Professor Niall Corcoran used genomic testing and predictive modelling to guide treatment and prevent the over-diagnosis and over-treatment of early-stage prostate cancer, in the world's first randomised clinical trial.
Lead: Professor Niall Corcoran, Department of Surgery – RMH, University of Melbourne Centre for Cancer Research
Key partners: Professor Christopher Hovens, University of Melbourne Centre for Cancer Research, Western Health, Royal Melbourne Hospital, the Australian Prostate Centre, Princess Alexandra Hospital and WEHI. The study is sponsored and coordinated by ANZUP, the leading genitouinary oncology cancer clinical trials group in Australia.
Prostate cancer is one of the most diagnosed cancers in Australian men, with evidence suggesting it is frequently over-diagnosed and over-treated in early disease.
This project set out to reduce unnecessary treatment through the first of its kind clinical trial which used genomic testing and predictive disease modelling to guide active surveillance in men with favorable intermediate-risk (FIR) prostate cancer.
The team activated four clinical trial sites, recruiting 55 patients across Victoria's Royal Melbourne Hospital, Western Health, and Australian Prostate Centre and the Princess Alexndra Hospital in Queensland.
Each patient underwent multi-omic testing, including germline whole genome sequencing, tumour panel analysis, and transcriptional assays. Data was received and stored on Illumina’s Connected Analytics (ICA) production platform.
The data has strengthened work being done to identify men at lower risk of disease progression, tracking their prostate cancer without the need to resort to heavy treatment.
"Our research is using genomics to identify patients who may be carrying mutations associated with a high risk of prostate cancer progression. This could spare people from the anxiety and stress of unnecessary treatment and support us to identify those that do need interventions,”
Professor Niall Corcoran
Developing a future ready, genomics focused workforce was integral to the project, and the research enabled the creation of seven new genomics-related roles including three research assistants and three postdoctoral researchers.
Eight student interns also supported the research through literature reviews, bioinformatics and market research.
The research was featured in three scientific publications and was presented at three conferences and seminars.
The work will now look to develop genomic tests which can identify and guide potential treatment with the hope of introducing a standardised clinical protocol for FIR patients.
This project utilised the TAGC Genomics Platform to perform targeted sequencing on a bespoke germline capture panel analysed by the Bioinformatics Platform. The Health Economics Platform also engaged in evaluating the cost-effectiveness of utilising genomic tests to determine risk level and aid in the active surveillance of prostate cancer patients.