A new research programme in Auckland is investigating how rare cancers can be better diagnosed and treated. 

The programme, for Auckland's Regional Cancer and Blood Service, is part of an Australian-based clinical trial called the Cancer Molecular Screening and Therapeutics (MoST), and is the first of its kind in New Zealand. 

Cancer patients who have exhausted other treatment options can have their specific cancer analysed using genomic profiling, to determine if other more targeted therapies are available. 

Based at Auckland City Hospital, the programme is in collaboration with the University of Auckland and genomic profiling company Foundation Medicine, part of healthcare company Roche. 

Genomic profiling is a diagnostic tool that interrogates a cancer sample at the genetic level, allowing oncologists to look into each person's cancer more deeply. 

This then provides clues towards the cancer's specific genetic make-up, allowing clinicians to treat the cancer in a more targeted way, says genomic profiling lead for Roche in New Zealand Stuart Ryan. 

"Cancer can be defined in terms of the genetic changes that make it grow and divide," he said. 

"And if you can identify those genetic changes, it gives you the opportunity to be able to look at what treatments could be used to target that particular genetic change." 

Genomic profiling lead for Roche in New Zealand Stuart Ryan. Photo / Supplied 

Studies using genomic profiling aim to identify genes that change in cancer, so drugs can be developed to target and suppress those changes, allowing patients to live better and longer. 

"As this technology develops and we find more and more genetic changes in cancer, pharmaceutical companies like Roche are developing drugs that target these different genetic changes." 

"Those drugs are generally much more effective than a generic therapy like chemotherapy, as opposed to something that directly targets the genomic change in someone's cancer." 

In one example, a New Zealand farmer underwent genomic profiling after two failed therapies for advanced lung cancer. 

"In that particular case, the patient had exhausted all other available therapies and the test was able to identify a particular genetic change, and there was a targeted therapy available to treat that genetic change," Ryan said. 

"That patient is now, after three years going on that drug, well and healthy and living life to the full." 

The programme was the first step in researching how the technology worked in a New Zealand setting, he said. 

"What we're here to do is support Auckland Hospital and the university to be able to achieve their goals, and look at how we can bring this technology to New Zealand quicker." 

Genomic profiling is a diagnostic tool that interrogates a cancer sample at the genetic level. Photo / Supplied 

The research programme began last year with the first test result taken in October. 

Auckland Hospital's principal investigator Dr Michelle Wilson, a medical oncologist and service clinical director for Cancer and Blood Research, says 17 patients have now consented to genomic testing of their cancers. 

"We're aiming to do at least 200 in the next two years, but that's just our starting point," she said. 

"We're mainly concentrating on rare cancers and that's where it started in Australia … focusing on rare cancers, particularly where we don't have good treatment options." 

"This is not going to cure people, but it's about trying to ensure people live longer and live better." 

While genomic profiling is normally a self-paid test, there would be no cost to the patient through the clinical trial. 

An important aspect of the study was also the insight gathered from interviewing patients, Wilson said. 

"One of the exciting things about this project beyond just the genomic testing is that it has a lot of qualitative research – it asks the patient a lot about what they want and what they expect," she said. 

"That's going to give us really valuable information about how best to move genomic testing forward as well, because we have the patient voice which is so important." 

Beginning in Syndey in 2016, MoST research is now underway in multiple sites across Australia. While Auckland City Hospital is the first New Zealand public hospital to take part in the research, Wilson hopes it will also grow throughout the country in the future. 

"The aim is that with what we learn we will be able to make it a permanent part of what we can offer to people on a wider scale." 

Auckland University professor in molecular medicine and pathology Cristin Print describes the programme as an "energetic partnership" between the university, Auckland DHB and Roche. 

The programme was funded throughout its set-up phase with funding from each of the three parties and a grant from the university's Centre for Cancer Research. 

Print said the programme was the fastest way to bring the benefits of genomic precision medicine to Auckland patients. 

"By including ethically approved research at the centre of this trial, we learn more from every patient about the genetic re-wiring that drives tumours." 

- by Sophie Trigger, NZ Herald