2018 Spinnaker grants – project overview

2018 Spinnaker grants – project overview

Identification of an aggressive Subtype of Colorectal Cancer

Research team: Dr Andrew Laycock, Dr Jacqueline Bentel, Dr Michael Texler

Bowel cancer is common in Western Australia and although treatment can have severe short-term and long-term side-effects, many patients are successfully treated with combinations of surgery, radiotherapy and drug therapies.

Our study will develop specialised tests to identify bowel cancers which are likely to have worse outcomes. This will allow the affected patients to receive additional treatment and more frequent monitoring, while sparing other patients who have less aggressive cancers. The reduced costs and decreased side-effects of unnecessary cancer treatment will improve the quality of life of cancer patients and cancer survivors while providing savings to the WA healthcare system.

 

Peripheral muscle function in chronic heart failure: key to lessening the cardiac load

Research team: A/Prof Andrew Maiorana, Prof Luke Haseler , Prof Girish Dwivedi

To improve the quality of life in chronic heart failure patients we will exercise train the leg muscles and breathing muscles to determine how effectively leg training, breathing training or both leg and breathing will improve the ability of heart failure patients to exercise.

This research will provide a new understanding of why exercise intolerance in chronic heart failure patients is so severe and provide the basis for future integration of innovative and low cost therapies into the clinical management of chronic heart failure, with the ultimate goal of alleviating the suffering caused by cardiovascular disease in Australia.

 

Circulating tumour DNA (ctDNA) as a biomarker of disease status and treatment response in breast cancer patients

Research team: Dr Benjamin Dessauvagie, Dr Hilary Martin, Prof Christobel Saunders, Dr Benhur Amanue, Dr Cleo Robinson, Dr Leslie Calapre, Dr Elin Gray, Dr Mel Ziman

New research has demonstrated that simple blood tests could dramatically change the way cancers are diagnosed, treated and monitored.

Such blood tests, known as “liquid biopsies” detect DNA from cancer cells which escape from the main tumour and circulate in the blood stream. This circulating tumour DNA can provide useful information about the cancer which helps tailor treatment to the individual and may be able to tell us how a patient’s breast cancer is responding to treatment, and if the cancer has returned, without the need for an invasive tissue biopsy.

In this study we will use two new technologies to find unique markers in individual patient breast cancers. Then we will look for the marker(s) in the patient’s blood and see if the level(s) decreases when the tumour shrinks after chemotherapy.

“Liquid biopsies” will benefit cancer patients because they are less painful, less invasive, and cheaper than taking tumour biopsies and thus can be taken regularly to quickly detect treatment failure and adjustment of treatment regimes. “Liquid biopsies” could be offered in any pathology laboratory across Australia, including rural and remote areas.

 

In general surgery patients, does an individualised prehabilitation exercise program with targeted education, improve patient recovery time and outcomes, compared to usual practice?

A/ Prof Dale Edgar, A/ Prof Anne-Marie Hill, Dr Jacqueline Francis-Coad, Ms Alix Barrett-Lennard, Prof Marina Wallace, Mrs Claire Cloney, Dr Kris Owen, Prof Fiona Wood, Prof David Fletcher, Dr Dana Hince

Empowered and informed patients achieve better health outcomes, particularly through self-management strategies.

Education, combined with exercise and increased activity significantly improve in-hospital and long-term health outcomes.

In May, a novel rehabilitation (education and exercise) program         commenced in the State Adult Burns Unit for patients undergoing scar surgeries. The burn and general surgery teams at FSH wish to build on that program. The enhanced PEERS (Preoperative Exercise and Education for Recovery after Surgery) Program, aims to drive patient self-determination of physical and non-physical outcomes. We aim to empower participant’s self-management by eliciting, and responding to, the voice of involved patients.

 

Celecoxib for Acute Burn Inflammation and Fever. The CABIN Fever Trial.

Researcher: Dr Edward Raby

The acute management of burn injury is the start of a journey of care that aims to minimise the lifelong physical, aesthetic, psychosocial and long term medical impacts of the burn.

In this study, we will test whether the anti-inflammatory drug, celecoxib, speeds up recovery and improves scar quality. As well as being of major significance to patients, poor scar quality is linked with chronic illnesses including heart disease and depression. Collaborations with scientists at the Burn Injury Research Unit and the Australian National Phenome Centre will provide state-of-the art laboratory research to advance

understanding of inflammation following burn injury.

 

User experience of Adult Outpatient Department Oncological services at  Fiona Stanley Hospital: Exploring the ethnic minority perspective

Research team: Dr Hilary Martin, Dr Shaouli Shahid, Dr Sadhana Bose, Ms Barbara O’Callaghan, A/Prof Suzanne Robinson

There is strong evidence of inequalities in cancer outcomes between  ethnic groups resulting from a ‘One size fits all’ approach to care.

A complex interplay of patient, health system, socio-cultural factors contribute to the disparities observed – e.g., communication issues, delayed presentation and reduced access to phone assistance.

There is also evidence that systematic collection of culturally sensitive information helps hospitals (and policy makers) address unequal access to or provision of services.

This proposed study will interview cancer patients identified by staff as ethnic minority users. Findings will benefit the community by looking at what is being done well and what can be improved to enhance ethnic minority patient experience.

 

Targeting the Fn14 receptor to inhibit chronic liver disease progression

Researcher: Dr Jully Gogoi Tiwari

End-stage liver disease is a growing health problem, which results in considerable morbidity and death world-wide.

Hepatocellular carcinoma is the seventh most common cancer and third highest cause of cancer-related deaths (Yang and Roberts, Nature Reviews Gastroenterology and Hepatology, 2010).

Currently, end-stage liver disease is only resolved by organ transplantation. The increasing gap between patient organ demand and donor availability demands a concerted effort to find alternatives to prevent liver injury progression to end-stage disease.

This proposal is based on clinically highly relevant data and investigates Fn14 targeting as a novel therapeutic avenue to inhibit disease progression and cancer formation.

 

Sleep apnea and depression in pregnancy

Research team: Ms Karen Redhead, Prof Megan Galbally, Dr Stuart Watson

In pregnancy, women have disturbed sleep, which often becomes worse once their baby is born. Women are more likely to experience depression during pregnancy and early motherhood. As maternal depression is a predictor of poor infant and child outcomes, reducing maternal           depression has both long- and short-term benefits for mother and baby.

This study will measure the sleep patterns of women in pregnancy, and both women and babies 6 months postpartum. We will investigate how poor sleep relates to mood and depression. Understanding factors that contribute to mothers developing depression will guide development of advice and strategies to reduce risk.

 

PIANOFORTE – A randomised controlled trial comparing antibiotic treatment strategies in patients with acute prosthetic joint infection

Research team: Dr Laurens Manning, Dr Ben Clark, Prof Piers Yates

Acute infections of artificial joints will be a major future challenge because every year the number of arthroplasties being performed is increasing year on year. This results in an even greater prevalence of people living with joint replacements in the community.

We plan a trial to compare short (2 weeks) with long (6 weeks) courses of intravenous antibiotics for patients with acute infections of their artificial joints. In addition the benefits for patients receiving a short IV course in terms of quality-of-life and fewer adverse events, health sector cost savings of $11,200-$16,800 could be realised per patient.

 

Preliminary validation of Sheer Wave Elastography as an outcome tool in muscle disease

Dr Shereen Paramalingam, A/Prof Helen Keen, Prof Merrilee Needham

Inflammatory Myopathies (IIM) are diseases characterised by muscle   inflammation. Traditionally, Magnetic Resonance Imaging (MRI) is used to assess diseased muscle, but is limited by cost, access delays, and patient discomfort. Ultrasonography is cheap and accessible. Sheer Wave Elastography (SWE) is a novel form of ultrasonography that measures tissue response to external pressure.

This study aims to assess normal and diseased muscles with SEW, as a basis for further studies into the utility and validity of SWE in muscle disease.

It may improve patient care by enabling quick assessment of abnormal muscle in IIM and guiding muscle biopsies and aid understanding muscle diseases.