The elusive goal of the Liver Cancer Collaborative

Every day countless people across the world devote their time, energy and intellect to an elusive goal… discovery of a novel mechanism to arrest the spread of cancer.

It’s a race against the clock, or perhaps against the rate at which these cells multiply, for researchers like Clinical A/Prof. Michael Wallace, Clinical Director of the Liver Cancer Collaborative, which brings together over 50 multidisciplinary experts to help address the growing global challenge of defeating liver cancer.

With October being Liver Cancer Awareness month, and collaboration and personalised care being so important to Minderoo Foundation, we asked Michael why he does what he does.

The desire to contribute to the discovery of new knowledge that may one day lead to better outcomes for patients is the core reason. Additionally, research gives me the opportunity to work with people from a range of disciplines other than mine, from other hospitals and universities around the world, all of whom share the same desire for discovery.

The management of primary liver cancer is challenging, from barriers to early diagnosis, to underlying advanced liver disease often precluding curative therapies, to a lack of proven systemic therapies. One of the most significant challenges is the vast variation and gaps in our understanding of the genetic drivers of primary liver cancer, both between patients and even within the one tumour – meaning a ‘one size fits all approach’ is not appropriate. Gaining a more complete understanding of this tumour heterogeneity is a core aim of the Liver Cancer Collaborative.

The Liver Cancer Collaborative aims to develop a comprehensive and deeply characterised primary liver cancer biobank linked with blood samples and detailed clinical information collected across a range of patient types (early, intermediate and advanced stages; cirrhotic and non-cirrhotic; various underlying aetiologies such as fatty liver disease, chronic viral hepatitis etc.) and time points such as at presentation and after relapse or recurrence. Thus far, almost all that is known about the genomics of primary liver cancer comes from patients with early-stage disease at one time point, at which time, systemic therapy is rarely required.

By broadening the range of patients contributing to the biobank, and applying cutting-edge technologies we hope to paint a more complete genomic picture of primary liver cancer, which in turn will allow us to answer a range of critical questions all the way from why this cancer develops in certain situations through to how we may be able to better treat advanced stage disease.

I am contributing to the overall management and strategic direction of the Liver Cancer Collaborative as a member of the Executive Committee, providing a clinical perspective to the scientific platform leads and assisting in hypothesis generation, supervision of research nurses, and patient identification and enrolment through my clinical role.

We have established the infrastructure of the biobank including a strong governance framework, obtained ethics approval for the operation of the biobank, employed research nurses at Sir Charles Gairdner Hospital and Royal Perth Hospital, with a third soon to be recruited at Fiona Stanley Hospital, brought two PhD candidates on board, consented and enrolled 40 patients, obtained patient tumour and blood samples, and have begun the process of optimisation of the various scientific platform techniques.

Without collaboration the Liver Cancer Collaborative could not exist. To build this truly translational team we have brought together bright minds from across the spectrum of scientific disciplines, including clinicians and basic scientists, from a variety of different institutions. And our collaborators across Australia and into Asia are contributing patient samples and bringing an international focus and insights. This collaboration has generated an incredible amount of excitement, a real sense of teamwork, and allowed us to set ambitious goals.

“With so many disciplines involved, all working towards a common goal, it feels like assembling a complex machine. In this first year of the Liver Cancer Collaborative we now have the frameworks in place, are recruiting patients and are constantly picking up speed. We are on an exciting, world-first journey towards generation of a publicly accessible database that will link detailed molecular liver cancer patient profiles with new drug screening data. This will provide an invaluable tool for clinicians to enable personalised treatment and underpin better patient outcomes.”

– A/Prof. Nina Tirnitz-Parker and Prof. Peter Leedman, Program Directors

More information on the Liver Cancer Collaborative can be found by visiting www.livercancercollaborative.au