[Associate Professor Lisa Horvath]
I'm a medical oncologist and I'm the Director of Medical Oncology at Lifehouse.
I'm also the Director of Research for Lifehouse. And in that capacity, I run the clinical research unit. What got me interested in research was my first year of training in medical oncology. That was the year that the first clinical trials in Herceptin, which is an antibody against a growth pathway in breast cancer, were presented at the American Society of Clinical Oncology meeting. And this trial actually showed that if you gave that drug with chemotherapy, you turned this disease, which was very poor prognosis, bad outcome disease for breast cancer women. And you could switch it around and get these women responding to chemotherapy and targeted therapies.
So it revolutionised what we did in breast cancer. It just felt like a new world was starting to open up. And what's happened in those 20 years is we've gone from the first targeted therapy to an absolute multitude of targeted therapies and new agents and new drugs and things we couldn't have possibly imagined 20 years ago when I started training.
And it's all because people do clinical trials. Because it doesn't matter what happens in a cell culture dish or a mouse. It doesn't tell you what's going to happen in a complex organism like a patient. And it's incredibly important that we take those findings and work with the researchers to run clinical trials to change how we manage patients and improve survival.
We were involved in 2 trials called the Cougar 1 and Cougar 2 trials of a drug called Abiraterone, used to treat very advanced prostate cancer. Suddenly, these patients were getting extraordinary clinical responses and improved pain and were able to get up and do things that we hadn't imagine would happen. But that became part of the registration study that has resulted in the drug going on the Pharmaceutical Benefits Scheme and being available to all patients with advanced prostate cancer. So not only did we see patients get huge benefits on the trial, they contributed to the licensing of the drug worldwide side for the benefit of many, many millions of patients with prostate cancer.
Clinical trials doesn't just mean new drugs, it means new techniques of doing everything from robotic surgery to community nursing in patients having chemotherapy. We can never say to a patient, 'this trial will help you'. We can say 'this is the likelihood that this trial may help you', but we're always very honest about the fact that this may not work and this may be purely a philanthropic gesture on their behalf.
They're case managed by our clinical trial nursing staff. Through the trial, they have they have matrices of when their appointments are happening. And of course, they have lots of clinical contact with both the nursing and the medical staff in terms of feeding back of their concerns. And in particular, if they're trialling a brand new drug, are their side effects we haven't thought about, that they need to tell us about.
These clinical trials are done by people with a high level of interest, a high level of professionalism. And I cannot I can't think of a patient that's ever been unhappy with the level of care provided on a clinical trial. They may not have been happy with the results of the clinical trial, but they have always felt cared for. Largely, patients are hugely philanthropic. They would love it if it helped them, but they also want it to help people in the future. So that other people can do better with this disease.
Chris O`Brien Lifehouse research director and prostate cancer medical oncologist Lisa Horvath first became interested in medical research in her first year of training in medical oncology. That was the year that the first clinical trials in Herceptin, an antibody against a pathway in breast cancer, were presented at the American Society of Clinical Oncology.
‘And this trial actually showed that if you gave that patient chemotherapy, you turned this disease which had a very poor prognosis and bad outcome for patients, and you could switch it around and get these women responding to chemotherapy and targeted therapies. So it revolutionised what we did in breast cancer. It just felt like a new world was starting to open up.’
From Herceptin, heralded as a major advance in targeted cancer therapies (where treatments target a specific type of cell), cancer treatment has been revolutionised by a multitude of targeted therapies and new agents and new drugs ‘…and things we couldn’t possibly have imagined 20 years ago when I started training. And it’s all because people do clinical trials.’
‘It’s incredibly important that we’re able to take basic research findings and real-life treatment experience and work with the researchers to run clinical trials to change how we manage patients and improve survival.’
Clinical trials don’t just involve new drugs. They trial new techniques for everything from surgical robotics to community nursing for patients having chemotherapy.
At Chris O`Brien Lifehouse, new medicine trials are case managed by clinical trial nursing staff, with close contact and supervision. Patients are encouraged to communicate freely with nursing and medical staff.
‘In particular if patients are trialling a brand new drug, are there side effects that we haven’t thought about that they need to tell us about.
Sadly, Prof Horvath says, drug trials may not work for every patient.
‘We can never say to a patient “this trial will help you”. We can say “this is the likelihood that this trial may help you” but we’re always very open about the fact that this may not work and that this may be purely a philanthropic gesture on their part.’
However, Prof Horvath recalls her involvement with 2 trials called the Cougar 1 and Cougar 2 trials of the drug Abiraterone, used to treat very advanced prostate cancer.
‘Suddenly these patients were getting extraordinary clinical responses and improved pain and were able to get up and do things that we hadn’t imagined would happen. But that became part of the registration study that resulted in the drug going on the pharmaceutical benefits scheme and being available to all patients with prostate cancer. So not only did we see patients getting huge benefits on the trial, they contributed to the licencing of the drug worldwide for the benefit of many millions of patients with prostate cancer.’
‘Largely, patients are hugely philanthropic. They would love it if it helped them, but they also want to help people in the future so that other people can do better with this disease.’