GICI is also very pleased to announce an award of $50,000, thanks to the generosity of the Hugh Green Foundation, to Dr Rachel Purcell of the University of Otago.

New Zealand has one of the highest rates of colorectal cancer (CRC) in the world. Dr Purcell and her team will be looking at molecular subtyping and the gut flora in relation to colorectal cancers asking the following two questions.

i) Can molecular subtyping of Colo Rectal Cancer lead to a more personalised approach to treatment and improved outcomes? CRC is a highly heterogeneous disease, with varying clinical outcomes, response to therapy, and morphological features. Currently, no molecular subtyping system, such as the one in place for breast cancer, is in clinical use for CRC in NZ, and consequently more tailored treatments based on molecular profiling are not routinely administered in NZ. Therefore, classification into clinically useful and reproducible subtypes is of utmost importance in order to implement the best available treatment regimen.

ii) How do differences in the gut microbiome contribute to CRC? In addition to validating a classification system that would improve outcome, Dr Purcell seeks to investigate the mechanisms underpinning the development of the spectrum of CRC subtypes. The human colon plays host to a vast and complex microbial community of microorganisms, and gut biome dysfunction is believed to play a role in the development of CRC. Comparison of faecal microbiomes from CRC patients and healthy control has identified particular bacterial species that are enriched in CRC, and analysis of tumour, adenoma, and matched normal tissue from the same patients found that changes in local communities of potentially interacting bacteria, so called ‘meta-communities’, are associated with different disease states.

Major Announcement
GICI funds three new trials!! $50,000 has been awarded to Dr Roslyn Kemp of the University of Otago. In colorectal cancer, a strong immune response within the tumour is associated with a good outcome for patients. Dr Kemp will validate this finding, for the first time, in New Zealand patients. She will also use a new technology to characterize these immune cells to determine their mechanisms of action. This is vital research bringing colorectal cancer up to the latest in immunological responses. We look forward to the outcomes of this is major research!

GICI part funds patients onto clinical trial INTEGRATE ll for recruitment for radiology and laboratory requirements.
INTEGRATE ll is a Randomised III Double-Blind Placebo-Controlled Study of regorafenib in Advanced Gastro-Oesophageal Cancer (AGOC) which will be conducted in Australia, New Zealand, Korea, Japan, Taiwan, Canada and the USA.
There currently exist few effective treatment options for patients with Advanced Gastro-Oesophageal Cancer (AGOC) that has returned after surgery or where it is incurable (metastatic) at diagnosis. Chemotherapy can be effective at first, but once the cancer has become resistant to it, the options for treatment are limited. A second course of a different chemotherapy can prolong survival, but not all patients are fit to receive this treatment. For those who do receive a second course, their cancer will eventually become resistant to these drugs. In both of these situations, there are currently no accepted treatment options that have been shown to be both effective against the cancer and tolerable for patients. Better treatment options are urgently needed.
Regorafenib is a ‘multi-targeted therapy’ targeting a number of different signals in the cancer cell that cause it to grow and produce blood vessels. In other cancers such as colon cancer, Regorafenib has been proven to be of benefit when other drugs have ceased to work. INTEGRATE demonstrated efficacy with the use of Regorafenib in advanced Gastro-Oesophageal Cancer, and could potentially become a new standard of care after other therapeutic agents have stopped working. INTEGRATE II is being undertaken to confirm the findings of the Phase II trial in a larger population.
If the study is positive it will provide evidence for Regorafenib as a new standard of care after other treatments no longer benefit patients with gastric cancer.
Worldwide 350 – Auckland Hospital – GICI has agreed to fund 3 patients over 2 years funded at a cost of $8852 for all three.