New diagnostic could improve outcomes for oesophageal cancer 

A team of The University of Queensland’s Frazer Institute scientists and clinicians based at the Translational Research Institute (TRI) has identified biological markers which could be used in a simple blood test to help improve survival rates for patients with the cancer, oesophageal adenocarcinoma.

Each year, more than 1600 Australians are diagnosed with oesophageal adenocarcinoma, which affects the oesophagus or the tube that food travels from your mouth to stomach. The cancer has a five-year survival rate sitting at 22 per cent.

Spurred on by the poor survival rates, Dr Vanessa Bonazzi and her colleagues from the Surgical Oncology Group within Frazer Institute at the TRI, analysed more than 200 blood and tumour samples from 57 patients with oesophageal adenocarcinoma.

Backed by a $100,000 Metro South Health research grant and a collaboration with Roche Diagnostics, Dr Bonazzi said the team specifically focused on circulating tumour DNA or DNA shed by the tumour cells, which they found in the blood of patients.

“By focusing on the genetic mutations in the circulating tumour DNA we identified biomarkers that we were able to align with the same mutation in the patient tumour,” said Dr Bonazzi.

“This is an important finding because it means these biomarkers have the potential to be used in the clinic as a prognostic biomarker for survival,” she said.

“If proven to be successful as a test, it would mean patients would only need to have a routine monthly blood test to monitor whether their treatment is working, which is less invasive and less expensive than an endoscopy or a PET scan, which are used at the moment.”

The research results were recently published in the journal, ESMO Open, and the group is now applying for funding to test the biomarkers in a clinical trial.

Dr Bonazzi said she was also leading a similar project to identify biomarkers for melanoma that spreads to the brain, with the data currently being analysed for publication.

“What’s interesting about the melanoma project is that we suspect the biomarkers we’ve found may allow the melanoma cells to pass through the blood brain barrier [when they shouldn’t be able to], and these biomarkers may be common to other brain cancers.” 

In addition to oesophageal cancer and melanoma, Dr Bonazzi is similarly identifying biomarkers for pancreatic cancer, but across all three types of cancer her goal is to improve the precision or ‘personalisation’ of treatment for patients.

“I work in many different types of cancer, mainly because our Group Leader, Professor Andrew Barbour, is an academic general surgeon, and our research is based on the types of tissue samples that he can access.”

The patient tissue and blood samples collected by Professor Barbour, have been built in an extensive biobank, which is managed by Dr Bonazzi. The resource includes more than 10,000 samples from around 1500 patients with oesophageal cancer, pancreatic cancer or melanoma who were treated at either the Princess Alexandra, Greenslopes or the Mater private hospitals in Brisbane.

“I am very active in terms of managing our research Group’s biobank, and I also supervise collaborative research programs we have in Brisbane and nationally as well as being involved in some national committees for clinical trials and an initiative to develop national guidelines for biobanking in Australia.

“What I love most in my various positions is cross-collaboration and being able to see outcomes from clinical trials being implemented in to improve patient care and have an impact.”

A melanoma study Dr Bonazzi was involved in, which was published in the prestigious journal, Nature Genetics, in 2011 resulted in a change in treatment, which is still used today.

Dr Bonazzi grew up on the Caribbean Island of Guadeloupe, before moving to Paris to initially study medicine and then switching to science so that she could have a more global impact on patient outcomes. A chance holiday to Australia saw her fall in love with the country and take up a research position in Brisbane.