A new study is underway aimed at getting thousands of Australian cancer patients onto potentially life-saving clinical trials and providing precision oncology treatments, with NSW Health Pathology’s Statewide Genomics Sequencing Service playing a key role.

The PrOSPeCT (Pre­ci­sion Oncol­o­gy Screen­ing Plat­form Enabling Clin­i­cal Tri­als) project, Aus­trali­a’s largest can­cer genomics ini­tia­tive, is aim­ing to rev­o­lu­tionise can­cer treat­ment and pro­vide new hope for can­cer patients.

Launched in July 2023, PrOSPeCT links Australia’s top can­cer research insti­tutes with indus­try part­ners and gov­ern­ment organ­i­sa­tions, open­ing up new treat­ment paths for 23,000 Aus­tralians with rare, or dif­fi­cult-to-treat can­cers, includ­ing ovar­i­an and pan­cre­at­ic can­cer, sar­co­mas and can­cer metastasis.

It will pro­vide free access to NSW Health Pathology’s world-class genom­ic pro­fil­ing, clin­i­cal assess­ment of results by an expert clin­i­cal team and match­ing to the best advanced pre­ci­sion (‘per­son­alised’) treat­ments avail­able local­ly, includ­ing ear­ly-stage clin­i­cal trials.

NSW Health Pathol­o­gy is pro­vid­ing a range of ser­vices for PrOSPeCT including:

• blood col­lec­tion
• sup­ply of diag­nos­tic tissue
• cen­tral tis­sue sec­tion­ing at Prince of Wales Hos­pi­tal Rand­wick anatom­i­cal pathol­o­gy laboratory
• genom­ic sequencing/comprehensive genom­ic pro­fil­ing ser­vices at our Genomics State-wide Sequenc­ing Ser­vice and Mol­e­c­u­lar Med­i­cine Depart­ment in Newcastle
• stor­age of blood sam­ples at the NSW Health Statewide Biobank (NSWHSB), and
• logis­tics, ICT infra­struc­ture, bioin­for­mat­ic, oper­a­tional and research support.

NSW Health Pathol­o­gy expects to receive more than 3,500 sam­ple requests over the course of the program.

Senior Hos­pi­tal Sci­en­tist for NSWHP’s Statewide Genomics Sequenc­ing Ser­vice Michael Hip­well says it’s an excit­ing oppor­tu­ni­ty for his team, which will be expand­ing to pro­vide this service.

“We are cur­rent­ly recruit­ing, and the posi­tions will require high lev­el ana­lyt­i­cal skills, as each patient will have thou­sands of genet­ic vari­ants detect­ed and we need to report on the few that are rel­e­vant to the case,” he says.

Mr Hip­well says the pro­gram is a glimpse into the future of can­cer treat­ment options.

“This type of com­pre­hen­sive genom­ic tumour pro­fil­ing is prob­a­bly going to be the way can­cer treat­ments are planned in the future, par­tic­u­lar­ly as oncol­o­gists become famil­iar with the addi­tion­al infor­ma­tion pro­vid­ed by these reports, giv­ing them a com­plete pic­ture of what’s hap­pen­ing genet­i­cal­ly in the tumour.”

His team has been work­ing for the past 12 months devel­op­ing the new diag­nos­tic assay, required for the research project.

“The assay we’re using for the com­pre­hen­sive tumour pro­fil­ing inter­ro­gates more than 500 genes in the tumour’s DNA to iden­ti­fy vari­a­tions or muta­tions in these genes that could be respon­si­ble for the patient’s can­cer,” Mr Hip­well explains.

“We’re also look­ing at the RNA of the tumour for a sub­set of the 500+ genes to iden­ti­fy any fusion events or gene ampli­fi­ca­tions that could cause the cancer.”

“We gen­er­ate a report which is then sent to the study coor­di­na­tors to inves­ti­gate if there are any rel­e­vant clin­i­cal tri­als in which the patient can be enrolled. That infor­ma­tion is then passed onto their treat­ing oncologist.”

NSWHP’s Act­ing Chief Exec­u­tive Prof Rob Lin­de­man said the PrOSPeCT project will allow the organ­i­sa­tion to build on its already com­pre­hen­sive genom­ic pro­fil­ing capability.

“Pro­vid­ing ser­vices for PrOSPeCT will build vital capac­i­ty, estab­lish our organ­i­sa­tion as a leader in the pro­vi­sion of ser­vices for diag­nos­tic and can­cer research and ulti­mate­ly ben­e­fit the peo­ple of NSW,” he said.

“Genomics diag­nos­tic ser­vices and genomics research rep­re­sent areas of strate­gic sig­nif­i­cance for NSW Health Pathology.”

The land­mark nation­al pro­gram is led by Omi­co, a gov­ern­ment-backed, not-for-prof­it nation­al net­work of Australia’s lead­ing can­cer research insti­tu­tions and hospitals.

The $185 mil­lion PrOSPeCT project is joint­ly fund­ed by the Fed­er­al and NSW gov­ern­ments, as well as pri­vate enterprise.

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