Cancer of Low Survival and Unmet Need Initiative

A cancer of unmet neeed, or rare cancer, has less than 6 incidences per year per 100,000 population, and a less common cancer has an incidence rate between 6 and 12 cases per 100,000 persons (Rare Cancers Australia). It is estimated that 42,000 people are diagnosed with a form of rare or less common cancer in Australia every year (Cancer Australia, 2019).

These are rare or aggressive tumours, those resistant to standard therapies, or those that are difficult to diagnose. This includes cancers such as bone, pancreatic or brain cancer.

These cancers present a clinical conundrum. They are often beyond the standard of care; can have enigmatic diagnosis, with ambiguous prognosis or tissue of origin; and are evolved, resistant to treatment, and prone to relapse.

These classes of cancers have not seen the improved outcomes of many of the more common types of cancer. In 2015, around 1 in 3 people diagnosed with cancer were diagnosed with a rare or less common cancer; for the same year these cancers accounted for just under 1 in 2 cancer-related deaths (Australian Institute of Health and Welfare).

This initiative does not provide any therapies. What is does provide is a report for your clinician presenting information that may assist in selection of therapies according to your genomic profile.

The results may provide additional information about your tumour including which treatments may work better, clarifying what sort of cancer you have and finding that you may have an inherited a genetic problem that leads to you developing cancer.

The results of testing on tumour and/or blood may reveal information about inherited conditions that run in your family. If present, this information will be provided to your oncologist along with the other results of your testing. In this event, if you agree, your oncologist will refer you to the Familial Cancer Service at your hospital for confirmatory testing and discussion about the results.

Research has shown that cancers are caused by gene mutations, which then cause abnormal cell growth or resistance to standard cancer treatments. Researchers study genes in order to understand why some people have cancer and why some people do not. Understanding a person’s genes also may be able to explain why some people respond to a treatment, while others do not. In some circumstances, a specific change in DNA may even make the cancer respond better to a specific targeted treatment.

Gene sequencing allows the identification of mutations, and new technologies have made it possible to map out the entire genome at the same time.

This initiative will use these new technologies to identify gene mutations present in a person’s cancer which could potentially assist the doctors to select appropriate treatment option according to their particular genomic profile. As each person’s cancer genomic profile may be different, this may help doctors to develop a ‘personalised’ cancer therapy for each patient.

Our clinical partners are the entry point to the COLUMN Initiative, enabling recruitment into clinical studies. The initiative is currently delivered through hospitals across the Victorian Comprehensive Cancer Centre Alliance, including the Peter MacCallum Cancer Centre, The Royal Melbourne Hospital, The Women's, Western Health and Austin Health.

There are specific eligibility requirements for the COLUMN Initiative. People with cancer will need to talk to their clinician to understand if they are suitable for this program. The program is designed for cancers of unmet need, including rare and less common cancer types. Talk to your clinician to understand if you are suitable.

For clinicians

If you have a patient you would like to refer, or a potential clinical study partnership, please get in touch with us to discuss further.