Associate Professor Lisa Horvath,
Director of Medical Oncology & Acting Director of Research, Chris O'Brien Lifehouse
Chris O`Brien Lifehouse research director and prostate cancer medical oncologist Lisa Horvath first became interested in medical research in her first year of training in medical oncology. That was the year that the first clinical trials in Herceptin, an antibody against a pathway in breast cancer, were presented at the American Society of Clinical Oncology.
“And this trial actually showed that if you gave that patient chemotherapy, you turned this disease which had a very poor prognosis and bad outcome for patients, and you could switch it around and get these women responding to chemotherapy and targeted therapies.
“So it revolutionised what we did in breast cancer. It just felt like a new world was starting to open up.”
From Herceptin, heralded as a major advance in targeted (where treatments target a specific type of cell) cancer therapies, cancer treatment has been revolutionised by a multitude of targeted therapies and new agents and new drugs “…and things we couldn’t possibly have imagined 20 years ago when I started training. And it’s all because people do clinical trials.”
“It’s incredibly important that we’re able to take basic research findings and real-life treatment experience and work with the researchers to run clinical trials to change how we manage patients and improve survival.”
Clinical trials don’t just involve new drugs. They trial new techniques for everything from surgical robotics to community nursing for patients having chemotherapy.
At Chris O`Brien Lifehouse, new medicine trials are case managed by clinical trial nursing staff, with close contact and supervision. Patients are encouraged to communicate freely with nursing and medical staff.
“In particular if patients are trialling a brand new drug, are there side effects that we haven’t thought about that they need to tell us about.
Sadly, A/Prof Horvath says, drug trials may not work for every patient.
“We can never say to a patient ‘this trial will help you’. We can say ‘this is the likelihood that this trial may help you’ but we’re always very open about the fact that this may not work and that this may be purely a philanthropic gesture on their part.”
However, A/Prof Horvath recalls her involvement with two trials called the Cougar 1 and Cougar 2 trials of the drug Abiraterone, used to treat very advanced prostate cancer.
“Suddenly these patients were getting extraordinary clinical responses and improved pain and were able to get up and do things that we hadn’t imagined would happen.
“But that became part of the registration study that resulted in the drug going on the pharmaceutical benefits scheme and being available to all patients with prostate cancer. So not only did we see patients getting huge benefits on the trial, they contributed to the licencing of the drug worldwide for the benefit of many millions of patients with prostate cancer.
“Largely, patients are hugely philanthropic. They would love it if it helped them, but they also want to help people in the future so that other people can do better with this disease.”