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Take a look inside a compulsory drug treatment centre

Take a look inside a compulsory drug treatment centre

Here at NSW Health Pathology we spend a lot of time analysing samples and producing results. Recently we got to see how our work is making a difference on the other side of a very high fence.

Inside a secure facil­i­ty on the grounds of Sydney’s Parklea Cor­rec­tion­al Cen­tre, two young men dressed in prison greens kick a foot­ball across a grassed court­yard. Anoth­er is busy in a kitchen prepar­ing chick­ens for roast­ing, and in a near­by art room a group of men are cre­at­ing extra­or­di­nary paintings.

But despite the razor wire on the fences, they’re not in prison; they’re part of a spe­cial drug treat­ment pro­gram over­seen by the NSW Drug Court.

Denise Con­stan­ti­nou is the Senior Psy­chol­o­gist at the Parklea Com­pul­so­ry Drug Treat­ment Cor­rec­tion­al Cen­tre and explains how par­tic­i­pants go through three stages of recov­ery after they arrive at the facility.

A woman smiling, sitting in an office.
Senior Psy­chol­o­gist Denise Con­stan­ti­nou works with par­tic­i­pants at the drug treat­ment centre.

“The pro­gram runs for a min­i­mum 18 months, with six months spent in each of the three stages,” she said.

“Stage one requires them to par­tic­i­pate in ther­a­peu­tic pro­grams to address their past drug use and offend­ing behaviour.

“We devel­op their treat­ment plan in col­lab­o­ra­tion with them and their adher­ence to that treat­ment plan is mon­i­tored on a week­ly basis.”

Ms Con­stan­ti­nou says par­tic­i­pants are required to pro­vide super­vised urine sam­ples reg­u­lar­ly through­out their treat­ment to ensure they remain drug free.

Cus­to­di­al offi­cers col­lect a urine sam­ple from par­tic­i­pants at least twice a week dur­ing stage one of the program.

“When they move to stage two the week­ly urine analy­sis actu­al­ly increas­es to three times a week because they’re able to access the com­mu­ni­ty,” she explains.

“Then in stage three when they are liv­ing out in the com­mu­ni­ty, but still part of the pro­gram, the urine analy­sis con­tin­ues at a rate of three times a week.

“All those tests hap­pen at the cen­tre so staff can see the par­tic­i­pants, assess their behav­iour, and ensure they’re not try­ing to evade detec­tion of drug use.”

Ms Con­stan­ti­nou says staff watch while the men give their urine sam­ple in a spe­cial­ly designed bathroom.

A open window looking into a room with a toilet and mirror on the opposite wall.
The design of the toi­let is aimed at pre­vent­ing par­tic­i­pants tam­per­ing with urine samples.
A large board covered in traditional Aboriginal dot designs and totems.
Dot paint­ings being cre­at­ed in the treat­ment cen­tre art room.

“Some will com­plain about hav­ing to par­tic­i­pate – there are some strin­gent pro­to­cols,” she said.

“We’re also very aware that some of our clients have expe­ri­enced a his­to­ry of trau­ma so uri­nat­ing in front of some­body can be very trig­ger­ing. So there needs to be some sen­si­tiv­i­ties around that process.

“But par­tic­i­pants also recog­nise that it does hold them account­able and ‘keeps them on track’. They know that if their drug use is detect­ed there will be con­se­quences in terms of the priv­i­leges and rewards that are afford­ed with­in the program.”

Ms Con­stan­ti­nou says some of the par­tic­i­pants are also work­ing on par­ent­ing plans to have con­tact with their chil­dren, so pro­vid­ing urine sam­ples means they can prove they’re stay­ing drug-free.

Sam­ples tak­en at the cen­tre are checked imme­di­ate­ly for drug mark­ers and if there’s a pos­i­tive indi­ca­tion, the urine is sent to NSW Health Pathology’s Drug Tox­i­col­o­gy Unit (DTU) for fur­ther test­ing and analy­sis to deter­mine what the drug is.

NSW Health Pathology’s Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice Direc­tor of Foren­sic and Envi­ron­men­tal Tox­i­col­o­gy San­ti­a­go Vazquez says the lat­est tech­nol­o­gy at the DTU lab­o­ra­to­ry ensures results are received by the Parklea cen­tre with­in days.

“We work with staff at the Com­pul­so­ry Drug Treat­ment Cor­rec­tion­al Cen­tre to ensure they know how to inter­pret the results of the urine tests and the reports that we pro­vide,” Dr Vazquez said.

“Our lab­o­ra­to­ry uses world-lead­ing tech­nol­o­gy to analyse a wide range of drugs and their metabolites.

“We’re proud to be sup­port­ing the work of the NSW Drug Courts and help­ing to man­age the recov­ery of participants.”

Since the drug treat­ment pro­gram began in 2006, the Parklea CDTCC has col­lect­ed more than 80,000 urine sam­ples for testing.

A woman in a Corrective Services uniform standing with another woman and a man outside a high-security fence.
Lin­da Fer­rett, Direc­tor Com­pul­so­ry Drug Treat­ment Cor­rec­tion­al Cen­tre, Dr San­ti­a­go Vazquez, NSWHP Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice, and Denise Con­stan­ti­nou, Senior Psy­chol­o­gist CDTCC.

Drug alert for high dose ‘Gucci’ MDMA tablets

Our Forensic & Analytical Science Service (FASS) has played a key role in alerting the community to the dangers posed by high dose MDMA tablets, recently seized by NSW Police.

NSW Health has issued a pub­lic drug warn­ing for the high dose MDMA (ecsta­sy) tablets that are pink/orange in colour, with the word Guc­ci print­ed on one side, along with a ‘Guc­ci’ logo.

NSW Health Pathology’s Illic­it Drug Analy­sis Unit (IDAU) recent­ly test­ed a tablet seized by NSW Police, not­ing the logo and appear­ance hadn’t been seen at the IDAU previously.

Lab­o­ra­to­ry Man­ag­er, Una Cul­li­nan said the larg­er than aver­age tablet con­tained 414mg of the drug.

“That is more than four times the amount of MDMA usu­al­ly found in these tablets, which aver­age at around 100mg,” she said.

“NSW Police and NSW Health were imme­di­ate­ly informed of the results.”

Med­ical Direc­tor of the NSW Poi­sons Infor­ma­tion Cen­tre, Dr Dar­ren Roberts, said the con­sump­tion of high dos­es of MDMA has caused seri­ous ill­ness and death in NSW.

“It can cause severe agi­ta­tion, raised body tem­per­a­ture, seizures or fits, irreg­u­lar heart rhythm and death,” Dr Roberts said.

“The health risks from MDMA are great­ly increased if high amounts, includ­ing mul­ti­ple dos­es, are con­sumed over a short peri­od. Oth­er risks include tak­ing MDMA in com­bi­na­tion with oth­er stim­u­lants, such as amphet­a­mines or cocaine.

“Hot envi­ron­ments can also increase the risk of harm from MDMA. Sev­er­al music fes­ti­vals are tak­ing place this week in New South Wales, and hot weath­er is pre­dict­ed. Tak­ing a break from danc­ing, seek­ing shade, and drink­ing water are impor­tant mea­sures to reduce the risk of over­heat­ing at festivals.”

Police and health author­i­ties are remind­ing the com­mu­ni­ty that the appear­ance of a tablet is not a reli­able indi­ca­tor of its drug contents.

“It is very impor­tant to remem­ber the amount of MDMA in a tablet or cap­sule can vary a lot, even with­in the same batch,” explained Dr Roberts.

“If you or a friend have tak­en drugs, please watch out for each oth­er and know the warn­ing signs that you need help. If you or a friend feel unwell, you won’t get into trou­ble for seek­ing med­ical care. Please seek help immediately.”

NSW Health Pathology’s Illic­it Drug Analy­sis and Foren­sic Tox­i­col­o­gy teams work every day to keep the com­mu­ni­ty safe by con­duct­ing expert analy­sis of blood, urine and oral flu­id sam­ples as well as test­ing illic­it drugs seized by police.

Their work sup­ports the health and jus­tice sys­tems and con­tributes to pub­lic health alerts such as this.

For more infor­ma­tion on drug alerts, vis­it the NSW Health website.

 

 

Meet Lorretta – our first statewide pathology collections manager

Lorretta Thomson was a registered nurse in oncology and cardiology before making the move to pathology where she has worked as a collector, trainer and manager.

Let’s get to know her a bit better.

 

How long have you been with NSWHP

Com­ing up to 6 years now.

 

How did you end up here? How did you get into the field?

I worked as a Reg­is­tered Nurse in oncol­o­gy and car­di­ol­o­gy for many years before I made the switch to work in pathol­o­gy for the pri­vate sector.

I’ve had many roles in pathol­o­gy as a col­lec­tor, a train­er and a manager.

I was brows­ing online one day and came across an advert for a col­lec­tion train­ing role for NSW Health Pathol­o­gy in the Hunter region.

The idea of a new chal­lenge was appeal­ing, but I loved my job and leav­ing my long-term employ­er was­n’t some­thing I had ever envisaged.

I got brave, applied, and found I was the pre­ferred appli­cant. I approached my man­ag­er and asked for a leave of absence so I could pluck up the courage to explore this new opportunity.

Very gra­cious­ly, they gave me a six-month win­dow where I could return if I was­n’t hap­py in my new role.

But, when I start­ed with NSW Health Pathol­o­gy, I knew I’d found my new home.

Since then, I’ve held sev­er­al roles at NSW Health Pathol­o­gy. The most chal­leng­ing but huge­ly sat­is­fy­ing role was as the Nurse Unit Man­ag­er (NUM) at the COVID-19 dri­ve-through test­ing clin­ic at the Uni­ver­si­ty of New­cas­tle. After that, I was NUM 2IC for col­lec­tions in the Hunter, and now, this new posi­tion as Statewide Col­lec­tions Manager.

 

Do you have an analogy to help us understand your work?

I see myself as one of those sup­port vehi­cles for a long-haul cycling team. I’m here to help, hope­ful­ly in prac­ti­cal ways. I’m here to keep an eye on the big pic­ture and give ongo­ing sup­port as we progress in our jour­ney as a tru­ly con­nect­ed statewide service.

 

What are your plans for the role and what are you working on now?

I’ll be doing my part to con­tin­ue the work to stan­dard­ise prac­tis­es with­in the col­lec­tion space. Cur­rent­ly, I’m learn­ing about the dif­fer­ent needs in our col­lec­tion areas across our vast state. Togeth­er, our col­lec­tion man­agers are shar­ing valu­able learn­ings and insights as we become a more inte­grat­ed team.

Our focus is on train­ing our col­lec­tors, recog­nis­ing our front-line staff, high­light­ing our pae­di­atric exper­tise, and improv­ing our ser­vice for all our diverse patients and communities.

 

What motivates you? What are you passionate about?

Peo­ple are my moti­va­tion and my pas­sion. Work­ing in a team dynam­ic ener­gis­es me. Con­nect­ing and feel­ing a sense of belong­ing makes it easy to come to work each day. I’m com­mit­ted to mak­ing sure our patients receive expert care and the best pos­si­ble expe­ri­ence in a wel­com­ing and safe envi­ron­ment. I’ve always found great sat­is­fac­tion in see­ing patients leave and know­ing that their day is a lit­tle lighter because of their time spent with us – even if the pro­ce­dure itself is less than fun.

 

What would you be doing if you hadn’t started your career in pathology?

I think I’d be work­ing as an oncol­o­gy nurse. I expect I would’ve stud­ied to become a spe­cial­ist breast care or pro­sta­t­ic can­cer nurse and be part of a team that sup­ports can­cer patients.

 

What makes you get up in the morning?

Get­ting up in the morn­ing is always easy for me. It’s the best part of the day. I have a mantra that’s got­ten me through some pret­ty tough days and brought extra joy to the good days: ‘Have some­thing to look for­ward to. Find some­thing to laugh about, and do some­thing for some­one else.’ It works for me.

 

What’s your favourite pastime?

I enjoy music, long walks and spend­ing time with fam­i­ly and friends.

 

What’s the best advice you were ever given?

Often, rather than react­ing with a straight-up ‘no’ it’s bet­ter to pause, take a breath and say ‘Let me think about that’….and then actu­al­ly go away and think it through with an open mind!

 

What’s your favourite season?

My favourite time of the year is autumn with lots of sun­shine, blue skies, pret­ty colours and warm days.

 

What’s your secret talent? Can you tell us a fun fact about you?

No real secrets here. I’m an open book! I do ok on the piano.

Grow­ing up, we moved from state to state every 2 or 3 years. I went to 3 pri­ma­ry schools and 3 high schools and was for­ev­er the ‘new kid’. This led to a con­sis­tent theme in my school reports, ‘Lor­ret­ta would do bet­ter if she focussed more on her class­es and less on social­is­ing’. On the upside, I made many long-last­ing con­nec­tions. On the down­side, maths is def­i­nite­ly not my strength!

 

Find more infor­ma­tion about pathol­o­gy tests and look up where your local pathol­o­gy col­lec­tion cen­tre is.

Our key role in PrOSPeCT

NSW Health Pathology staff are playing a key role in a new study aimed at opening up new, potentially life-saving treatment pathways for more than 23,000 Australians with rare, difficult-to-treat or incurable cancers, including ovarian, pancreatic and sarcomas.

PrOSPeCT (Pre­ci­sion Oncol­o­gy Screen­ing Plat­form enabling Clin­i­cal Tri­als), offi­cial­ly launched by Omi­co on 27 July 2023, will pro­vide faster access to the most advanced can­cer fight­ing treat­ments – genom­ic pro­fil­ing and match­ing to pre­ci­sion treat­ments, includ­ing ear­ly-stage clin­i­cal trials.

The study brings togeth­er a nation­al net­work of lead­ing can­cer research cen­tres, and diag­nos­tic and treat­ment ser­vices, with NSWHP pro­vid­ing a range of ser­vices including:

  • blood col­lec­tion
  • sup­ply of diag­nos­tic tissue
  • cen­tral tis­sue sectioning
  • genom­ic sequencing/comprehensive genom­ic pro­fil­ing services
  • biobank­ing of blood sam­ples, and
  • logis­tics, ICT infra­struc­ture, bioin­for­mat­ic, oper­a­tional and research support.

We expect to receive more than 3,500 sam­ple requests over the course of the study.

Act­ing Chief Exec­u­tive Prof Rob Lin­de­man says it’s an excit­ing oppor­tu­ni­ty for NSWHP, which has been made pos­si­ble by the exper­tise and ded­i­ca­tion of our peo­ple right across the state.

“I’m incred­i­bly proud to be pro­vid­ing inte­grat­ed, statewide ser­vices for this col­lab­o­ra­tive, cut­ting-edge project that will offer new treat­ment path­ways for those who great­ly need them,” he said.

“Over the last 12 months, our mul­ti­dis­ci­pli­nary teams have been work­ing hard to build vital capac­i­ty and infra­struc­ture to sup­port our participation”.

We want to recog­nise some of the peo­ple with­in our organ­i­sa­tion who have played a key role in the PrOSPeCT project so far.

Our project team

Our core project team has worked tire­less­ly to facil­i­tate the plan­ning for this com­plex project and ensure our ser­vices for PrOSPeCT are ready for the offi­cial launch. Michael Hip­well, Senior Hos­pi­tal Sci­en­tist, Nicole Pearce, Clin­i­cal Ser­vices Oper­a­tions Man­ag­er Genomics and Dr Bente Talseth-Palmer, Research Strat­e­gy Lead have led the project for NSWHP, coor­di­nat­ing the involve­ment of our staff from right across the organisation.

Michael, Nicole and Bente have been sup­port­ed by:

  • Prof Rob Lin­de­man, NSWHP Act­ing Chief Exec­u­tive and Exec­u­tive Sponsor
  • Mar­tin Cano­va, Direc­tor Strat­e­gy and Trans­for­ma­tion and Act­ing Direc­tor Clin­i­cal Operations
  • Louise Carey, Act­ing Direc­tor of Genomics
  • Dar­ren Croese, Chief Oper­at­ing Officer
  • Prof Jen­nifer Byrne, Direc­tor of Biobanking
  • Sarah Balk, Senior Legal Counsel
  • the PrOSPeCT Steer­ing Com­mit­tee, whose mem­bers have pro­vid­ed lead­er­ship in clin­i­cal oper­a­tions, cor­po­rate gov­er­nance, finance, ICT, DevOps, pro­cure­ment, qual­i­ty, research, peo­ple and cul­ture, project man­age­ment and strate­gic com­mu­ni­ca­tions, and
  • our Col­lec­tors, CSRs and research coor­di­na­tors right across the state.

Dr Cliff Mel­drum, who recent­ly cel­e­brat­ed his retire­ment, was also an instru­men­tal mem­ber of the project team.

Our genomic sequencing and comprehensive genomic profiling services

Our Genomics Statewide Sequenc­ing Ser­vice and Mol­e­c­u­lar Med­i­cine depart­ment locat­ed at John Hunter Hos­pi­tal New­cas­tle and led by Senior Hos­pi­tal Sci­en­tist, Michael Hip­well have worked for 12 months to devel­op the new test, or assay, required for PrOSPeCT, which looks at more than 500 genes. With the sup­port of Clin­i­cal Super­vi­sor Dr Michael Buck­ley and Kel­ly Kiej­da, Genomics JHH, Michael Hip­well also secured our NATA accreditation.

Our supply of diagnostic tissue and central tissue sectioning service

Our Anatom­i­cal Pathol­o­gy (AP) labs across the state are sup­ply­ing diag­nos­tic tis­sue for the PrOSPeCT study and col­lab­o­ra­tion with Prof Wendy Coop­er, AP Clin­i­cal Stream Lead and Senior Staff Spe­cial­ist and the AP Clin­i­cal Stream has been essen­tial to enable this. Hui Yin, Senior staff spe­cial­ist and Ricar­do Valain, Staff Spe­cial­ist at our John Hunter Hos­pi­tal AP Lab are ensur­ing ade­qua­cy or suit­abil­i­ty of tis­sue sam­ples for the project.

NSWHP is also pro­vid­ing a cen­tral tis­sue sec­tion­ing ser­vice based at our Prince of Wales Hos­pi­tal (PoWH) Rand­wick lab. A/Prof Trent David­son, Local Pathol­o­gy Direc­tor, South East Syd­ney, Clin­i­cal Direc­tor Anatom­i­cal Pathol­o­gy and Senior Staff Spe­cial­ist is respon­si­ble for this essen­tial ser­vice and over­sees staffing, resources and pro­cess­ing out­puts. He is sup­port­ed by Joanne La Mal­fa, Anatom­i­cal Pathol­o­gy Man­ag­er, and Mon­i­ca Ahu­ja, Senior Sci­en­tif­ic Offi­cer at PoWH who have led the set­up of infra­struc­ture and recruit­ment of spe­cial­ist staff at PoWH for PrOSPeCT.

Our Statewide Biobank

All blood sam­ples col­lect­ed for the PrOSPeCT study are banked at the NSW Health Statewide Biobank. Dr Beth Caru­a­na, Senior Sci­en­tist, and the team at the Biobank have imple­ment­ed new high-through­put lab­o­ra­to­ry work­flows to process thou­sands of patient sam­ples for future research.

Our ICT infrastructure and bioinformatics pipeline

Our ICT Infra­struc­ture and bioin­for­mat­ic pipeline sup­port and enable data and analy­sis for our labs to analyse and pro­vide a diag­nos­tic report. Con­nor McBride, NSWHP Genomics Cloud DevOps, Eva Chan, Senior Bioin­for­mati­cian and her team and Neil Cur­ry­er, Fiona Mil­lar-Hen­nessey and Simon Win­ters, Clin­i­cal Oper­a­tions ICT and Tim Eck­er­s­ley, Chief Tech­nol­o­gy Offi­cer have been instru­men­tal in its creation.

 

Read more about the launch of PrOSPeCT and the work of NSW Health Pathology’s Statewide Genomics Sequenc­ing Ser­vice here.

Nitazene drug warnings prompt action from TGA

The work of NSW Health Pathology’s Forensic & Analytical Science Service laboratories has been recognised by Australia’s health watchdog, as it moves to restrict the use of a dangerous class of drugs.

The Ther­a­peu­tic Goods Admin­is­tra­tion is act­ing to restrict the use of potent syn­thet­ic opi­oids known as nitazenes that have been the sub­ject of recent warn­ings by health author­i­ties in NSW, the ACT, and Victoria.

The TGA deci­sion not­ed that “pub­lic expo­sure appears to be entire­ly recreational…and their abuse and illic­it use pos­es a sig­nif­i­cant risk to pub­lic health”.

The TGA del­e­gate fur­ther not­ed that the nitazene fam­i­ly of sub­stances were orig­i­nal­ly devel­oped with the inten­tion to be used in anaes­the­sia, but the poten­cy of the sub­stances and asso­ci­at­ed risk of res­pi­ra­to­ry depres­sion and death means “they are con­sid­ered unsuit­able for use in a ther­a­peu­tic context”.

“I also recog­nise that there are increas­ing reports of the pres­ence of these sub­stances in drugs intend­ed for recre­ation­al use, which has result­ed in a pro­por­tion­ate increase in adverse events and fatal­i­ties asso­ci­at­ed with expo­sure to nitazenes,” the del­e­gate said.

“While these reports are large­ly lim­it­ed to over­seas juris­dic­tions thus far, I note with con­cern the recent reports of the detec­tion of nitazenes in seizures of hero­in and oth­er illic­it and coun­ter­feit drugs in Australia.”

White powder inside a mortar and pestle, being held by blue-gloved hands.
NSW Health Pathol­o­gy’s illic­it drug test­ing lab­o­ra­to­ries have played a cru­cial role in iden­ti­fy­ing nitazenes.

The Foren­sic Tox­i­col­o­gy Lab­o­ra­to­ry and Illic­it Drug Analy­sis Unit (IDAU) at NSW Health Pathology’s Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice (FASS) are work­ing in part­ner­ship with sev­er­al oth­er agen­cies to ensure the safe­ty of the com­mu­ni­ty when it comes to illic­it and oth­er drugs of abuse.

The Com­bined Sur­veil­lance and Mon­i­tor­ing of Seized Sam­ples (CoS­MoSS) project, which includes the IDAU, NSW Police, and the NSW Min­istry of Health involves analy­sis and report­ing on street lev­el drugs seized by NSW Police.

The Pre­scrip­tion, Recre­ation­al and Illic­it Sub­stance Eval­u­a­tion (PRISE) pro­gram is a col­lab­o­ra­tion includ­ing FASS Foren­sic Tox­i­col­o­gy, NSW Poi­sons Infor­ma­tion Cen­tre and the NSW Min­istry of Health pro­vid­ing expe­dit­ed com­pre­hen­sive tox­i­co­log­i­cal test­ing for patients with severe or unusu­al sub­stance relat­ed toxicity.

The organ­i­sa­tions recent­ly col­lab­o­rat­ed to issue a pub­lic drug warn­ing that iso­toni­tazene has been detect­ed in ‘hero­in’ seized on the NSW Cen­tral Coast. The drugs had been linked to sev­er­al over­dos­es and ICU admissions.

FASS Direc­tor Michael Symonds said the TGA con­sid­ered the drug alert issued by NSW Health in mak­ing its deci­sion on nitazenes.

“This is great recog­ni­tion of the work being done by our Foren­sic Tox­i­col­o­gy and Illic­it Drug Analy­sis teams and shows that our focus on sur­veil­lance and keep­ing com­mu­ni­ties safe is work­ing,” Mr Symonds said.

“Nitazenes are a par­tic­u­lar­ly dan­ger­ous syn­thet­ic opi­oid and require time-con­sum­ing lab work to trace.

“The poten­cy of nitazenes means dos­es are small and it can be present in extreme­ly low con­cen­tra­tions in drug and bio­log­i­cal samples.

“But our lab­o­ra­to­ries have been able to detect even small quan­ti­ties of this dan­ger­ous drug.”

The TGA deci­sion to restrict nitazenes will come into effect from 1 Octo­ber 2023 and comes just months after the UK announced sim­i­lar restric­tions.

A man wearing a black suit and blue tie, smiling.
FASS Direc­tor Michael Symonds.

Exciting PrOSPeCTs for precision cancer treatments

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.

 

Michael Hipwell 4 EDIT
Michael Hip­well, Senior Hos­pi­tal Sci­en­tist for NSWHP’s Statewide Genomics Sequenc­ing Service
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