Princess Alexandra Hospital Centres for Health Research
The Princess Alexandra Hospital Centres for Health Research was established to foster research on, and in collaboration with, the campus across the whole spectrum of research from basic biomedical to translational, clinical, health services and population health research.
It is the coordinating body for research at the Princess Alexandra Hospital and seeks to support and facilitate the research endeavours of all professional groups.
The focus of all research at the Princess Alexandra Hospital and the Metro South Health Service District is translational research, utilising research based understanding of disease processes to develop new treatments and therapies to improve the health of the community.
Further information about the Centres for Health Research is available on their website.
Obesity treatment and breast cancer research
Purpose:
To find out if the chemotherapy doses given to obese women with breast cancer are too low for their body size. This study will enable individualised dosing for people of different body size having breast cancer chemotherapy, an idea that could be used to personalise the dose in other situations where obese people get chemotherapy (such as bowel cancer).
Significance: Women with breast cancer are more likely to die if they are obese. If this is because they get less chemotherapy than what they need for their body size, protocols for treatment of breast cancer will need to change and take into account body size.
Progress:
A recent meta-analysis by the team showed a detrimental effect of obesity on breast cancer death even after adjusting for known risk factors, with an effect greater than that seen with many anti cancer medications. For the prospective dosing study, tests to measure the drug levels in the blood have been developed and the team is planning to start measuring these drug levels in obese and lean women having chemotherapy soon.
People:
This is a collaborative study between the University of Queensland and the Princess Alexandra Hospital Departments of Chemical Pathology, Medical Oncology and Internal Medicine
- Mohammed Saleem, UQ School of Medicine and Princess Alexandra Hospital
- Melinda Protani, UQ School of Population Health
- Maree Costello Princess Alexandra Hospital Department of Medical Oncology
- Paul Taylor, Princess Alexandra Hospital
- Carl Kirkpatrick, UQ School of Pharmacy
- Goce Dimeski, Princess Alexandra Hospital
- Euan Walpole, Princess Alexandra Hospital, Department Medical Oncology
- Jennifer Martin, UQ School of Medicine and Princess Alexandra Hospital, Department of Internal Medicine
Head and neck cancer treatment
Purpose:
The main objective of this research is to determine, in patients who have undergone surgery with curative intent for high-risk cutaneous squamous cell carcinoma of the head and neck, whether there is a difference in time to loco-regional relapse between patients treated with post-operative concurrent chemo-radiotherapy and post-operative radiotherapy alone. Secondary objectives of the research are to compare disease-free survival time, overall survival time, late effects of radiotherapy and chemotherapy and quality of life receiving both treatment arms. Patients are randomised to one of two arms, radiotherapy and chemo-radiotherapy with allocation to treatment balanced according to high-risk nodal disease and advanced primary disease, and institution.
Significance:
Given the potential toxicity of chemoradiation in patients with high risk cutaneous squamous cell carcinoma it was considered highly desirable to prospectively identify which patients are most likely to benefit from this approach, therefore molecular studies are being performed on tumour tissue from consenting patients to identify predictive markers for outcome and for response to chemoradiation,
Progress:
In October 2008 the independent Data Safety Monitoring Committee reviewed 150 patients and determined that the toxicities observed were acceptable and that the accrual rate was satisfactory, and that the trial continue without modification. Recruitment is on target with recruitment reaching 248 participants as of the 7th of October 2010. The accrual target of 265 is expected to be reached in late 2010 or early 2011.
People: The project is run under the aegis of the Trans-Tasman Radiation Oncology Group as TROG 05.01 by Associate Professor Sandro Porceddu. This trial has received grants to support data management and regulatory costs from the Royal Australian and New Zealand College of Radiologists, the Princess Alexandra Hospital Foundation, the Cancer Council Queensland, the PAH Cancer Collaborative Group, the Trans-Tasman Radiation Oncology Group, the Health Research Council of New Zealand and a Queensland Government Smart State Grant.
Melanoma research
Purpose:
The research, which commenced in 1992, aimed to address the high rate of melanoma recurrence in patients who required surgery to the lymph node. It was led by surgeon Assoc Prof Mark Smithers with Professor Burmeister.
Significance:
Recurrence of melanoma in the lymph nodes after surgery can be extremely disabling with swelling of the arm (lymphedema), fungation, bleeding discharge, and pain
Initial results in treating melanoma suggested that radiation after surgery was effective in reducing recurrence of disease but for the treatment to be accepted, years of investigation and data collection were necessary to establish the best and safest method of treating melanoma in this situation.
Progress:
- Phase 1: Initial results highlighting reduced recurrence and limited side effects were first published in 1995.
- Phase 2: A much larger study involving 234 patients showed the recurrence of the disease was less than 15% in patients who received radiation therapy. The research involved 234 patients from eight centres across the Trans Tasman Radiation Oncology Group, with 45 per cent of participants coming from the PAH. The results were published in 2006.
- Phase 3: A third study focused on patients with lymph node disease having surgery alone, compared with patients who had both surgery and radiation therapy. With 250 patients recruited from 16 centres around the world, the results showed a reduction from 32% to 18% recurrence with the addition of radiation therapy. Of those 106 patients came from PAH. The results were published in May 2009.
People:
- Associate Professor B Mark Smithers, General Surgeon, Senior Lecturer The University of Queensland Department of Surgery, Chairman Queensland Melanoma Project, Chairman Upper GI and Soft Tissue Unit
- Professor Bryan Burmeister, Director, Radiation Oncology, Princess Alexandra Hospital Brisbane 4102
