Bertalli Chair in Cancer Medicine, Prof Sean Grimmond talks about where cancer medicine is heading and the potential of the MRFF to transform his work.
The $20 billion Medical Research Future Fund has the potential to transform how we diagnose and treat disease, according to Professor Sean Grimmond, the University’s director of cancer research.
His office is in the Victorian Comprehensive Cancer Centre, a complex that incorporates the new Peter MacCallum Cancer Centre, where clinicians and researchers work together. The massive influx of money from the future fund (MRFF) will give local cancer patients access to the latest advances by allowing more large-scale clinical trials to be held in Australia, he says.
Grimmond’s special area of interest is medical genetics, and his research has examined the underlying genetics controlling tissue repair and cancer. Recent advances in DNA sequencing technologies means the cost of sequencing a person’s genome has fallen to about $1000 – down from about $1 million in 2010. That change, combined with “greater information about what makes a cancer grow”, means personalised cancer treatments are “where the world is heading”, he adds.
Personalised cancer therapies means the hit-and-miss chemo treatments commonly prescribed now will eventually be phased out, Grimmond says. In the future, a cancer patient’s genome will be decoded “to see if you are likely to have a toxic response to a particular drug”. Doctors will also be able to determine with greater precision whether more recent treatments such as immunotherapy can be successfully employed – these drugs don’t work for everyone, and only on particular types of cancer. But “an enormous amount of research” is required before this more tailored response can be rolled out, he says.
We have to enable whole new ways of doing things. We want to minimise the harm we do. And we want the most cost-effective health care possible.
Personalised cancer medicine will also require “a co-ordinated whole of system change” in cancer hospitals, as oncologists adapt their treatment strategies and nurses are trained in new protocols. “With the MRFF, we can allow for whole of system improvements to allow this co-ordinated response to happen,” he explains.
This type of wholesale change is already being pursued in the UK, Europe and North America. France recently announced an investment of €670 million to incorporate genomics into the treatment of cancer, diabetes and rare illnesses.
“There is potential to improve outcomes, Grimmond continues. “We have to enable whole new ways of doing things. We want to minimise the harm we do. And we want the most cost-effective health care possible.”
Cancers were once classified and treated according to the primary site where they appeared in the body. But genetic decoding of tumours shows the underlying structure of the cancer, potentially allowing existing treatments to be applied in new ways (breast cancer drugs could be used to treat pancreatic cancer, for instance) and for new drugs to be tested.
Grimmond is careful not to overstate his case. He does not claim that a cure for cancer is at hand – but he does predict that in the not-too-distant future a cancer diagnosis may not strike the same level of fear that it does today. We can look forward to cancer becoming “a treatable chronic condition”, he says.