Cabrini Cancer Institute

A further step in cancer research at Cabrini

Cabrini Cancer Institute, opened in April 2021, is a further step in the development of cancer research at Cabrini. Research at Cabrini is currently carried out by the departments of medical oncology, surgery, urology, radiation oncology, psycho-oncology and palliative care and there are currently more than 100 active clinical trials for patients to participate in.

A grant from the Federal Government has allowed us to develop phase one of a two-part project to create the Cabrini Cancer Institute. Phase one allows us the capacity to double the number of clinical trials within the next two years and create a state-of-the-art exercise research facility to better understand how to integrate exercise into every cancer patient’s treatment. Associated with the exercise research is a fully functional gymnasium staffed by Cabrini exercise physiologists.

The development of the Cabrini Cancer Institute also allows the expansion of research in patient experience using Patient Reported Outcome Measures (PROMs), development of novel techniques to determine best therapies, such as tumour organoids, collection and analysis of data to improve patient outcomes, and provision of exercise and wellbeing programs. Cabrini is committed to providing innovative, integrated, individualised, multidisciplinary, personalised cancer care for patients from pre-diagnosis through to treatment and survivorship, including palliative care.

As one of Australia’s leading providers of cancer services, the integration of the Cabrini Cancer Institute within the Cabrini Malvern hospital allows researchers and clinicians to better work together, developing breakthroughs to deliver better health outcomes for all cancer patients.

We place our patients at the very centre of a multidisciplinary team, recognising a patient’s right to actively participate in decisions concerning treatment and ongoing care. A range of healthcare professionals from different specialties work together to provide the optimum care. This approach ensures access to the right people who can help with every aspect of patients’ treatment and recovery, whether it be surgery, nursing, rehabilitation or counselling.

Clinical trials – new cancer treatments

The Cabrini Cancer Institute allows better access to new cancer treatments of all types. Collaboration with the Monash Academic Health Sciences Centre allows the integration of exciting translational research, where findings from the laboratory can be used to design more effective and less toxic treatments for patients. It allows the ability to tailor treatments for individual patients, better known as precision (or personalised) medicine.

Precision medicine is an emerging approach for disease treatment and prevention, which takes into account individual variability in genes, environment, and lifestyle for each person. This approach allows doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. It is in contrast to a one-size-fits-all approach, in which disease treatment and prevention strategies are developed for the average person, with less consideration for the differences between individuals.

It involves the following:

• New Drug Discovery: For many years, the only available options for treating cancer were to surgically remove it or to kill the rapidly dividing cells with cytotoxic chemicals or radiotherapy. These were blunt tools compared to today’s therapeutic strategies. Although all three modalities still play a vital role, their use is now often in combination with a more sophisticated generation of targeted drugs and immunotherapies. Cabrini currently has more than 100 clinical trials using novel cancer drugs. Furthermore, we have a cancer organoid (3-D tumours developed in vitro) program in colorectal, breast and ovarian cancers, that involves drug sensitivity and toxicity profilings.
• Cancer Genomics: Cancer genomics is the study of the totality of DNA sequence and gene expression differences between tumour cells and normal host cells. It aims to understand the genetic basis of tumour cell proliferation and the evolution of the cancer genome under mutation and selection by the body environment, the immune system and therapeutic interventions. Beyond the identification of individual targetable alterations, genomic methods can gauge mutational load, which might predict a therapeutic response to immune-checkpoint inhibitors or identify cancer-specific proteins that inform the design of personalised anticancer vaccines. Emerging clinical applications of cancer genomics include monitoring treatment responses and characterising mechanisms of resistance. Cabrini participates in the Monash Partners Comprehensive Cancer Consortium (MPCCC) precision medicine program, identifying actionable tumour mutations for specialised treatment programs. Immunotherapy: Cancer immunotherapy is a therapy used to treat cancer patients that involves or uses components of the immune system. Cabrini currently has more than 50 active immunotherapy drug trials, and works in partnership with the Hudson Institute and Peter MacCallum Cancer Centre in development of CAR-T therapies in solid tumours.

Visit our cancer trials page

Cancer research

Cancer organoids

Organoids are a promising area of research that have the potential to shape the future of personalised cancer treatment for patients. Organoids are three-dimensional cultures of cells grown in a laboratory dish from tissue biopsies from healthy patient tissues and tumours. Organoids mimic the complex features of the tissue from which they are derived and are a powerful research tool that can be used to test common therapeutics to determine if a patient is likely to respond to treatment. As a research tool combined with extensive patient data captured at Cabrini, organoids can also be used in high-throughput drug testing to identify novel agents, improve our understanding of cancer biology and make predictions about patient survival outcomes. The Cabrini Cancer Institute is at the forefront of organoids research, collaborating with Professor Helen Abud’s laboratory at the Monash Biomedicine Discovery Institute, Monash University, a world leader in organoid research development. Organoid research at the Cabrini Cancer Institute is currently being conducted in colorectal cancer, breast cancer and ovarian cancer, with the aim of expanding into other cancers. The research teams, Cabrini Monash University Department of Surgery and Cabrini Monash University Department of Medical Oncology, are leading organoid research at the Cabrini Cancer Institute.

Epigenetics

Epigenetics is the study of inheritable changes in gene function that are not associated with changes in the DNA sequence. The epigenetic outlook of a cell is determined by status of DNA methylation, histones covalent modifications, chromatin structure, and non-coding RNAs and networking with each other. The Department of Medical Oncology and Department of Surgery at Cabrini work closely with the Department of Biochemistry and Molecular Biology, Biomedical Discovery Institute at Monash University in epigenetic research. 

Patient experience

Measuring the experiences of patients and reporting back to the health system enables cancer services and health professionals to better understand the unique needs of people affected by cancer. Understanding a patient’s perspective throughout each stage of their cancer experience can enable more personalised treatment and drive improvements in the quality of care provided by cancer services. Patient Reported Outcome Measures (PROMs) capture the perspectives of patients on their experiences and outcomes of their cancer care. Gathering patient-reported measures involves asking cancer patients about their experiences and outcomes, which ultimately measures their overall wellbeing. Cabrini currently has PROMs research in chemotherapy toxicity and lung and pancreatic cancers. We are currently developing the PROMs instrument for the Victorian Lung Cancer Registry.

Medical informatics

A complete and detailed collection of data about every cancer is the key to understanding this complex disease – the symptoms people have, how their cancer is diagnosed, how they respond to treatment and how their cancer progresses over time. The current areas where Cabrini uses medical informatics include:

• Cancer registries: Australia has comprehensive population-based cancer registries in each state and territory. The primary role of these registries is broad population health surveillance and research support. They are coordinated nationally through the Australian Institute of Health and Welfare (AIHW) and the Australasian Association of Cancer Registries (AACR).
• Individual cancer databases: Cabrini cancer care is divided into tumour streams, allowing multimodality treatment. There are currently comprehensive databases in colorectal, breast, lung, and gynaecologic cancers. There are plans to develop further databases in all other tumour streams.
• Big data: Extremely large data sets may be analysed computationally to reveal patterns, trends, and associations. This helps identify novel therapeutic targets, design biomarker-driven clinical trials and find genomic determinants of response to therapy. Artificial intelligence algorithms are already beginning to affect cancer research and clinical care, such as early diagnosis and prevention, drug discovery, matching patients to clinical trials and treatment decisions. It impacts cancer research in sequencing cancer genomes, high-throughput sequencing of patient samples, and analysis of transcriptomes for better cancer monitoring, incorporating machine learning algorithms for diagnostic modelling, presenting greater clarity on disease prognosis, and research into cancer relapses.

Exercise and wellbeing research