Professor Howard Gurney's story

Professor Howard Gurney is Director of Medical Oncology and Clinical Trials, Macquarie University and Head of Clinical Research for Medical Oncology, Westmead Hospital. Watch Howard's story.

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[Professor Howard Gurney]

I'm a medical oncologist and currently I am the director of Clinical Trials for the Faculty of Medicine and Health Sciences at Macquarie University. I’m still running the Clinical Trials Unit at Westmead Hospital, too in the medical oncology unit. So, I actually run

two trials units in a large part of Sydney.

My reason to get into clinical trials is because medicine, the human body and the disease processes are so complex that we cannot possibly understand them. And clinical trials is the conduit to understand things more and therefore improve patient care. So, I worked as a medical oncology trainee in various hospitals and back then doing cancer medicine was all about clinical trials. The treatments were hopeless to be honest, we had very few drugs and it became obvious that the only way to make things better was to develop new agents.

Medical oncology is all about drug therapies. Don Metcalf discovered G-CSF, and so I think they were the first proper studies that were done in Australia, the introduction of Granulocyte colony stimulating factor in the clinic, and how you could actually get human protein and re-inject it into people and see that it actually did something good at stop neutropenia. That allowed you to give chemotherapy safely in some patients. And then I went overseas to Manchester and in fact that department's unit was all about clinical trials. You actually didn't see patients unless they were on a clinical trial, and that was really mind opening and how you could see from even in the time that I was there from one year over two or three years, you could see a new drug introduced and more than that how it actually really changed the face of medicine and patient care.

If you want to be a medical oncologist, if you want to be in cancer medicine, you really have to be in clinical trials. It's the only way to improve, the care of our patients and get more treatment options for them. And negative studies as well I mean, I used to treat lymphomas and there was a study of this particular regimen called CHOP and another quite aggressive regimen called MACOP-B, and everyone was using MACOP-B because we all believe that was better and you're going to cure more patients with lymphoma. And so, the study was done, I was an investigator. It was a negative study, and that was a real eye opener, like everybody thought this MACOP-B is better, you're going to cure, why do we have to do this study? And of course, the study came out, it was no better. That showed me that you can't just make it up as you go along. These things that we intrinsically believe in our gut, that this is going to be good, often is wrong. And the only way you can find out whether something's better or not is to do a randomised clinical trial.

If you're offered a clinical trial, seriously, consider it. If you're not on a clinical trial and you're not offered a clinical trial, I would suggest you look for one that might suit you, and there are various websites that you can track down. So, for the Australian one, it's AustralianClinicalTrials.gov.au and then you can search on those about your particular illness, whatever it is. And a number of trials will come up and usually there's a contact for the various sites where the trials are being undertaken.

Australia's reputation in clinical trials is excellent, we have good reputation worldwide for getting good data, often quickly crewing well to trials and being able to do it in a cost-effective manner. If you're not being involved with trials, get involved with trials. It's good for your patients it’s also good for you. It's good for your CV, but also you become the expert.

My legacy I guess, would be to building up good clinical trial units that can efficiently

look after the patients and undertake these clinical trials in a lot of patients, not just one or two. A lot of Australians can benefit from doing clinical trials generally and get access to these drugs and hopefully make their disease better. So, I guess that's the thing that most satisfies me.

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Story
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My reason to get into clinical trials is because medicine, the human body and the disease processes are so complex that we cannot possibly understand them. Clinical trials are the conduit to understand things more and therefore improve patient care.

If you want to be a medical oncologist, if you want to be in cancer medicine, you really have to be in clinical trials. It's the best way to improve the care of our patients and get more treatment options for them.

It’s about what might work better, but also what is not working as well. For example, many years ago I was an investigator on a clinical trial where the result was negative and that was a real eye-opener. We conducted a trial of a particular regimen called CHOP, and another quite aggressive regimen called MACOP-B. Everybody thought MACOP-B would be better, you're going to cure more, why do we have to do this study? When the study was finalised, it demonstrated MACOP-B was no better. That showed me that you can't just make it up as you go along. These things that we intrinsically believe in our gut, that this is going to be good is often wrong. The best way to find out whether something is better or not is to do a randomised clinical trial.

A lot of Australians can benefit from doing clinical trials generally and get access to these drugs and hopefully make their disease better. That is incredibly satisfying to me.

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  • Running clinical trials