Blood test may help improve equity for late-stage lung cancer patients

Lung cancer and improving the diagnostic process by sampling circulating tumour DNA in blood, is at the heart of research that has won the 2022 Roche Translational Cancer Research Fellowship (RTCRF).

Dr Annie Wong is leading a team of New Zealand’s top oncologists from the universities of Otago and Auckland, to develop a method to speed up that diagnosis.

“Lung cancer is a top research priority in New Zealand as it is the leading cause of cancer-related death,” Dr Wong says. “Unfortunately, it also disproportionately affects Māori, both in incidence and mortality.”

Obtaining a lung cancer diagnosis by an invasive biopsy can take months from the onset of symptoms and it is dependent on limited specialist resources at hospitals. Yet, Dr Wong says, currently invasive biopsy is the only way to find mutations that help cancers grow.

“Finding these mutations is important as there are treatments targeting them that can improve the average survival of advancer cancer patients from months to years,” Dr Wong says. “Yet not all patients are able to have an invasive biopsy and this can mean they miss life-prolonging treatment.”

Dr Wong, a consultant medical oncologist at Wellington Blood and Cancer Centre and a senior lecturer at the University of Otago, says identifying oncogenes in circulating tumour DNA (ctDNA) in peripheral blood could replace the invasive biopsy with a simple blood draw – and reduce diagnosis from months to weeks.

Dr Wong, working with academic colleague Dr Kirsty Danielson, will lead a translational study, to be developed through the Thoracic Oncology Group of Australasia, called FAST (feasibility analysis of ctDNA in the diagnosis of lung cancer in patients with poor performance status).

Alexander Muelhaupt, general manager for Roche Products New Zealand, says the company is proud to continue supporting the RTCRF, which encourages collaboration between scientists and clinicians to develop translational research projects.

“The ongoing partnership between Roche and the New Zealand Society for Oncology (NZSO) creates an opportunity for our community to collaborate to bring the greatest benefit to New Zealanders impacted by cancer.”

Associate Professor Margaret Currie, the NZSO’s president says Dr Wong’s team put together an outstanding proposal for the research fellowship that not only looks at the development of a clinical technique, but also increasing the opportunity for diagnosis and treatment for Māori.

Dr Wong did her PhD on melanoma immunotherapy biomarkers and integrating patient factors, functional imaging and novel laboratory techniques to personalise cancer treatments.

Dr Danielson is a senior lecturer at the University of Otago and is principal investigator of its surgical cancer research group. Her research focuses on the discovery of novel predictive biomarkers of disease and their function within tissue microenvironments.

The fellowship award will allow Drs Wong and Danielson to collaborate with a wider team internationally renowned in the ctDNA field, including Professor Parry Guilford (Otago), Professor Cris Print, Dr Sandra Fitzgerald, and Dr Cherie Blenkiron (University of Auckland), and Shonell Nicolls and Dr Laird Cameron.

The team is being mentored by Professors Ben Solomon and Sarah-Jane Dawson from the Peter MacCallum Cancer Centre, which houses Australia’s largest laboratory-based cancer research effort. Its work will foster clinical/laboratory collaborations both in New Zealand and internationally.

Success will see the ctDNA method introduced into clinical practice championing the RTCRF objective to scale research from “bench to bedside to community”.

The winning team believes the development of this technology will help improve Māori cancer outcomes. Research into the clinical applications of ctDNA will be crucial also for the surveillance and treatment of other cancers.