use the printer to build bone scaffolds using scoring system, the Toronto Extremity Salvage the strong polymer Poly-ethyl-ethyl ketone Score (TESS) and Quality of Life-C30 (QLQ- (PEEK). The scaffolds were then treated using 30) were strongly correlated to radiographic a plasma gas method to attract bone growth. outcomes. (Mr Katsifis was awarded the Robinson Prize by ACPSEM for the best biomedical engineering Our researchers also contributed to the project in 2018.) national Trans Tasman Radiation Oncology Group randomised phase 3 trial that looked The team comprises Head and Neck Surgeon at whether postoperative concurrent Jonathan Clark AM, cell biologist Linda Rogers, chemoradiotherapy, where there is high- and medical physicist Natalka Suchowerska risk cutaneous squamous cell carcinoma from Chris O'Brien Lifehouse working in (SCC) of the head and neck, improves patient collaboration with materials physicist Professor outcomes as opposed to postoperative David McKenzie and Georgio Katsifis. radiotherapy.

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This study will ultimately using a powerful combination of peptides, in collaboration with the University of NSW, enable patients who were tested on urinary catheters and found to have lost bone to prevent infection in the form of biofilms from developing. This finding means that patients' receive a customised risk of infection, associated with medical scaffold implanted to devices, is significantly reduced and the need for catheter replacement is reduced. support regrowth of the patient's own cells. Funds from Tour de Cure were used to create a magnetic nanoparticle treatment that can carry therapeutic molecules into cancer In working to reduce the risk of infection cells. Many types of treatments can now be during cancer surgery and treatment, considered for targeted delivery to cancer VectorLAB has developed an innovation with cells by nanoparticles, one of them being the potential to benefit all surgical patients, a gene silencing therapy for hard to treat not just those being treated for cancer. cancers such as mesothelioma. The antimicrobial treatments, developed

30 RESEARCH REPORT 2017 & 2018

Gynaecological Oncology

Department List Summary By Numbers

Prof Jonathan Carter MBBS Dip RACOG FACS FRANZCOG CGO MS MD 15 publications (Director) A/Prof Selvan Pather MBChB FCOG FRANZCOG 69 presentations CGO A/Prof Samir Saidi MBChB MRCOG FRANZCOG 17 students PhD A/Prof Trevor Tejada-Berges MD MSc FRCPSC 1 grant FACOG FRANZCOG Dr Rhonda Farrell BAppSc MBBS (Hons) Dip ObGyn FRANZCOG CGO MS (Incoming Deputy Dr Paulette Maroun MBBS FRANZCOG Director) Dr Karuna Raja MBBS MS MOHS FRANZCOG Dr Robyn Sayer MD FACOG FRANZCOG CGO Dr Anthony Richards MBBS FRANZCOG MBA Nurse Practitioner Shannon Philp NP MRMed CGO RN BN MN (NP) GradCertCancNurs Dr Sofia Smirnova MBBS Mmed (RHHG) GradCertWomen'sHealthNurs FRANZCOG Nurse Specialist Katie Dicks RN BN A/Prof Nesrin Varol PhD MIPH FRANZCOG Dr Gemma Blain MBBS (Hons) MRMed BSc MBBS FRANZCOG Dr Joyce Wu BSc MBBS FRANZCOG A/Prof Michael Cooper OAM MBBS MRCOG FRANZCOG MHKCOG FRCOG

Highlights

For years, the question of optimal adjuvant cervical cancer patients since the GOG 92 therapy for lymph node-negative cervical trial (a Gynecologic Oncology Group study cancer patients with intermediate risk factors initiated in 1989) found that it reduced the has been debated. rate of recurrence and improved survival.

Extra treatment modalities come with Through a review of the literature and substantial risks to patients, increasing the retrospective cohort study using data from chances and severity of complications and multiple institutions, researchers found side effects. Yet adjuvant radiotherapy after adjuvant therapy is not a significant prognostic radical surgery has been advocated for these factor for these patients. This different and

31 CHRIS O'BRIEN LIFEHOUSE

substantially better outcome can be attributed early-stage intermediate- and high-risk endo- to improved surgical techniques and more metrioid endometrial cancer, lymphadenecto- accurate preoperative and pathological my was found not to improve survival, yet was staging. associated with significantly higher rates of critical events and lymphoedema. The result from these findings will be that fewer patients The result will lead in this group will undergo lymphadenectomy to fewer patients and avoid higher related morbidity.

enduring unnecessary To date, our understanding of the relationship radiotherapy treatment, between diet and ovarian cancer survival has been limited. By examining the reducing complications relationship between pre-diagnostic diet and and risks, and improving overall survival in a population-based cohort of Australian women diagnosed with invasive quality of life. epithelial ovarian cancer, researchers have discovered links between ovarian cancer The role of lymphadenectomy (surgical survival a patient's pre-diagnosis diet. removal of one or more groups of lymph nodes) in patients with early-stage endometrial cancer is controversial. Previous studies Researchers observed have grouped patients with varying risks improved survival linked and histologies together, giving an unclear picture of the benefits of lymphadenectomies to fibre intake. in different patients. Furthermore, Long- term morbidity after lymphadenectomy has There was suggested further improvement remained uncertain. linked to eating green leafy vegetables, fish and poly- to mono-unsaturated fat ratio. Also By analysing data from a large prospective Aus- observed was a worse survival rate associated tralian National Endometrial Cancer Study, re- with a higher glycaemic index. searchers examined the association between lymphadenectomy and clinicopathological This new knowledge about the impact of a characteristics, adjuvant treatment, sur- pre-diagnosis diet on survival raises possibili- vival, patterns of disease recurrence, and ties for dietary choices after diagnosis. morbidity. In a large cohort of patients with

32 RESEARCH REPORT 2017 & 2018

Breast

Department List Summary By Numbers

Dr Cindy Mak MBBS (Hons) FRACS (Head of Department) 5 publications A/Prof Sanjay Warrier BSc (Med) MBBS FRACS MS 6 presentations Dr Farhad Azimi-Rashti MBBS MS FRACS Dr Ping-En Chen BHB MBCHB MS FRACS 1 student Dr Deborah Cheung MBBS FRAC Dr Senarath Edirimanne BMBS (Hons) FRACS 1 grant Dr George Fleischer BMBS FRACS Dr Irandi Jayatilleke BMedSc BMBS(Hons) Dr Joel Symonds BMedSc (Hons) MBBS FRACS FRACS GradCertSurg Dr David LittleJohn MBBS FRACS Dr April Wong MBChB MS FRACS Dr Belinda Chan MBBS FRACS MS Dr Michael Yunaev MBBS MPH BMedSc (Hons) MS FRACS

Highlights

In a significant development in reducing the Anecdotally, rates of risk of necrosis (cell death) following complex breast reconstruction procedures for women necrosis have decreased who have had mastectomy, researchers and a prospective trial is have demonstrated how intraoperative assessment of skin flaps using SPY Elite underway to determine influences decision-making in direct to implant the full impact of this and expander-based reconstruction. technology. SPY Elite technology gives surgeons the ability to monitor intraoperatively blood flow to The role of antibiotics in reconstructive different areas of the breast during surgery. implant work has been a matter of scrutiny, Surgeons who use this technology have with the question of clinical benefits derived reported being better informed to consider from using antibiotics and antiseptics to delayed techniques or avoid reconstruction washout the breast pocket or soak the breast altogether. implant during surgery remaining inconclusive.

33 CHRIS O'BRIEN LIFEHOUSE

The Centers for Disease Control and Prevention irrigation, which couples Negative Pressure give a muted recommendation for washing Wound Therapy with automated, controlled tissues in iodophor, but until now, the efficacy delivery of topical wound treatment solutions and impact of this practice in reducing to and from the wound bed. infection rates had not been adequately examined. The findings showed rapid cleaning of the wound and formation of granulations, and Through a systematic review of cohort stud- was followed by successful reinsertion of ies involving an implant or tissue expander in breast implants. augmentative surgery, researchers found that using antibiotics in pocket washout or implant immersion does indeed reduce infection rates, In what is a relatively however the evidence is deficient. While data simple solution, trends towards better outcomes with beta- dine and antibiotics, it remains unproven and this treatment a randomised control trial is needed. was demonstrably

As part of an ongoing series, researchers from capable of salvaging multiple hospitals examined approaches to reconstruction in the managing complications relating to breast implant infections. In one instance, they dis- event of infection. cussed treatment using Veraflo™ device and

34 RESEARCH REPORT 2017 & 2018

Neurosurgery

Department List

Dr Brindha Shivalingam MBBS FRACS (Director) Dr Johnny Wong MBBS (Hons) MMed PhD Dr Benjamin Jonker MBBS MMed FRACS FRACS Dr Rodney Allan MBBS (Hons) FRACS Dr Kim Kaufman, BMedSc (Hons) PhD

Highlights

The Neurosurgery research program launched Brainstorm Brain Cancer Research at the with the aim of improving the clinical manage- Brain and Mind Centre, Sydney University ment and outcomes for patients diagnosed and RPA Neuropathology Department, we with primary brain cancer. aim to launch Chris O'Brien Lifehouse as a new collection site of the Sydney Brain While primary malignant brain cancers have Tumour Bank. Tumour tissues, cells and blood a relatively low incidence, they carry a high specimens will be collected, preserved and disease burden. The most frequent subtype, made freely available to researchers world- glioblastoma, is incurable and often rapidly wide to support a variety of research into fatal. Despite paradigm-shifting advances in brain cancer. science, technology and healthcare over the last 30 years, survival rates for patients with With this framework in place, we are working glioblastoma have remained dismally low. towards the launch of GlioNET, a multi-centre, observational trial for newly diagnosed glioma This is a direct result of patients within the next 12 months. a lack of fundamental This ambitious project will track Australian patients diagnosed with glioma over the scientific research. entire course of their cancer journey. This will be the first concerted effort to While community awareness of brain cancer record complete longitudinal clinical and and its associated burden is growing, critical pathological information, bio-specimens research is hampered by the absence of ma- (blood, tumour tissues and cells), imaging terials to study. and patient- and caregiver-centred data (self- reported quality of life questionnaires, sleep In 2019, through our partnerships with and exercise data). Materials and information

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captured during GlioNET will create a unique, blood test for monitoring glioma tumour open-access platform to: progression, published by our group in 2018.1

1. Understand the molecular events driving Here we showed that robust molecular tumour evolution and adaptation, and signatures are detectable in blood exosomes failure of current standard therapies. and are specific to glioblastoma and lower 2. Discover and confirm novel biomarkers grade gliomas. that can accurately diagnose and predict tumour progression and treatment responses. This approach has 3. Identify opportunities for improving enormous potential to services and patient and carer morbidity. 4. Drive the implementation of adaptive revolutionise how brain clinical trials and ultimately, precision tumours are monitored. medicine. It could allow us to detect the very early stages GlioNET longitudinal data and specimens will of treatment failure, tumour recurrence and support a number of specific sub-studies, progression via simple blood tests. including the translation of a non-invasive

1 Ebrahimkhani S., Vafaee F., Hallal S., Wei H., Lee M. Y. T., Young P. E., Satgunaseelan L., Beadnall H., Barnett M. H., Shivalingam B., Suter C. M., Buckland M. E., Kaufman K. L. 2018. Deep sequencing of circulating exosomal microRNA allows non-invasive glioblastoma diagnosis. npj Precision Oncology, 2, 28 (2018). URL: https://www.nature.com/articles/s41698-018-0071-0.

36 RESEARCH REPORT 2017 & 2018

Uro-Oncology

Department List

Professor Henry Woo MBBS FRACS (Director) Dr Paul Sved BSc (Med) (Hons) MBBS (Hons) MMed FRACS Dr Nariman Ahmadi BSc (Med) MBBS FRACS Dr Ruban Thanigasalam MBBS MS FRACS Dr Norbert Doeuk MBBS MS FRACS Dr Arthur Vasilaras MBBS (Hons) FRACS Dr Scott Leslie BSc (Med) MBBS (Hons) FRACS Dr Tania Hossack MBBS (Hons) FRACS MSPro

Highlights

The Uro-Oncology research program launched could adversely affect quality of life at a time in 2018 and has contributed to several salient when the disease itself does not. Involving projects in its first months. 29 public and private cancer centres across Australia, New Zealand and Canada, the aim Inguinal hernia is a known consequence was to compare the effect of immediate ver- of radical prostatectomy that contributes sus delayed androgen-deprivation therapy on to patient morbidity and leads to higher health-related quality of life over five years. health care costs. Lesser known is that it is also common after minimally invasive Researchers found that immediate use of radical prostatectomy. In a systematic androgen-deprivation therapy was associated review of incidence, predictive factors and with early detriments in specific hormone- preventive measures, researchers found treatment-related symptoms, but no other high-level evidence that clarifies risk factors demonstrable effect on overall functioning and preventive strategies are lacking for of health-related quality of life. This evidence inguinal hernia following robotic and can be used to help decision-making about laparoscopic radical prostatectomy. The study treatment initiation for men at this disease demonstrated a justification for randomised stage. control trials to further evaluate this under- recognised clinical problem, which causes Researchers from multiple institutions sought patients distress and may require a second to evaluate the impact of publications on operation to fix. urological participation in social media by virtue of citations in the urological and In a multicentre phase 3 trial, researchers non-urological literature. They found that uro- studied whether androgen-deprivation ther- logical social media journal articles are highly apy for patients with prostate cancer (who cited, particularly in the non-urological litera- have relapsed with rising prostate-specific ture. It's likely the magnitude of citations has antigen concentration only or with non-cur- positively contributed to the impact factors of able but asymptomatic disease at diagnosis), publishing journals.

37 CHRIS O'BRIEN LIFEHOUSE

Supportive Care and Integrative Medicine

Department List Summary By Numbers

A/Prof Judith Lacey MBBS FRACGP FAChPM (FRACP) (Director) 14* publications Dr Suzanne Grant BAppSc (TCM) MPS PhD (Acupuncturist) 37 presentations Dr Toni Lindsay PhD (Clinical Psychologist) Mr Michael Marthick BSc GradDipSc (Ex 4 students Rehab) MPH (Exercise Physiologist) 9 grants Dr Diana Naehrig (Research Fellow, Supportive Care) * Includes co-publications with other Dr Victoria Choi (Acupuncturist, Researcher) Chris O'Brien Lifehouse departments

Highlights Integrative oncology is a fast-evolving field as Chris O'Brien Lifehouse is committed to more patients seek a holistic approach to their developing integrative oncology research disease and symptoms. The research strategy in Australia, working in collaboration with of the Supportive Care and Integrative Med- the University of Sydney, Western Sydney icine service at Chris O'Brien Lifehouse is fo- University, University of Technology, Sydney, cused on developing a strong evidence base NSW Health and other institutions nationally to support the integration of holistic medical and internationally. The last two years have care, complementary therapies, exercise and been particularly productive as this service has nutrition into standard cancer care. developed.

Furthermore, as people with cancer live Our researchers initiated a practice-chang- longer, there is a growing need to develop ing study into living well with melanoma programs that support them to live well. The and immunotherapy. Despite an increasing research program in the Supportive Care ser- number of metastatic melanoma patients vice aims to identify the best ways to support receiving immunotherapy treatment, includ- patients with a focus on symptoms. ing Pembrolizumab, the long term impacts on their well-being remain underexplored. A

38 RESEARCH REPORT 2017 & 2018

pilot study assessed the feasibility, perceived Australian healthcare setting, researchers benefit, and acceptability of a supportive care reflected on the Chris O'Brien Lifehouse intervention for people with metastatic mela- hospital experience. noma being treated with immunotherapy. They found the This pilot has paved the strategic integration of way for a feasible model medical specialist and of care in supportive integrative oncology cancer care and services, as part of the immunotherapy. hospital's supportive

It will contribute data to develop guidelines to care services, led to support these patients, and will inform a model improved acceptance of care for programs beyond melanoma. by specialists and This research informed a secondary objective, nursing staff. which was to explore the lived experience of these patients. The publication highlighted the patient experience of coping with Researchers have undertaken a retrospective uncertainty. evaluation over one year, interviewing oncologists, radiation oncologists, surgeons Exercise physiologist and researcher, Michael and clinical staff, to investigate how they Marthick, investigated the feasibility, usability approach meeting the supportive care and acceptability of an interactive web needs of their patients. This qualitative data portal developed to support patients with is being analysed and written. By evaluating cancer to increase daily physical activity the unmet supportive care needs of cancer levels. He found that the portal was feasible, patients at Chris O'Brien Lifehouse, this but further research is needed to determine research will inform interventions and service optimal coaching methods. development and enable benchmarking with services within Australia and internationally, In a paper that explored the establishment promoting collaboration in the integrative of an integrative oncology service in the oncology and supportive care space.

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Affiliates PoCoG & CeMPED

The Psycho-oncology Co-operative Research • All patients are invited to complete reg- Group (PoCoG) and Centre For Medical Psy- ular screening for anxiety and depression chology & Evidence-Based Decision-Making by completing a short online question- (CeMPED), are research centres of the Univer- naire. sity of Sydney collaborating with Chris O'Brien • Staff are alerted by the online system if Lifehouse on a large project that is evaluat- patients' scores indicate they are experi- ing the resources and support required to encing anxiety and depression. implement a clinical pathway to manage • The system recommends appropriate care anxiety and depression in cancer patients for that individual's level of anxiety and (ADAPT). depression. • Staff are prompted to discuss treatment options with the patient, and they record The ultimate goal of actions taken on the portal, including re- this project is to ensure ferrals to psychosocial health professionals. all patients receive • The portal triggers treatment comple- the best care possible, tion reports, and re-screening every three months. including for the • An online intervention using cognitive-be- emotional impact of haviour therapy is available to patients with mild to moderate anxiety/depres- cancer. sion.

In this study, twelve oncology units in NSW are ADAPT has recently 'gone live' at Chris O'Brien randomised to receive basic versus extended Lifehouse, with two patients registered in support to implement ADAPT. the system in the first week. Chris O'Brien Lifehouse will use ADAPT for one year. Staff are After training staff members in the clinical surveyed and a small group are interviewed pathway and how to use the online portal three times during the year, to gain feedback through which ADAPT operates, the project on how ADAPT is functioning. has these key features:

40 RESEARCH REPORT 2017 & 2018

Sydney Catalyst

Chris O'Brien Lifehouse is one of the original • Describe the natural history of and member groups of Sydney Catalyst and the re- patterns of care for lung cancer; lationship between the two organisations has • Better define, treat and care for patients gone from strength to strength. across Sydney Catalyst member hospitals, including Chris O'Brien Lifehouse; The Sydney Catalyst central office is housed • Create a platform for researchers across within the Lifehouse building. This has provided the T1-T3 translational research spectrum an important opportunity for the groups to develop and initiate clinical research to work closely together across a range of and intervention studies to address gaps. translational research projects and activities, challenging institutional and work culture Professor Boyer is a clinical lead for EnRICH boundaries. Co-location also provides Sydney and more than one-third of patients currently Catalyst staff with a unique opportunity to involved in EnRICH have been recruited from experience the inner workings of Chris O'Brien and/or treated at Chris O'Brien Lifehouse. Lifehouse, enriching their understanding of clinical practice and breaking down some of Some of the key research questions being the walls between researchers and clinicians. addressed by EnRICH include: • What are the molecular, disease and pa- The appointment of Professor Michael tient characteristics of patients with lung Boyer AM as the Director of Sydney Catalyst cancer? further harnesses the relationship, as does • What is the natural history of patients with the involvement of Professor Lisa Horvath, lung cancer in terms of recurrence-free Director of Research, on the Sydney Catalyst survival, overall survival and patient re- Scientific Advisory Committee. ported outcomes? • What are the main prognostic factors for EnRICH is an important example of translational these outcomes related to molecular, dis- research collaboration between Chris O'Brien ease and patient characteristics? Lifehouse and Sydney Catalyst. • What are current patterns of care for patients with lung cancer? How and why do The Embedding Research (and Evidence) patterns of care vary? in Cancer Healthcare (EnRICH) program is the major flagship translational cancer Significant new research opportunities have research program for Sydney Catalyst. Chris been made possible by EnRICH enabling Syd- O'Brien Lifehouse is a significant partner in this ney Catalyst members and others locally and program. internationally to use the resource to improve outcomes for people affected by cancer. A EnRICH is assembling a clinical cohort of number of sub-studies using biospecimens 1,000 patients with lung cancer to: and data from the EnRICH cohort are currently being undertaken.

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Cancer Nursing Research

The Cancer Nursing Research Unit is a member and mentorship of specialist nurses at Chris group of Sydney Catalyst and advances clinical O'Brien Lifehouse. nursing practice by supporting cancer nurses in research, higher degree studies and hosting Collaboration and one-on-one mentoring postgraduate students. has led to more nurses working more fre- quently within a research framework. The The CNRU conducts its research activities CNRU supports nurses to develop projects, under four themes: prepare papers and presentations, and submit • Supportive care; abstracts for presentations. • Psychosocial and quality of life; • Models of healthcare delivery; and • Improving research capacity and skills for By encouraging nurses cancer and palliative care nurses. to work within a

Recruitment has been completed and data research framework, analysis is well underway in a project that the CNRU empowers evaluates shared care pathway intervention to reduce chemotherapy outpatients' nurses to proactively unplanned presentations to hospital (a part- respond to patient nership with Lifehouse and Concord Repatria- tion General Hospital). needs that they observe through their work. A project to assess adolescent and young adult cancer patients' transition to palliative care and the effect on health care An example is a scalp cooling initiative professionals has been completed to recruit- which helps reduce the volume of hair that ment, with a paper in draft. is lost during chemotherapy. A methodology has been developed on another site and Outside of these formal research activities, the CNRU is working with Chris O'Brien Lifehouse CNRU continues to demonstrate the benefits to evaluate factors that will facilitate of co-location through its informal support implementation.

42 RESEARCH REPORT 2017 & 2018

RPA Institute of Academic Surgery

Established in 2014, the RPA Institute of This crucially underpins Academic Surgery (IAS) supports surgical departments across the broader Royal Prince more than 35 studies Alfred Hospital (RPAH), Chris O'Brien Lifehouse across the entire and University of Sydney campus to enhance their research and education. The IAS worked Advanced GI Surgical in close collaboration with a number of Program. Chris O'Brien Lifehouse surgical and medical departments on a range of research projects during 2017 and 2018. A new and exciting multi-site study that has been developed and commenced in 2017/18 Within the Head and Neck surgery is the ReLaPSeD trial. This is a prospective department this included commencing randomised controlled trial comparing re- pilot studies examining the effectiveness of look laparoscopy versus standard follow-up designing and printing 3D models to assist for early detection and treatment of patients with the surgical planning for complex at high risk of peritoneal metastases after reconstruction cases and the utilisation of resection of colorectal cancer. the IAS surgical skills facilities to undertake pre-clinical investigations as part of the Within breast surgery, projects were BLINC research project aiming to assist undertaken looking at the use of 3D printed patients with severe nerve damage to their models to assist in surgical planning and eyelids. patient education, as well as the ongoing investigation of the use and potential The delivery of the Advanced GI Surgical benefits of SPY imaging technology for Program incorporating pelvic exenteration, breast reconstruction patients. peritonectomy and advanced upper GI malignancy continues to be a strong point of In addition to their specific areas of research, collaboration between the IAS and a range of surgical staff from Chris O'Brien Lifehouse also leading clinicians from Chris O'Brien Lifehouse, provide regular teaching and mentoring to from Medical Oncology, Gynae Oncology a range of junior medical, nursing and allied and Radiation Oncology. This includes health staff doing research at the IAS, as well contributing to the program-wide research as the supervision of research projects being databases (PESQI, PREMIER and HUGO). undertaken by MD students at the University of Sydney.

Publications CHRIS O'BRIEN LIFEHOUSE

Medical Oncology

AHMADZADA, T., KAO, S., REID, G., BOYER, M., MAHAR, A. & HOLT, L., HAMID, O., RUTKOWSKI, P., MCNEIL, C., GARBE, COOPER, W. A. 2018. An Update on Predictive Biomarkers C., LOQUAI, C., DRENO, B., THOMAS, L., GROB, J. J., LISZ- for Treatment Selection in Non-Small Cell Lung Cancer. J KAY, G., NYAKAS, M., GUTZMER, R., PIKIEL, J., GRANGE, F., Clin Med, 7. HOELLER, C., FERRARESI, V., SMYLIE, M., SCHADENDORF, D., MORTIER, L., SVANE, I. M., HENNICKEN, D., QURESHI, A. AHMADZADA, T., REID, G. & KAO, S. 2018. Biomarkers in & MAIO, M. 2017. Ipilimumab 10 mg/kg versus ipilimum- malignant pleural mesothelioma: current status and fu- ab 3 mg/kg in patients with unresectable or metastat- ture directions. J Thorac Dis, 10, S1003-s1007. ic melanoma: a randomised, double-blind, multicentre, phase 3 trial. Lancet Oncol, 18, 611-622. AHN, M. J., KIM, D. W., CHO, B. C., KIM, S. W., LEE, J. S., AHN, J. S., KIM, T. M., LIN, C. C., KIM, H. R., JOHN, T., KAO, ASCIERTO, P. A., LONG, G. V., ROBERT, C., BRADY, B., DUTR- S., GOLDMAN, J. W., SU, W. C., NATALE, R., RABBIE, S., HAR- IAUX, C., DI GIACOMO, A. M., MORTIER, L., HASSEL, J. C., ROP, B., OVEREND, P., YANG, Z. & YANG, J. C. 2017. Ac- RUTKOWSKI, P., MCNEIL, C., KALINKA-WARZOCHA, E., SAV- tivity and safety of AZD3759 in EGFR-mutant non-small- AGE, K. J., HERNBERG, M. M., LEBBE, C., CHARLES, J., MI- cell lung cancer with CNS metastases (BLOOM): a phase HALCIOIU, C., CHIARION-SILENI, V., MAUCH, C., COGNET- 1, open-label, dose-escalation and dose-expansion study. TI, F., NY, L., ARANCE, A., SVANE, I. M., SCHADENDORF, Lancet Respir Med, 5, 891-902. D., GOGAS, H., SACI, A., JIANG, J., RIZZO, J. & ATKINSON, V. 2018. Survival Outcomes in Patients With Previously AMUNDSEN, A., BERGVIK, S., BUTOW, P., TATTERSALL, M. H. Untreated BRAF Wild-Type Advanced Melanoma Treated N., SORLIE, T. & NORDOY, T. 2018. Supporting doctor-pa- With Nivolumab Therapy: Three-Year Follow-up of a Rand- tient communication: Providing a question prompt list omized Phase 3 Trial. JAMA Oncol. and audio recording of the consultation as communication aids to outpatients in a cancer clinic. Patient Educ BALACHANDRAN, V. P., LUKSZA, M., ZHAO, J. N., MAKAROV, Couns, 101, 1594-1600. V., MORAL, J. A., REMARK, R., HERBST, B., ASKAN, G., BHANOT, U., SENBABAOGLU, Y., WELLS, D. K., CARY, C. AMUNDSEN, A., ERVIK, B., BUTOW, P., TATTERSALL, M. H., I. O., GRBOVIC-HUEZO, O., ATTIYEH, M., MEDINA, B., BERGVIK, S., SORLIE, T. & NORDOY, T. 2017. Adapting an ZHANG, J., LOO, J., SAGLIMBENI, J., ABU-AKEEL, M., ZAPPA- Australian question prompt list in oncology to a Norwe- SODI, R., RIAZ, N., SMORAGIEWICZ, M., KELLEY, Z. L., BAS- gian setting-a combined method approach. Support Care TURK, O., GONEN, M., LEVINE, A. J., ALLEN, P. J., FEARON, Cancer, 25, 51-58. D. T., MERAD, M., GNJATIC, S., IACOBUZIO-DONAHUE, C. A., WOLCHOK, J. D., DEMATTEO, R. P., CHAN, T. A., GREEN- ARMSTRONG-GORDON, E., GNJIDIC, D., MCLACHLAN, A., BAUM, B. D., MERGHOUB, T. & LEACH, S. D. 2017. Identi- HOSSEINI, B., GRANT, A., BEALE, P. & WHEATE, N. J. 2018. fication of unique neoantigen qualities in long-term survi- Patterns of platinum drug use in an acute care setting: a vors of pancreatic cancer. Nature, 551, 512-516. retrospective study. Journal of Cancer Research and Clini- cal Oncology, 144, 1561-1568. BARNET, M. B., BLINMAN, P., COOPER, W., BOYER, M. J., KAO, S. & GOODNOW, C. C. 2018. Understanding Im- ASCIERTO, P. A., DEL VECCHIO, M., ROBERT, C., MACKIEW- mune Tolerance of Cancer: Re-Purposing Insights from ICZ, A., CHIARION-SILENI, V., ARANCE, A., LEBBE, C., BAST- Fetal Allografts and Microbes. Bioessays, 40, e1800050.

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ALLANSON, B. M., LOW, T. H., CLARK, J. R. & GUPTA, R. CHIA, N., WEN, L., LYONS, J. G., ELLIOTT, M., LEE, M., 2018. Squamous Cell Carcinoma of the External Auditory PALME, C. E., CLARK, J. R. & GUPTA, R. 2018. Challenges Canal and Temporal Bone: An Update. Head Neck Pathol, and recommendations for minimally resourced biobanks 12, 407-418. in tertiary Australian hospitals. ANZ J Surg, 88, 115-116.

ASHFORD, B. G., CLARK, J., GUPTA, R., IYER, N. G., YU, B. & CH'NG, S. 2018. Commentary on: Supratrochlear Artery RANSON, M. 2017. Reviewing the genetic alterations in Based Periosteal Flaps: A New Alternative Technique for high-risk cutaneous squamous cell carcinoma: A search Nasal Lining Reconstruction. Plast Reconstr Surg. for prognostic markers and therapeutic targets. Head Neck, 39, 1462-1469. CH'NG, S. 2018. Reply: The Inside-Out Septal Mucoperi- chondrial Flap: Reconstruction of Nasal Lining Simplified. BADLANI, J., GUPTA, R., BALASUBRAMANIAN, D., SMITH, J., Plast Reconstr Surg, 142, 101e-102e. LUK, P. & CLARK, J. 2018. Primary salivary gland malignancies: a review of clinicopathological evolution, molecular CHONG, L. S. H., EVISTON, T. J., LOW, T. H., HASMAT, S., mechanisms and management. ANZ J Surg, 88, 152-157. COULSON, S. E. & CLARK, J. R. 2017. Validation of the Clinician-Graded Electronic Facial Paralysis Assessment. BADLANI, J., GUPTA, R., SMITH, J., ASHFORD, B., CH'NG, S., Plast Reconstr Surg, 140, 159-167. VENESS, M. & CLARK, J. 2018. Metastases to the parotid gland - A review of the clinicopathological evolution, mo- CHONG, L. S. H., TJAHJONO, R., EVISTON, T. J. & CLARK, J. lecular mechanisms and management. Surg Oncol, 27, R. 2017. Dual chimeric innervated vastus lateralis free 44-53. flap for single stage blink and midface reanimation. Head Neck, 39, 1894-1896. BARRY, C. P., WONG, D., CLARK, J. R., SHAW, R. J., GUPTA, R., MAGENNIS, P., TRIANTAFYLLOU, A., GAO, K. & BROWN, DIRVEN, R., EBRAHIMI, A., MOECKELMANN, N., PALME, C. J. S. 2017. Postoperative radiotherapy for patients with E., GUPTA, R. & CLARK, J. 2017. Tumor thickness versus oral squamous cell carcinoma with intermediate risk of depth of invasion - Analysis of the 8th edition American recurrence: A case match study. Head Neck, 39, 1399- Joint Committee on Cancer Staging for oral cancer. Oral 1404. Oncol, 74, 30-33.

BRUNNER, M., CH'NG, S., SHANNON, K., CLIFFORD, A., DORT, J. C., FARWELL, D. G., FINDLAY, M., HUBER, G. F., ASHFORD, B., ELLIOTT, M. & CLARK, J. R. 2017. Bone re- KERR, P., SHEA-BUDGELL, M. A., SIMON, C., UPPINGTON, J., section for facial cutaneous malignancies. J Surg Oncol, ZYGUN, D., LJUNGQVIST, O. & HARRIS, J. 2017. Optimal 116, 545-549. Perioperative Care in Major Head and Neck Cancer Sur- gery With Free Flap Reconstruction: A Consensus Review BUCKLEY, L., JACKETT, L., CLARK, J. & GUPTA, R. 2018. and Recommendations From the Enhanced Recovery Af- HPV-related Oropharyngeal Carcinoma: A Review of Clin- ter Surgery Society. JAMA Otolaryngol Head Neck Surg, ical and Pathologic Features With Emphasis on Updates 143, 292-303. in Clinical and Pathologic Staging. Adv Anat Pathol, 25, 180-188. EVISTON, T. J., CHONG, L. S. H. & CLARK, J. R. 2018. Reply:

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Validation of the Clinician-Graded Electronic Facial Paraly- JABBOUR, J., DHILLON, H. M., SHEPHERD, H. L., SUNDARE- sis Assessment. Plast Reconstr Surg, 141, 615e-616e. SAN, P., MILROSS, C. & CLARK, J. R. 2017. Challenges in Producing Tailored Internet Patient Education Materials. EVISTON, T. J., CHONG, L. S. H., KWAI, N. C. G., CLARK, J. R. Int J Radiat Oncol Biol Phys, 97, 866-867. * & KRISHNAN, A. V. 2018. Altered axonal excitability prop- erties in facial palsy. Muscle Nerve, 57, 268-272. JABBOUR, J., DHILLON, H. M., SHEPHERD, H. L., SUNDARE- SAN, P., MILROSS, C. & CLARK, J. R. 2018. The relationship FINDLAY, M., RANKIN, N., SHAW, T., WHITE, K., BOYER, M., between role preferences in decision-making and level of MILROSS, C., DE ABREU LOURENCO, R., BROWN, C., COLL, psychological distress in patients with head and neck can- J., BEALE, P. & ET AL. Innovation in implementation: A new cer. Patient Educ Couns, 101, 1736-1740. * model of nutrition care for patients with head and neck cancer improves outcomes. Dietitians Association of Aus- JABBOUR, J., MILROSS, C., SUNDARESAN, P., EBRAHIMI, A., tralia 35th National Conference, 2018 Sydney. SHEPHERD, H. L., DHILLON, H. M., MORGAN, G., ASHFORD, B., ABDUL-RAZAK, M., WONG, E., VENESS, M., PALME, C. E., FRIDMAN, E., NA'ARA, S., AGARWAL, J., AMIT, M., BACHAR, FROGGATT, C., COHEN, R., EKMEJIAN, R., TAY, J., ROSHAN, G., VILLARET, A. B., BRANDAO, J., CERNEA, C. R., CHATURVE- D. & CLARK, J. R. 2017. Education and support needs in DI, P., CLARK, J., EBRAHIMI, A., FLISS, D. M., JONNALAGA- patients with head and neck cancer: A multi-institutional DDA, S., KOHLER, H. F., KOWALSKI, L. P., KREPPEL, M., LIAO, survey. Cancer, 123, 1949-1957. * C. T., PATEL, S. G., PATEL, R. S., ROBBINS, K. T., SHAH, J. P., SHPITZER, T., YEN, T. C., ZOLLER, J. E. & GIL, Z. 2018. The JABBOUR, J., WYKES, J., MILROSS, C., SUNDARESAN, P., role of adjuvant treatment in early-stage oral cavity squa- EBRAHIMI, A., SHEPHERD, H. L., DHILLON, H. M. & CLARK, mous cell carcinoma: An international collaborative study. J. R. 2018. Examining clinicians' perceptions of head and Cancer, 124, 2948-2955. neck cancer (HNC) information. Asia Pac J Clin Oncol. *

GNANASEKARAN, T., LOW, H., GUPTA, R., GAO, K. & CLARK, KARAGIANNIS, P., CLARK, J. R. & CH'NG, S. 2017. The In- J. 2018. Prognosis of metastatic head and neck squamous side-Out Septal Mucoperichondrial Flap: Reconstruc- cell carcinoma over the last 30 years. ANZ J Surg, 88, tion of Nasal Lining Simplified. Plast Reconstr Surg, 140, 1158-1162. 644e-645e.

GUPTA, S., PARIKH, S. & GOEL, S. 2018. Parosteal osteosar- KHOO, T. K., YU, B., SMITH, J. A., CLARKE, A. J., LUK, P. P., coma of mandible: A rare case report. J Cancer Res Ther, SELINGER, C. I., MAHON, K. L., KRAITSEK, S., PALME, C., 14, 471-474. BOYER, M. J., DINGER, M. E., COWLEY, M. J., O'TOOLE, S. A., CLARK, J. R. & GUPTA, R. 2017. Somatic mutations in HASAN, Z., DWIVEDI, R. C., GUNARATNE, D. A., VIRK, S. A., salivary duct carcinoma and potential therapeutic targets. PALME, C. E. & RIFFAT, F. 2017. Systematic review and me- Oncotarget, 8, 75893-75903. ta-analysis of the complications of salvage total laryngec- tomy. Eur J Surg Oncol, 43, 42-51. LIU, J., EBRAHIMI, A., LOW, T. H., GAO, K., PALME, C. E., SYDNEY, C., ASHFORD, B. G., IYER, N. G., CLARK, J. R. & GUP- HAYDU, L. E., SCOLYER, R. A., LO, S., QUINN, M. J., SAW, R. P. TA, R. 2018. Predictive value of the 8th edition American M., SHANNON, K. F., SPILLANE, A. J., STRETCH, J. R., MCCAR- Joint Commission Cancer (AJCC) nodal staging system for THY, W. H. & THOMPSON, J. F. 2017. Conditional Survival: patients with cutaneous squamous cell carcinoma of the An Assessment of the Prognosis of Patients at Time Points head and neck. J Surg Oncol, 117, 765-772. After Initial Diagnosis and Treatment of Locoregional Mel- anoma Metastasis. J Clin Oncol, 35, 1721-1729. LOMAX, A. J., MCGUIRE, H. M., MCNEIL, C., CHOI, C. J., HERSEY, P., KARIKIOS, D., SHANNON, K., VAN HAL, S., CARR, INFANTINO, S., LIGHT, A., O'DONNELL, K., BRYANT, V., U., CROTTY, A., GUPTA, S. K., HOLLINGSWORTH, J., KIM, H., AVERY, D. T., ELLIOTT, M., TANGYE, S. G., BELZ, G., MACKAY, FAZEKAS DE ST GROTH, B. & MCGILL, N. 2017. Immuno- F., RICHARD, S. & TARLINTON, D. 2017. Arginine methyla- therapy-induced sarcoidosis in patients with melanoma tion catalyzed by PRMT1 is required for B cell activation treated with PD-1 checkpoint inhibitors: Case series and and differentiation. Nat Commun, 8, 891. immunophenotypic analysis. Int J Rheum Dis, 20, 1277-

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1285. * NARAYANAPPA, H., LOW, T. H., VARGAS CALDERON, A. C., SELINGER, C. & GUPTA, R. 2018. Inflammatory myofibro- LOW, T. H., LINDSAY, A., CLARK, J., CHAI, F. & LEWIS, R. 2017. blastic tumours of the head and neck. Pathology, 50, 356- Reconstruction of maxillary defect with musculo-adipose 358. rectus free flap. Microsurgery, 37, 137-141. NELIGAN PC, C. N. S. 2018. The evolution of head and LOW, T. H., YEH, D., ZHANG, T., ARASLANOVA, R., HAM- neck reconstruction. Aust J Plast Surg., 1(2), 24-30. MOND, J. A., PALMA, D., READ, N., VENKATESAN, V., MAC- NEIL, S. D., YOO, J., NICHOLS, A. & FUNG, K. 2017. Evalu- ROPER, E., LUM, T., PALME, C. E., ASHFORD, B., CH'NG, S., ating organ preservation outcome as treatment endpoint RANSON, M., BOYER, M., CLARK, J. & GUPTA, R. 2017. PD- for T1aN0 glottic cancer. Laryngoscope, 127, 1322- L1 expression predicts longer disease free survival in high 1327. risk head and neck cutaneous squamous cell carcinoma. Pathology, 49, 499-505. * LOW, T. H. & YOO, J. 2017. Subtotal Parathyroidectomy and Relocation of the Parathyroid Remnant for Renal Hy- SATGUNASEELAN, L., CHIA, N., SUH, H., VIRK, S., ASHFORD, perparathyroidism: modification of a traditional opera- B., LUM, T., RANSON, M., CLARK, J. & GUPTA, R. 2017. p16 tion. J Otolaryngol Head Neck Surg, 46, 60. expression in cutaneous squamous cell carcinoma of the head and neck is not associated with integration of high LUK, P. P., SELINGER, C. I., COOPER, W. A., MAHAR, A., PALME, risk HPV DNA or prognosis. Pathology, 49, 494-498. C. E., O'TOOLE, S. A., CLARK, J. R. & GUPTA, R. 2018. Clini- cal Utility of In Situ Hybridization Assays in Head and Neck SELINGER C, E. B., GUPTA, ET AL. 2018. Examples of the di- Neoplasms. Head Neck Pathol. agnostic utility of USP6 Fish in soft tissue and bone pahtol- ogy. Pathology, 50, S141-S142. MOECKELMANN, N., EBRAHIMI, A., DIRVEN, R., LIU, J., LOW, T. H., GUPTA, R., ASHFORD, B., CH'NG, S., PALME, C. E. & SHARMA, A., CAO, E. Y., KUMAR, V., ZHANG, X., LEONG, H. CLARK, J. R. 2018. Analysis and Comparison of the 8th S., WONG, A. M. L., RAMAKRISHNAN, N., HAKIMULLAH, M., Edition American Joint Committee on Cancer (AJCC) Nod- TEO, H. M. V., CHONG, F. T., CHIA, S., THANGAVELU, M. al Staging System in Cutaneous and Oral Squamous Cell T., KWANG, X. L., GUPTA, R., CLARK, J. R., PERIYASAMY, G., Cancer of the Head and Neck. Ann Surg Oncol, 25, 1730- IYER, N. G. & DASGUPTA, R. 2018. Longitudinal single-cell 1736. RNA sequencing of patient-derived primary cells reveals drug-induced infidelity in stem cell hierarchy. Nat- Com MOECKELMANN, N., EBRAHIMI, A., TOU, Y. K., GUPTA, R., mun, 9, 4931. LOW, T. H., ASHFORD, B., CH'NG, S., PALME, C. E. & CLARK, J. R. 2018. Prognostic implications of the 8th edition SMITH, J. A., VIRK, S., PALME, C. E., LOW, T. H., CH'NG, S., American Joint Committee on Cancer (AJCC) staging sys- GUPTA, R., GAO, K. & CLARK, J. 2018. Age is not a predictor tem in oral cavity squamous cell carcinoma. Oral Oncol, of prognosis in metastatic cutaneous squamous cell carci- 85, 82-86. noma of the head and neck. ANZ J Surg, 88, E273-e277.

MORTON, R. L., TRAN, A., VESSEY, J. Y., ROWBOTHAM, N., SMITHERS, F. A. E., CHENG, K., JAYARAM, R., MUKHERJEE, P. WINSTANLEY, J., SHANNON, K., SPILLANE, A. J., STRETCH, J., & CLARK, J. R. 2018. Maxillofacial reconstruction using in- THOMPSON, J. F. & SAW, R. P. 2017. Quality of Life Follow- house virtual surgical planning. ANZ J Surg, 88, 907-912. ing Sentinel Node Biopsy for Primary Cutaneous Melano- ma: Health Economic Implications. Ann Surg Oncol, 24, SUAN, D., KRAUTLER, N. J., MAAG, J. L. V., BUTT, D., BOURNE, 2071-2079. K., HERMES, J. R., AVERY, D. T., YOUNG, C., STATHAM, A., ELLIOTT, M., DINGER, M. E., BASTEN, A., TANGYE, S. G. & MUELLER, S. A., GAUTHIER, M.-E. A., ASHFORD, B., GUPTA, BRINK, R. 2017. CCR6 Defines Memory B Cell Precursors R., GAYEVSKIY, V., CH'NG, S., PALME, C. E., SHANNON, K., in Mouse and Human Germinal Centers, Revealing Light- CLARK, J. R., RANSON, M. & COWLEY, M. J. Mutational Pat- Zone Location and Predominant Low Antigen Affinity. Im- terns in Metastatic Cutaneous Squamous Cell Carcinoma. munity, 47, 1142-1153.e4. Journal of Investigative Dermatology.

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SUBRAMANIAM, N., BALASUBRAMANIAN, D., LOW, T. H., J. F. & SCOLYER, R. A. 2017. Neurotropic melanoma: an MURTHY, S., CLARK, J. R., THANKAPPAN, K. & IYER, S. 2018. analysis of the clinicopathological features, management Factors Affecting Survival in Surgically Salvaged Locore- strategies and survival outcomes for 671 patients treated gional Recurrences of Squamous Cell Carcinoma of the at a tertiary referral center. Mod Pathol, 30, 1538-1550. * Tongue. J Oral Maxillofac Surg, 76, 1133.e1-1133.e6. VASAN, K., LOW, T. H., GUPTA, R., ASHFORD, B., ASHER, SUBRAMANIAM, N., MURTHY, S., BALASUBRAMANIAN, D., R., GAO, K., CH'NG, S., PALME, C. E. & CLARK, J. R. 2018. LOW, T. H., VIDHYADHARAN, S., CLARK, J. R., THANKAPPAN, Lymph node ratio as a prognostic factor in metastatic cu- K. & IYER, S. 2018. Adverse pathologic features in T1/2 taneous head and neck squamous cell carcinoma. Head oral squamous cell carcinoma classified by the American Neck, 40, 993-999. Joint Committee on Cancer eighth edition and implications for treatment. Head Neck, 40, 2123-2128. YIP, S., FLEMING, J., SHEPHERD, H. L., WALCZAK, A., CLARK, J. & BUTOW, P. 2018. "As Long as You Ask": A Qualita- TAM, S., ARASLANOVA, R., LOW, T. H., WARNER, A., YOO, tive Study of Biobanking Consent-Oncology Patients' and J., FUNG, K., MACNEIL, S. D., PALMA, D. A. & NICHOLS, A. Health Care Professionals' Attitudes, Motivations, and Ex- C. 2017. Estimating Survival After Salvage Surgery for Re- periences-the B-PPAE Study. Oncologist. current Oral Cavity Cancer. JAMA Otolaryngol Head Neck Surg, 143, 685-690. ZHOU, K., LUONG, J. K., CLARK, J. R. & CH'NG, S. 2018. Coned Radial Forearm Free Flap for Improved Retention TRAUTMAN, J., GORE, S., POTTER, M., CLARK, J., HYAM, D., of Orbital Prosthesis following Orbital Exenteration. Plast TAN, N. C., NGO, Q. & ASHFORD, B. 2018. Supraclavicular Reconstr Surg, 142, 818e-819e. flap repair in the free flap era. ANZ J Surg, 88, 540-546. ZILBERG, C., LEE, M. W., YU, B., ASHFORD, B., KRAITSEK, TSEROS, E., RIFFAT, F., PALME, C. E., COLEMAN, H. G. & SIN- S., RANSON, M., SHANNON, K., COWLEY, M., IYER, N. G., GH, N. P. 2017. Neville Wran's voice: how the Premier's PALME, C. E., CH'NG, S., LOW, T. H., O'TOOLE, S., CLARK, J. Teflon-coated vocal cords came unstuck. Med J Aust, 207, R. & GUPTA, R. 2018. Analysis of clinically relevant somat- 468-470. ic mutations in high-risk head and neck cutaneous squamous cell carcinoma. Mod Pathol, 31, 275-287. VAREY, A. H. R., GOUMAS, C., HONG, A. M., MANN, G. J., FOGARTY, G. B., STRETCH, J. R., SAW, R. P. M., SPILLANE, A. * Publication shared with other Chris O'Brien Lifehouse J., SHANNON, K. F., LEE, K. J., QUINN, M. J., THOMPSON, department

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DAS I.J., MORALES J. 2017. Small-field dosimetry in meg- FROGGATT, C., COHEN, R., EKMEJIAN, R., TAY, J., ROSHAN, avoltage x-ray beams. In: DAS, I. (ed.) Radiochromic Film: D. & CLARK, J. R. 2017. Education and support needs in Role and Applications in Radiation Dosimetry 2017. 1 ed. patients with head and neck cancer: A multi-institutional survey. Cancer, 123, 1949-1957. * ESTOESTA, R. P., ATTWOOD, L., NAEHRIG, D., CLAR- IDGE-MACKONIS, E., ODGERS, D., MARTIN, D., PHAM, M., JABBOUR, J., WYKES, J., MILROSS, C., SUNDARESAN, P., TOOHEY, J. & CARROLL, S. 2017. Assessment of voluntary EBRAHIMI, A., SHEPHERD, H. L., DHILLON, H. M. & CLARK, deep inspiration breath-hold with CINE imaging for breast J. R. 2018. Examining clinicians' perceptions of head and radiotherapy. J Med Imaging Radiat Oncol, 61, 689-694. * neck cancer (HNC) information. Asia Pac J Clin Oncol. *

FOGARTY, G. B., HONG, A., ECONOMIDES, A. & GUIT- JONES, C. W., SHATROV, J., JAGIELLO, J. M., MILLINGTON, ERA, P. 2018. Experience with Treating Lentigo Maligna S., HONG, A., BOYLE, R. & STALLEY, P. D. 2017. Clinical, with Definitive Radiotherapy. Dermatol Res Pract, 2018, functional and radiological outcomes of extracorporeal 7439807. irradiation in limb salvage surgery for bone tumours. Bone Joint J, 99-b, 1681-1688. HEWSON, E. A., BUTSON, M. J. & HILL, R. 2018. Evaluating TOPAS for the calculation of backscatter factors for low KROON, H. M., VAN DER BOL, W. D., TONKS, K. T., HONG, energy x-ray beams. Phys Med Biol, 63, 195014. A. M., HRUBY, G. & THOMPSON, J. F. 2018. Treatment of Clinically Positive Cervical Lymph Nodes by Limited Local HILL R., PODER J. 2017. Kilovoltage X-ray beam dosimetry Node Excision and Adjuvant Radiotherapy in Melanoma and imaging In: DAS, I. (ed.) Radiochromic Film: Role and Patients with Major Comorbidities. Ann Surg Oncol, 25, Applications in Radiation Dosimetry 2017. 1 ed. 3476-3482.

HIRSHMAN, B. R., WILSON, B. R., ALI, M. A., SCHUPPER, A. LAI, K., KILLINGSWORTH, M., YONG, J., MATTHEWS, S., J., PROUDFOOT, J. A., GOETSCH, S. J., CARTER, B. S., SIN- EBRAHIMI, A., MCGUINNESS, J., NGO, Q., CAIXEIRO, N., CLAIR, G., BARTEK, J., JR., CHIANG, V., FOGARTY, G., HONG, HONG, A. & LEE, C. S. 2017. Specific localization of LC3B A. & CHEN, C. C. 2018. Cumulative Intracranial Tumor Vol- in autophagosome: A correlative labelling study with nan- ume Augments the Prognostic Value of Diagnosis-Specific oparticle in oral squamous cell carcinoma. Exp Mol Pathol, Graded Prognostic Assessment Model for Survival in Pa- 102, 422-427. tients with Melanoma Cerebral Metastases. Neurosurgery, 83, 237-244. LAI, K., MATTHEWS, S., WILMOTT, J. S., KILLINGSWORTH, M. C., YONG, J. L., CAIXEIRO, N. J., WYKES, J., SAMAKEH, A., HONG, A. M., JONES, D., BOYLE, R. & STALLEY, P. 2018. Ra- FORSTNER, D., LEE, M., MCGUINNESS, J., NILES, N., HONG, diation Therapy as an Alternative Treatment for Desmoid A., EBRAHIMI, A. & LEE, C. S. 2018. Differences in LC3B Fibromatosis. Clin Oncol (R Coll Radiol), 30, 589-592. expression and prognostic implications in oropharyngeal and oral cavity squamous cell carcinoma patients. BMC JABBOUR, J., DHILLON, H. M., SHEPHERD, H. L., SUNDARE- Cancer, 18, 624. SAN, P., MILROSS, C. & CLARK, J. R. 2017. Challenges in Producing Tailored Internet Patient Education Materials. LONG, G. V., ATKINSON, V., HONG, A., MCARTHUR, G. A. & Int J Radiat Oncol Biol Phys, 97, 866-867. * MENZIES, A. M. 2018. Omitting radiosurgery in melanoma brain metastases: a drastic and dangerous de-escalation - JABBOUR, J., DHILLON, H. M., SHEPHERD, H. L., SUNDARE- Authors' reply. Lancet Oncol, 19, e367. SAN, P., MILROSS, C. & CLARK, J. R. 2018. The relationship between role preferences in decision-making and level of MARTINAGE, G., HONG, A. M., FAY, M., THACHIL, T., ROOS, psychological distress in patients with head and neck can- D., WILLIAMS, N., LO, S. & FOGARTY, G. 2018. Quality cer. Patient Educ Couns, 101, 1736-1740. * assurance analysis of hippocampal avoidance in a melanoma whole brain radiotherapy randomized trial shows JABBOUR, J., MILROSS, C., SUNDARESAN, P., EBRAHIMI, A., good compliance. Radiat Oncol, 13, 132. SHEPHERD, H. L., DHILLON, H. M., MORGAN, G., ASHFORD, B., ABDUL-RAZAK, M., WONG, E., VENESS, M., PALME, C. E., OLEJNIK, J., SUCHOWERSKA, N., HERRID, M., JACKSON, A.,

64 RESEARCH REPORT 2017 & 2018

JACKSON, M., ANDRONICOS, N. M., HINCH, G. N. & HILL, J. J., HALKETT, G. K. B., TURNER, R. M., MILROSS, C. & DHIL- R. 2018. Sensitivity of spermatogonia to irradiation var- LON, H. M. 2018. A low literacy targeted talking book ies with age in pre-pubertal ram lambs. Anim Reprod Sci, about radiation therapy for cancer: development and ac- 193, 58-67. ceptability. Support Care Cancer. *

OLEJNIK, J., SUCHOWERSKA, N., HERRID, M., JACKSON, SMITH, S. K., NATHAN, D., TAYLOR, J., VAN GELDER, E., DIX- M., HINCH, G. & HILL, J. 2018. Spermatogonia survival in ON, A., HALKETT, G. K. B., MILROSS, C. & DHILLON, H. M. young ram lambs following irradiation, Busulfan or ther- 2017. Patients' experience of decision-making and receiv- mal treatment. Small Ruminant Research, 166, 22-27. ing information during radiation therapy: A qualitative study. Eur J Oncol Nurs, 30, 97-106. PENG, V., SUCHOWERSKA, N., ESTEVES, A. D. S., ROGERS, L., CLARIDGE MACKONIS, E., TOOHEY, J. & MCKENZIE, D. SUNDARESAN, P., KING, M., STOCKLER, M., COSTA, D. & MIL- R. 2018. Models for the bystander effect in gradient radi- ROSS, C. 2017. Barriers to radiotherapy utilization: Con- ation fields: Range and signalling type. J Theor Biol, 455, sumer perceptions of issues influencing radiotherapy-re- 16-25. lated decisions. Asia Pac J Clin Oncol, 13, e489-e496.

PENG, V., SUCHOWERSKA, N., ROGERS, L., CLARIDGE MACK- TIO, M., WANG, X., CARLINO, M. S., SHIVALINGAM, B., FOG- ONIS, E., OAKES, S. & MCKENZIE, D. R. 2017. Grid therapy ARTY, G. B., GUMINSKI, A. D., LO, S., HONG, A. M., MEN- using high definition multileaf collimators: realizing bene- ZIES, A. M. & LONG, G. V. 2018. Survival and prognostic fits of the bystander effect. Acta Oncol, 56, 1048-1059. factors for patients with melanoma brain metastases in the era of modern systemic therapy. Pigment Cell Melano- POLLOCK, S., TSE, R., MARTIN, D., MCLEAN, L., PHAM, M., ma Res, 31, 509-515. TAIT, D., ESTOESTA, R., WHITTINGTON, G., TURLEY, J., KEAR- NEY, C., CHO, G., HILL, R., PICKARD, S., ASTON, P., MAKHIJA, VAREY, A. H. R., GOUMAS, C., HONG, A. M., MANN, G. J., K., O'BRIEN, R. & KEALL, P. 2018. Impact of audiovisual bi- FOGARTY, G. B., STRETCH, J. R., SAW, R. P. M., SPILLANE, A. ofeedback on interfraction respiratory motion reproduci- J., SHANNON, K. F., LEE, K. J., QUINN, M. J., THOMPSON, bility in liver cancer stereotactic body radiotherapy. J Med J. F. & SCOLYER, R. A. 2017. Neurotropic melanoma: an Imaging Radiat Oncol, 62, 133-139. analysis of the clinicopathological features, management strategies and survival outcomes for 671 patients treated PORCEDDU, S. V., BRESSEL, M., POULSEN, M. G., STONELEY, at a tertiary referral center. Mod Pathol, 30, 1538-1550. * A., VENESS, M. J., KENNY, L. M., WRATTEN, C., CORRY, J., COOPER, S., FOGARTY, G. B., COLLINS, M., COLLINS, M. K., YAO, M., ROGERS, L., SUCHOWERSKA, N., CHOE, D., MACANN, A. M. J., MILROSS, C. G., PENNIMENT, M. G., LIU, AL-DABBAS, M. A., NARULA, R. S., LYONS, J. G., SVED, P., H. Y., KING, M. T., PANIZZA, B. J. & RISCHIN, D. 2018. Post- LI, Z. & DONG, Q. 2018. Sensitization of prostate cancer operative Concurrent Chemoradiotherapy Versus Postop- to radiation therapy: Molecules and pathways to target. erative Radiotherapy in High-Risk Cutaneous Squamous Radiother Oncol, 128, 283-300. Cell Carcinoma of the Head and Neck: The Randomized Phase III TROG 05.01 Trial. J Clin Oncol, 36, 1275-1283. * Publication shared with other Chris O'Brien Lifehouse department SMITH, S. K., CABRERA-AGUAS, M., SHAW, J., SHEPHERD, H., NAEHRIG, D., MEISER, B., JACKSON, M., SAADE, G., BUCCI,

65 CHRIS O'BRIEN LIFEHOUSE

Gynaecological Oncology

CARTER, J., HAMMOND, I. & SMITH, M. 2017. The renewal JANDA, M., GEBSKI, V., DAVIES, L. C., FORDER, P., BRAND, of the National Cervical Screening Program. Med J Aust, A., HOGG, R., JOBLING, T. W., LAND, R., MANOLITSAS, T., 206, 274. NASCIMENTO, M., NEESHAM, D., NICKLIN, J. L., OEHLER, M. K., OTTON, G., PERRIN, L., SALFINGER, S., HAMMOND, CARTER, J., PATHER, S. & NASCIMENTO, M. 2018. Current I., LEUNG, Y., SYKES, P., NGAN, H., GARRETT, A., LANEY, M., status of ovarian cancer surgical management. Argument NG, T. Y., TAM, K., CHAN, K., WREDE, C. D., PATHER, S., SIM- for centralisation of care in Australia. Aust N Z J Obstet COCK, B., FARRELL, R., ROBERTSON, G., WALKER, G., ARM- Gynaecol, 58, 474-477. FIELD, N. R., GRAVES, N., MCCARTNEY, A. J. & OBERMAIR, A. 2017. Effect of Total Laparoscopic Hysterectomy vs CIBULA, D., ABU-RUSTUM, N. R., FISCHEROVA, D., PATHER, Total Abdominal Hysterectomy on Disease-Free Survival S., LAVIGNE, K., SLAMA, J., ALEKTIAR, K., MING-YIN, L., KO- Among Women With Stage I Endometrial Cancer: A Rand- CIAN, R., GERMANOVA, A., FRUHAUF, F., DOSTALEK, L., omized Clinical Trial. Jama, 317, 1224-1233. DUSEK, L. & NARAYAN, K. 2018. Surgical treatment of "intermediate risk" lymph node negative cervical cancer KARAMI JH, L. K., FUNG T, CARTER J, DING Z. 2017. An patients without adjuvant radiotherapy-A retrospective investigation of survival following ovarian cancer. Malays cohort study and review of the literature. Gynecol Oncol, J Med Biol Res 4 27-34. 151, 438-443. MORTON, R., ANDERSON, L., CARTER, J., PATHER, S. & SAI- EA, G. 2018. Diabetes and its role in gynaecological ma- DI, S. A. 2017. Intraoperative Frozen Section of Ovarian lignancies. O&G Magazine RANZCOG, 20, 48-49 Tumors: A 6-Year Review of Performance and Potential Pitfalls in an Australian Tertiary Referral Center. Int J Gyne- FARRELL, R., DIXON, S. C., CARTER, J. & WEBB, P. M. 2017. col Cancer, 27, 17-21. Lymphadenectomy in Early-Stage Intermediate-/High-Risk Endometrioid Endometrial Cancer: Clinical Characteris- PATHER, S., TEJADA BERGES, T., SAIDI, S. & CARTER, J. 2018. tics and Outcomes in an Australian Cohort. Int J Gynecol Re: Neoadjuvant chemotherapy for advanced ovarian Cancer, 27, 1379-1386. cancer. Who really benefits? Aust N Z J Obstet Gynaecol, 58, E25-e26. GANE, E. M., STEELE, M. L., JANDA, M., WARD, L. C., REUL- HIRCHE, H., CARTER, J., QUINN, M., OBERMAIR, A. & HAYES, PHILP, S., BARNETT, C., D'ABREW, N. & WHITE, K. 2017. S. C. 2018. The Prevalence, Incidence, and Quality-of-Life Nurse confidence in gynaecological oncology practice Impact of Lymphedema After Treatment for Vulvar or and the evaluation of a professional development mod- Vaginal Cancer. Rehabilitation Oncology, 36, 48-55. ule. Contemp Nurse, 53, 203-216.

HAYES, S. C., JANDA, M., WARD, L. C., REUL-HIRCHE, H., PHILP, S., MELLON, A., BARNETT, C., D'ABREW, N. & WHITE, STEELE, M. L., CARTER, J., QUINN, M., CORNISH, B. & OBER- K. 2017. The road less travelled: Australian women's ex- MAIR, A. 2017. Lymphedema following gynecological periences with vulval cancer. Eur J Cancer Care (Engl), 26. cancer: Results from a prospective, longitudinal cohort study on prevalence, incidence and risk factors. Gynecol PLAYDON, M. C., NAGLE, C. M., IBIEBELE, T. I., FERRUCCI, L. Oncol, 146, 623-629. M., PROTANI, M. M., CARTER, J., HYDE, S. E., NEESHAM, D.,

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NICKLIN, J. L., MAYNE, S. T. & WEBB, P. M. 2017. Pre-diag- TONG, P. S. Y., CONG, A. & PATHER, S. 2018. nosis diet and survival after a diagnosis of ovarian cancer. Hysteroscopy for Pyometra - Treading on Br J Cancer, 116, 1627-1637. Treacherous Grounds. Gynecol Minim Invasive Ther, 7, 185-186.

Breast

ATARA POSNER, F. A., DAVID GOLTSMAN AND SANJAY WAR- Pressure Wound Therapy for Salvaging Implant-Based RIER. 2017. Practicing changing cases using ICG technol- Breast Reconstruction. ogy in Breast Reconstruction. BJSTR, 1. OTHMAN, J., ROBBINS, E., LAU, E. M., MAK, C. & BRYANT, FROIS, A. O., HARBOUR, P. O., AZIMI, F., YOUNG, J., CHAN, C. 2017. Tattoo Pigment–Induced Granulomatous Lym- B., MAK, C. & WARRIER, S. 2018. The Role of Antibiotics in phadenopathy Mimicking Lymphoma. Annals of Internal Breast Pocket Irrigation and Implant Immersion: A System- Medicine, 167, 830-831. atic Review. Plast Reconstr Surg Glob Open, 6, e1868. SYMONDS, J. G., GRANT, A., NEWMAN, A., MIRTO, R. & GOLTSMAN, D., YONG CHEONG, J., POSNER, A., ABRAHAM, WARRIER, S. 2018. PO10 Management outcomes in lac- E., AZIMI, F. & WARRIER, S. 2018. The Role of Negative tational breast abscesses: 10-year tertiary centre review.

Uro-Oncology

CALOPEDOS, R. J. S., CHALASANI, V., ASHER, R., EMMETT, DUCHESNE, G. M., WOO, H. H., KING, M., BOWE, S. J., L. & WOO, H. H. 2017. Lutetium-177-labelled anti-pros- STOCKLER, M. R., AMES, A., D'ESTE, C., FRYDENBERG, M., tate-specific membrane antigen antibody and ligands for LOBLAW, A., MALONE, S., MILLAR, J., TAI, K. H. & TURN- the treatment of metastatic castrate-resistant prostate ER, S. 2017. Health-related quality of life for immediate cancer: a systematic review and meta-analysis. Prostate versus delayed androgen-deprivation therapy in patients Cancer Prostatic Dis, 20, 352-360. with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, mul- CALOPEDOS, R. J. S., GARCIA, C., RASHID, P., MURPHY, D. ticentre, non-blinded, phase 3 trial. Lancet Oncol, 18, G., LAWRENTSCHUK, N. & WOO, H. H. 2017. Citation indi- 1192-1201. * ces for social media articles in urology. BJU Int, 119 Suppl 5, 47-52. * Publication shared with other Chris O'Brien Lifehouse department

67 CHRIS O'BRIEN LIFEHOUSE

Supportive Care and Integrative Medicine

ELSNER, K., NAEHRIG, D., HALKETT, G. K. B. & DHILLON, H. LEVY, D., DHILLON, H. M., LOMAX, A., MARTHICK, M., MC- M. 2017. Reduced patient anxiety as a result of radiation NEIL, C., KAO, S. & LACEY, J. 2018. Certainty within uncer- therapist-led psychosocial support: a systematic review. J tainty: a qualitative study of the experience of metastatic Med Radiat Sci, 64, 220-231. melanoma patients undergoing pembrolizumab immunotherapy. Support Care Cancer. * ELSNER, K. L., NAEHRIG, D., HALKETT, G. K. B. & DHILLON, H. M. 2018. Development and pilot of an international M. EDWARDS, K., THOMAS, V., SEET-LEE, C., CHEEMA, B., survey: 'Radiation Therapists and Psychosocial Support'. J BOYER, M. & MARTHICK, M. 2018. Piloting the Effect of Med Radiat Sci, 65, 209-217. Aerobic Exercise during Chemotherapy Infusion in Pa- tients with Cancer: 1653 Board #3 May 31 3. ESTOESTA, R. P., ATTWOOD, L., NAEHRIG, D., CLAR- IDGE-MACKONIS, E., ODGERS, D., MARTIN, D., PHAM, M., MARTHICK, M., DHILLON, H. M., ALISON, J. A., CHEEMA, TOOHEY, J. & CARROLL, S. 2017. Assessment of voluntary B. S. & SHAW, T. 2018. Development of a Web Portal for deep inspiration breath-hold with CINE imaging for breast Physical Activity and Symptom Tracking in Oncology Pa- radiotherapy. J Med Imaging Radiat Oncol, 61, 689-694. tients: Protocol for a Prospective Cohort Study. JMIR Res * Protoc, 7, e136.

GRANT, S. J., HUNTER, J., BENSOUSSAN, A. & DELANEY, G. P. MARTHICK, M., DHILLON, H. M., ALISON, J. A., CHEEMA, B. 2018. Guidance for establishing an integrative oncology S. & SHAW, T. 2018. An Interactive Web Portal for Track- service in the Australian healthcare setting-a discussion ing Oncology Patient Physical Activity and Symptoms: paper. Support Care Cancer, 26, 471-481. Prospective Cohort Study. JMIR Cancer, 4, e11978.

GRANT, S. J., MARTHICK, M. & LACEY, J. 2018. Establishing MARTHICK M, A. J., CHEEMA BS, DHILLON H, SHAW T an integrative oncology service in the Australian health- 2018. Pulmonary rehabilitation and eHealth practices for care setting-the Chris O'Brien Lifehouse Hospital experi- patients undergoing surgical treatment for lung cancer : ence. Support Care Cancer. a survey of multidisciplinary team sites in Australia. Aus- tralian Journal of Cancer Nursing, 19, 14-20. HERRMANN, E., NAEHRIG, D., SASSOWSKY, M., BIGLER, M., BUIJSEN, J., CIERNIK, I., ZWAHLEN, D., PELLANDA, A. F., SMITH C, H. J., USSHER J. M, DELANEY G. P, GRANT S. J, MEISTER, A., BRAUCHLI, P., BERARDI, S., KUETTEL, E., DU- TEMPLEMAN K., KELLETT A 2017. Integrative Oncology in FOUR, J. F. & AEBERSOLD, D. M. 2017. External beam radi- Australia 2016: Mapping Service Provision and Exploring otherapy for unresectable hepatocellular carcinoma, an Unmet Needs. Western Sydney University. international multicenter phase I trial, SAKK 77/07 and SASL 26. Radiat Oncol, 12, 12. SMITH, C. A., HUNTER, J., DELANEY, G. P., USSHER, J. M., TEMPLEMAN, K., GRANT, S. & OYSTON, E. 2018. Integra-

68 RESEARCH REPORT 2017 & 2018 tive oncology and complementary medicine cancer ser- LON, H. M. 2018. A low literacy targeted talking book vices in Australia: findings from a national cross-sectional about radiation therapy for cancer: development and ac- survey. BMC Complement Altern Med, 18, 289. ceptability. Support Care Cancer. *

SMITH, S. K., CABRERA-AGUAS, M., SHAW, J., SHEPHERD, H., * Publication shared with other Chris O'Brien Lifehouse NAEHRIG, D., MEISER, B., JACKSON, M., SAADE, G., BUCCI, department J., HALKETT, G. K. B., TURNER, R. M., MILROSS, C. & DHIL-

Grants CHRIS O'BRIEN LIFEHOUSE

Medical Oncology

Simes J, Boyer MJ, Young J, Thomas D, Butow P, Vadas M. Research Excellence for Translational Breast Cancer Re- Translational Cancer Centre Grant, NSW Cancer Institute. search. From Discovery to Better Health Outcomes. $6,500,000. (2016-2021). $2,500,000. (2012-2017).

Barratt A, McCaffery K, Carter S, Glasziou P, Kerridge I, Simes J, Keech A, Gebski A, Stockler M, Caterson I, Cola- Semsarian C, Howard K, Doust J, Elshaug A, Moynihan (AI giuri S, Schofield D, Marschner I. Advancing the Evidence - Tattersall, M). NHMRC - Centres for Research Excellence Base for Care and Policy in Priority Health Areas (Program (APP1104136). Creating sustainable healthcare: ensuring Grant) 1037786. $10,643,000. (2013-2017). new diagnostics avoid harms, improve outcomes, and direct resources wisely. $2,400,000 over 5 years. (2017- Simes J. Research Fellowship, 1121008. $863,910. 2021). (2017-2021).

Sanson-Fisher R, Butow P, Tattersall M, D'Este C, Doran C, Simes J. Program Grant, 1150467. $12,215,472. (2019- Martin J. CCNSW Program Grant. Improving and maintain- 2023). ing holistic cancer survivor outcomes. A system-based program. $2,234,524.91 over 5 years. (2018-2022). Anderson RL, Swarbrick A, Johnstone R, Chua B, Gill A, Khanna K, Lakhani S, Loi S, O'Toole S, Saunders C. AI 4: Be- Juraskova I, Butow P, Laidsaar-Powell R, Boyle F, Yates P, ith J. Development of a national resource of primary and Schofield P, Kay J, Costa D. AI: Tattersall, M. NHMRC Pro- secondary metastatic breast cancers to test new drugs ject Grant (APP1146383). Empowering the clinician-pa- and identify the genetic changes that drive breast can- tient-carer TRIO: RCT of a novel online education modules cer growth and metastasis. NBCF National Infrastructure to facilitate effective family carer involvement in oncolo- Grant. $1,834,335 (2015-2019) AI 4 gy. $593,201.60 over 3 years. (2018-2020). Mahon, K. Movember Prostate Cancer Foundation of Aus- CI: Hui, M. NBCF Investigator Initiated Research Scheme. tralia Clinician Scientist Award. $450,000. (2016-2018) Discovering new therapeutic strategies for metastatic triple negative breast cancer at cellular resolution. (2018). Movember Revolutionary Team Award. $3 million. (2015- 2020). Hui, M. Sydney Breast Cancer Foundation Research Fellow- ship. (2017). Butler L, Hoy A, Swinnen J, Wittert G, Scott A, Tilley W. Exploiting alterations in lipid metabolism to improve di- CI: Hui, M. Roche Research and Development Grant. agnosis, treatment and molecular imaging of prostate (2017). cancer. Role: Team member – Kate Mahon

Hui, M. Sydney Catalyst Prof Rob Sutherland Travel Award. CIs: Butler L, Horvath L, Tilley W, Stricker P. Cancer Austral- (2017). ia/Prostate Cancer Foundation of Australia. 1050880. A pharmacodynamics study of the heat shock protein 90 Lindeman G, Mann G, Desai J, Forbes J, Fox S, Liew D, (Hsp90) inhibitor, AUY922, in high-risk, localized prostate Mcarthur G, Simes J, Sutherland R, Visvader J. Centre of cancer. $590,000. (2013-2019).

72 RESEARCH REPORT 2017 & 2018

CIs: Thomas D, Horvath LG. Cancer Gene Discovery and Fazekas de St Groth B, Kao S, Brown M, de Souza P, Grimison Validation Program. RT Hall. $334,425. (2016-2018). P, Ormerod J, McGure H. Predicting responses to cancer immunotherapy. Cancer Council Australia Project Grant, CI: Horvath LG. Peer-reviewed Astellas research project $599,705. (2018-2020). grant. Exploiting lipid metabolism to predict response to treatment in advanced prostate cancer. $200,000. Keebone A, Samra J, Le H, Nguyen N, Goldstein D, Apte M, (2016-2018). Barbour A, Oar A, Chander S, Espinoza D. AI Grimison, P. mFOLFIRINOX And STEreotactic body Radiotherapy (SBRT) CIs: von Itzstein M, Horvath LG. Peer-reviewed grant from for Pancreatic cancer with high-risk and Locally AdvaNced private foundation. The Cancer Glycome Project. $2.54 disease (MASTERPLAN): a multicentre, randomised phase million. (2016-2018). II study of the Australian Gastrointestinal Trials Group (AGITG). NHMRC MRFF Low Survival Cancers and Diseases CIs: Hart D, Clark G, Horvath L. CINSW Translational Pro- (LSCD) Grant, $1,470,201. (2018 - 2022). gram Grant. Therapeutic Antibody Translation into Pa- tients. $3.45 million. (2017-2022). Rasko J, Sandroussi C, Grimison P, Adelstein S. Cellular immuno-gene therapy for pancreatic cancer. Cancer Coun- Horvath L. Below the Belt ANZUP. Statins in metastat- cil NSW Pathways to a cancer-free future Grant Scheme, ic castration-resistant prostate cancer study. $36,000. $2,000,000. (2018 - 2022). (2017-2019). Grimison P, Haber P, Stockler M, Lintzeris N, Simes J, CIs: Stricker PD, Clark SJ, Hayes VM, Horvath LG, Kench JG, McGregor I, Oliver I, Allsop D, Gedye C, Kirby A. Pilot Rasiah K, Joshua A. Australian Government Department and definitive randomised double-blind placebo- of Health and Aging. Australian Prostate Cancer Research controlled trials evaluating an oral cannabinoid-rich Centre - NSW. Integrating research into clinical practice in THC/CBD cannabis extract for secondary prevention of prostate cancer. $1.5 million. (2017-2018). chemotherapy-induced nausea and vomiting. NSW Health. $2,792,269. (2015 – 2021). CIs: Horvath LG, Stricker PD, Kench J, Joshua A, Clark S, Emmett L, Hayes V. CINSW Translational Program Grant. Goldstein D, Friedlander M, Kiernan M, Krishnan A, Boyle TPG172146. $3.75 million. (2018-2023). F, Moalem-Taylor G, Haas M, Cohn R, Farrar M. AI Grimison P. Chemotherapy-induced Peripheral Neuropathy: Assess- CIs: Butler L, Lynn D, Hayes V, Horvath L, Mills I, Centen- ment strategies, Treatments and Risk Factors. Cancer In- era M. PdCCRS Cancer Australia Project Grant. Novel stitute NSW Program Grant for Excellence in Translational co-extinction strategies for treatment of prostate cancer. Research. $3,040,000. (2015 – 2019). $596,409. (2018-2020). Butow P, Andrews G, Kelly B, Girgis A, Aranda S, Viney R, CIs: Sandhu S, Horvath LG. Prostate Cancer Founda- Clayton J, Hack T, Price M, Beale P. AI Grimison P. A sus- tion Challenge Award. Harnessing synergies between tainable and supported clinical pathway for managing 177Lu-PSMA therapy and olaparib to improve clinical out- anxiety and depression in cancer patients: Developing and come of men with metastatic castration resistant pros- evaluating components and testing implementation strat- tate cancer (CRPC). (2017-2019). egies. Cancer Institute NSW Program Grant for Excellence in Translational Research. $3,643,992. (2015 - 2019). Butler LM, Swinnen JV, Tilley WD, Scott AM, Hoy AJ, Wittert GA, Horvath LG. Movember Foundation / Prostate Can- Grimison P, Toner G, Stockler M, Friedlander M, Thomson D, cer Foundation of Australia (Revolutionary Team Award). Gebski V, King M, Quinn D, Singhal N. Accelerating first-line Exploiting alterations in lipid metabolism to improve chemotherapy to improve cure rates for advanced germ diagnosis, treatment and molecular imaging of pros- cell tumours: an Australian-led, international randomised tate cancer. Phase I: 2015-2018, $3,250,000. Phase II: trial. Cancer Australia and Cancer Council Australia Project 2019-2020, $2,000,000. Grant, $595,342. (2013 - 2018).

73 CHRIS O'BRIEN LIFEHOUSE

Kao S. Cancer Council NSW Competitive Grant 2018. Pre- CI: Bhadri V. Australian Young Cancer Patient Clinical Trials dicting response to checkpoint therapy in lung cancer pa- Initiative 2018 – Ewing sarcoma. $522,000. tients as CIB. $758,033.50 over 5 years. CI: Bhadri V. Australian Young Cancer Patient Clinical Trials Kao S. Cancer Institute Research Infrastructure Grant Initiative 2018 – Medulloblastoma. $965,000. 2015: "Expanding the Asbestos Diseases Research Insti- tute (ADRI) biobank to create a state-wide repository for AI: Bhadri V. Australian Young Cancer Patient Clinical Trials research into thoracic cancers" as CIA. $300,000. (2015 Initiative 2018 – Genomic Screening. $950,000. - 2018).

Head and Neck

CI: Luk P. Sydney Catalyst 2018. Understanding the Body's and stay well hydrated before, during and after treat- Response to Cancer Invasion and Progression: Towards ment. $34,000. Assisting the Body's Defence System in Fighting Cancer. $50,000. CI: Clark J. ANZHNS Reconstructive Surgery Grant. The Bi- onic Lid Implant for Natural Eye Closure (BLINC). $10,000. CI: Gupta R. ANZHNCS 2018. Can Clinical Validation of Biologic Predictors of Metastases in Head and Neck Cu- Venchiarutti R. COSA Travel Grant. $425. taneous Squamous Cell Carcinoma be Achieved by Tran- scriptomic Profiling. $10,000. Venchiarutti R. Cancer Research Network University of Sydney. Cancer Research Network Postgraduate Student CI: Clark J. ANZHNCS Reconstructive Surgery Grant 2018. Conference Travel Grant. $1,716. The Bionic Lid Implant for Natural Eye Closure (BLINC). $10,000. Venchiarutti R. Primary Care Collaborative Cancer Clinical Trials Group (PC4): Self-reported management of possi- Awarded to Beyond Five. NSW Department of Health ble symptoms of head and neck cancer: a primary care 2018. Developing a sustainable structure for Beyond vignette survey. $4,000. Five. $15 000. Satgunaseelan L. RCPA Foundation Research Postgradu- Awarded to Beyond Five. Brady Cancer Support Founda- ate Fellowship. $25,000. tion 2018. Development of Head and Neck Cancer Pod- casts. $10,000. CI: Clark J. Equity Trustees. Identifying the genetic drivers of Metastasis in skin cancer. $30,000. CI: Vasan K. General Surgeons Australia 2018. Young patients with head & neck squamous cell carcinoma – Iden- CI: Findlay M. Sydney Research Health Informatics Re- tification of mismatch repair gene mutations. $1,000. searcher PhD Scholarship. Towards Value-Based Compre- hensive Cancer Care: Development and Implementation CI: Satgunaseelan L. RCPA Foundation Postgraduate Re- of a Next Generation Nutrition Care Analytical Dashboard search Fellowship 2018. Identifying actionable mutations for Patients with Head and Neck Cancer. $120,000. in young patients with oral cavity squamous cell carcinoma. $25,000. CI: Findlay M. Australia and New Zealand Head and Neck Cancer Society Research Foundation. Enhanced Recovery Awarded to Beyond Five. Dry July 2018. Dry July Founda- After Surgery: Feasibility of Pre-operative Carbohydrate tion grant to develop evidence based and easy to follow Loading in Patients Undergoing Major Head and Neck animations that help patients maintain good nutrition Cancer Surgery with Free Flap Reconstruction. $5,000.

74 RESEARCH REPORT 2017 & 2018

CI: Clark J. University of Sydney: Biomedical Research Col- CI: Clark J. Australian and New Zealand Head and Neck laboration Scheme. $15,000. (2017-2018). Cancer Society Foundation 2016: Markers of metastases in cutaneous SCC using Nanostring. $5,000. CI: Nadia Rosin. Tour de Cure 2018. Australia and New Zealand's first Head and Neck Cancer Patient Support CI Findlay M. NHMRC-Cancer Institute NSW Translating Group Portal. $31,000. Research Into Practice Fellowship. Best evidence to best practice: Implementing an innovative model of care for CI: Clark J. Sydney Local Health District. Building the IT nutritional management of patients with head and neck Infrastructure Needed to Support the SHNCI Research Pro- cancer. $272,911. (2015-2017). gram and to Improve Outcomes in Head and Neck Can- cers. $300,000. Prostate Cancer Foundation of Australia. Biologically Smart Radiotherapy: killing more prostate cancer by stimulating CI: Clark J. Sydney Local Health District. Identification of immune responses. $98,180. therapeutic targets, prognostic and predictive markers in high grade head and neck cancers that currently lack sec- University of Sydney ECR/MCR Seed Grant. Improving pa- ond line therapies. $300,000. tient outcomes in radiation therapy: does imaging dose affect the tumour response. $10,000. CI: Clark J. Sydney Local Health District. The Bionic Lid Im- plant for Natural Lid Closure (BLINC) for facial paralysis. University of Sydney Research Equipment Grant. To deter- $150,000. mine the impact of an additional imaging CBCT dose on cell survival following radiation therapy. $9,906. CI: Bruce Ashford. Genomic Landscape of metastatic cutaneous squamous cell carcinoma ANZHNCS Research Grant. $5,000. (2016-2017).

Radiation Oncology

CI: Suchowerska N. Prostate Cancer Foundation of Aus- CI: Suchowerska N. University of Sydney Research Equip- tralia. Biologically Smart Radiotherapy: killing more pros- ment Grant. To determine the impact of an additional tate cancer by stimulating immune responses. $98,180. imaging CBCT dose on cell survival following radiation therapy. $9,906. CI: Suchowerska N. University of Sydney ECR/MCR Seed Grant. Improving patient outcomes in radiation therapy: CI: Suchowerska N. Sydney Breast Cancer Foundation. does imaging dose affect the tumour response. $10,000. Breast cancer research. $10,000. 2017.

Gynaecological Oncology

ASCCP. A cohort of patients with HPV negative, High grade cervical dysplasia. $10,000.

75 CHRIS O'BRIEN LIFEHOUSE

Breast

AirXpander: Satisfaction of Carbon Dioxide Based Tissue Expander for Breast Reconstruction. $5,000.

Supportive Care and Integrative Medicine

Lacey J. MSD. Living well with melanoma. $135,000. Lacey J, Grant S, Spiegel G. Donor. Reflexology and Acu- (2017-2018). puncture in day therapy unit. $20,000.

Marthick M. Donor. Livingroom@home. $100,000. Lacey J. Donor. Supportive care study. $100,000.

Lacey J, Marthick M, Templeton S. Dry July. Lymphoedema Lacey J, Grimmison P. NSW Health. Medicinal Cannabis (LEAP). $30,000. NSW health observational and PK study. $3,600,000.

Lacey J, Marthick M, Dickson C. Donor. Mindfulness@ Lacey J. Bioceuticals. Medicinal Cannabis: Recurrent GBM. home. $10,000. $500,000.

Lacey J, Marthick M, Dickson C. Tour de Cure 2018. Mind- fulness@home. $70,000.

76 Featured Artist: Julia Westwood All artworks in this report are acrylic on canvas paintings by Julia Westwood. Julia, a National Art School graduate, was Artist In Residence at Chris O'Brien Lifehouse in 2019. The Artist in Residence program is an initiative by Arterie that brings practising artists to demonstrate in the main foyer of Chris O'Brien Lifehouse. www.juliawestwood.com.au. Chris O'Brien Lifehouse 119 - 143 Missenden Road Camperdown NSW 2050 PO Box M5 Missenden Road Camperdown NSW 2050 www.mylifehouse.org.au Report produced by Professor Lisa Horvath, Sarah Charlton Li and Juliette O'Brien. General Enquiries Designed by Juliette O'Brien. T: (02) 8514 0000 Printed by Vertifix Printing. [email protected] ABN 70 388 962 804 Donations & Support Registered Charity Number CFN 17573 T: (02) 8514 0006 Hospital Provider Number 0027350Y [email protected] © 2019 Chris O'Brien Lifehouse