PaCCSc and CST Annual Research Forum 2023| IMPACCT news

It was wonderful to all be in the same room as we heard from three excellent international speakers, a focus on implementation science as well as three discussion panels and the presentation of study results from PaCCSC and CST clinical trials.

There were a sense of renewed energy in the room and the chance to reconnect with colleagues in person for the first time in three years was welcomed by attendees.

Keynote speakers

Joining us via Zoom from Edinburgh, the day 1 keynote speaker was Professor Marie Fallon whose presentation was about a Randomised controlled trial of a cannabinoid-based medicine with embedded mechanistic substudy and the role of interdisciplinary co-investigators.

On Day 2, Dr Camilla Zimmermann joined us from Toronto to give a keynote presentation on the Challenges and solutions for palliative care trials using complex interventions. 

CALD communities

We also were pleased to welcome guest speaker Professor Miriam Johnson, Associate Director of the Wolfson Palliative Care Research Centre at the University of Hull, whose presentation of a clinical trial in the UK gave us an insight into the challenges of recruiting inclusively to clinical trials.

Dr Rayan Saleh Moussa, CST Postdoctoral Research Fellow, facilitated a discussion with an engaging and insightful panel of experts on the experience of Arabic-speaking people accessing the Australian healthcare system and their participation in clinical trials. Panel members included Dr Abhi Pal, Nadine El-Kabbout, Arwa Abousamra and Dr Charbel Bejjani.

The themes for the discussion were reality/lived experience, challenges in contact of clinical trials, and potential solutions.

This invaluable conversation only scratched the surface of the issues facing CALD communities’ access to healthcare in Australia. Dr Saleh Moussa is leading a research program to investigate some of the challenges. Read more about this discussion.

Consumer engagement

Dr Vanessa Yenson, CST Research Assistant-Writer has been coordinating the CST Delphi study on identifying cancer symptoms priorities and needs in Australia and New Zealand. This important study highlighted fatigue as a priority symptom for consumers and will also help CST with prioritising our research focus.

Dr Yenson is also a member of ConViCTioN, a NSW-based consumer group. She shared the ConViCTioN yarning circle video, which shows ConViCTioN members talking about the value of clinical trials.

Cancer cachexia

We heard from speakers with expertise in cancer cachexia, a distressing symptom that includes weight loss and muscle wastage. Dr Mariana Sousa, UTS Chancellor’s Research Fellow, chaired this session and facilitated a discussion with guest speakers, Professor Patsie Polly, Scientia Education Fellow, Cancer Cachexia Mechanisms Research Group (CCMRG), University of New South Wales, Dr Vanessa Vaughan, Sub-Dean Global Medicine, University of Western Australia, and Matt Ely, Barwon Health Physiotherapist. 

Professor Polly shared her research on a molecular roadmap for biomarkers in cancer cachexia while Dr Vaughan talked about patient experiences of a multi-professional cachexia clinic and Mr Ely shared his experience of working at the Cachexia and Nutritional Support Service at Barwon Health in Victoria, a clinic that puts the patient at the centre of care.

Implementation science

Two implementation scientists presented at the forum – Associate Professor Natalie Taylor and Dr Hannah Wardill. Associate Professor Taylor’s presentation explained what implementation science offers cancer clinical trials and considered intervention versus implementation and how implementation data supports intervention in practice.

Dr Wardill, who was also part of the substudies discussion panel, talked about how discovery-based science supports clinical trials and personalised medicine that takes into account that everyone has a different gut microbiome that can determine personal responses to medicines in terms of efficacy and toxicity.

Substudies

Facilitated by Dr Tim Luckett, the substudies discussion panel included Professor Jennifer Philip, Academic Lead, Palliative Care, Victorian Comprehensive Cancer Centre, Professor David Currow, Deputy Vice-Chancellor (Research and Sustainable Futures), University of Wollongong, Dr Hannah Wardill, NHMRC CJ Martin Biomedical Research Fellow, University of Adelaide, and Belinda Fazekas, National Project Officer, IMPACCT Trials Coordination Centre (ITCC).  

Belinda Fazekas has many years’ experience working in clinical trials and gave an excellent presentation on the value of substudies. She explained that separate research questions from parent protocols, contribute to the parent protocol’s objectives and, use all or a subset of study participants' data or specimens.

Substudies can enrich the data from the main study but consideration must be given to logistics and additional costs as well as burden to staff and patients.

Professor Philip’s presented on the contribution of qualitative research to clinical trials/studies: the findings from an ethnographic substudy. She explained that qualitative research, in health:

• gives insights when there is little baseline understanding
• questions existing assumptions
• offers viewpoints of specific groups
• provides understanding that is contextual and retains complexity

Professor Currow talked about how substudies can lead to the next clinical trial, highlighting that good studies do raise more questions than they answer, and substudies can allow participants to choose aspects of a study that are particularly relevant to them and allow new questions of interest to investigators. 

Study results

It was wonderful to hear the results of a number of studies at this forum, which were a testament to the fantastic work being undertaken by a talented and passionate group of clinicians and members of PaCCSC and CST.

Congratulations to the investigator teams represented at the forum for the below studies.

• Randomised double-blind, placebo-controlled phase III trial of oral melatonin for the prevention of delirium in hospital in people with advanced cancer - Professor Meera Agar
• Oxycodone/Naloxone PR is Superior to Oxycodone PR in Advanced Cancer - Dr Aaron Wong
• COMET Project - Increasing research capability and access to clinical trials for community-based palliative care patients and services - Dr Lucy Demediuk
• PEARL Study – Palliative care Early in Advanced Lung cancers - Associate Professor Jaclyn Yoong
• A randomised, double-blind, placebo-controlled feasibility study of lorazepam for anxiety in people with advanced life-limiting disease – Dr Nicola Atkin
• Breathlessness, exertion and morphine sulphate (BEAMS) study – Professor David Currow

IMPACCT Rapid Program

We also heard from the IMPACCT Rapid Program Chair, Dr Caitlin Sheehan and the Rapid Paediatric Program Lead, Dr Ross Drake. The program continues to grow under their leadership with support from the Rapid Program Coordinator, Yinyin Phyo.

The Rapid Program has 87 participating sites across ten countries, while the Rapid Paediatric Program now has members across 20 sites in nine countries. Rapid offers a unique opportunity for clinicians to get involved in research. It provides an accessible starting point for engagement with a supportive research community.

CST Emerging Trialist Award 2022

On day 1 of the forum, we were pleased to announce Dr Wei Lee as the winner of the CST Emerging Trialist Award 2022. This award recognises and celebrates the outstanding achievements and contributions of emerging clinical trial researchers. Read more.

Travel grants

Thanks to funding from the New South Wales, Ministry of Health, we were able to offer a number of $1,000 PaCCSC travel grants for attendance at the forum for clinicians based in rural and regional areas.  We were pleased to award these grants to two Clinical Nurse Consultants, Joanne Copper and Fiona Lysaught. Read more.

The PaCCSC & CST Annual Research forum was funded by the NSW Ministry of Health and Cancer Australia.