ANNUAL REPORT 2017 Department of Gynaecological Oncology

1

ANNUAL REPORT

2017

Department of Gynaecological Oncology

2

3

TABLE OF CONTENTS

Report from the Director 4

Overview of Our Service and Team 5

Summary of Department Activity for 2017 7 Out-patient occasions of service In-patient admissions Surgery / procedure breakdown Multidisciplinary team (MDT) case reviews Bio-banking

Summary of Activity Trends (2001 – 2017) 9 Out-patient occasions of service Admissions and bed days Average length of stay (ALOS) Multidisciplinary team (MDT) meetings

Case-mix Treated by the Department 11 Diagnosis of malignancy by site of disease

Cervical malignancies Uterine malignancies Ovarian, fallopian tube & primary peritoneal malignancies

Non-cancer diagnosis

Morbidity / Mortality Review 13 GOSPICE clinical indicators Important key surgical performance indicators Moving forward - National Gynae Oncology Registry (NGOR)

Socio-demographic Characteristics of Patients 16 Country of birth Age distribution Body mass index Referral base

Clinical Trials and Research Studies 18 Trials / Research Studies Open to Recruitment in 2017 Trials / Research Studies Closed With Patients Still in Long-term Follow-up

Grants Held 22 New grants awarded in 2017 Previous grants awarded and still held in 2017

Multidisciplinary Team Profile 25 Gynaecological Oncologists Nursing and Allied Health

Translational Research

Publications / Book Chapters 30

Conferences 33 Invited Speaker / Panellist Oral / Poster /Abstracts Organising / Chairing Sessions

Consumer and Community Engagements 37 Gynaecological Cancer Support Group Mindfulness Programs Media and Consumer Forums Fundraising for Research Consumer and Community Representation on Research Committees

4

REPORT FROM THE DIRECTOR

A/Prof Alison Brand MD, MMEd, FRCS(C), FRANZCOG, CGO Gynaecological Oncologist Westmead Hospital

Once again I am pleased to present the 2017 Department of Gynaecological Oncology Annual Report which showcases our achievements over the past year. Despite an extensive recruitment drive over the past year we remain short-staffed by 1.25 FTE gynaecological oncologist. My thanks the Dr Cecile Bergzoll who was able to provide locum service for 5 months this past year. We are all grateful for the fresh (and French) perspective she brought to the Department. This was the first year we have had a Clinical Fellow, Dr Amy Jamieson, after a lapse of many years. I now wonder how we managed without one for so long. Amy is participating in the RANZCOG CGO training program and will stay with us for 2018 as well. Despite the challenges of being short-staffed, our new patient numbers have increased by 5%, our MDT cases increased by 23%, and the percentage of cancer cases (including borderline tumours) relative to benign, increased to 60% (57% in 2016). Our average length of stay continues to decrease (now 2.7 days) with an ongoing decrease in unplanned readmissions (now ~3%). The percentage of endometrial cancer operations perfomed laparoscopically has almost doubled to 70% (37% in 2016). We had 25 clinical trials and research projects open to recruitment (19 in 2016) and recruited over 410 patients this year (173 in 2016). We continue to attract significant research funding ($23.8M- $8.26M in 2017 and $15.5M ongoing from previous years) and have an extensive publication record (25 papers, all in high-impact journals). In 2018 we will be one of 6 pilot sites to begin registering all our ovarian cancer patients into the National Gynae Cancer Registry (NGCR), which aims to benchmark surgical outcomes for ovarian cancer nationally. This is an important initiative which, at last, will confirm our standing relative to other tertiary units across the country. Such an impressive workload and output is only achieved through the stellar efforts of every single Department member – all of whom work together for the benefit of women in Western Sydney and beyond. My thanks also to Annie Stenlake for once again compiling this Report.

5

OVERVIEW OF OUR SERVICE AND TEAM

The Department of Gynaecological Oncology is a centralised specialist service, one of 6 designated gynaecological cancer services in the state. It is staffed by a multidisciplinary team of surgeons, nurses, allied health professionals and researchers providing specialist care in the treatment of gynaecological cancers, pre-malignant conditions, suspicious pelvic masses, as well as planned and emergency management of benign gynaecological and obstetrical conditions where more complex surgery is required.

Patients have access to the combined radiation / medical oncology service for complex chemotherapy regimens and radiation therapy and / or brachytherapy.

The Department comprises the following cancer specialists, nursing and allied health professionals:

Gynaecological Oncologists

A/Prof Alison Brand (Director) Dr Robyn Sayer (returned from maternity leave Apr 2017) Dr Cecile Bergzoll (locum Feb – Aug 2017)

Gynaecological Oncology Fellow

Dr Amy Jamieson (CGO Trainee)

Nursing

Clinical Nurse Consultant - Tish Lancaster Clinical Nurse Specialists - Zahra Anoneuvo, Wendy Jessop, Evangline Madriaga, Rachel Matulin, Quintina Reyes, Nursing Unit Manager - Linc Marlow

Allied Health

Clinical Specialist Social Worker - Kim Hobbs Clinical Psychologist - Suparna Karpe

Data Manager

Annie Stenlake BHSM (Info)

Clinical Trial Co-ordinators

Yuan Guo BMed (China) Ashika Kumar MBBS (Fiji), MPH

Administrative Support

Kathleen Burrows Christine Grech (temp 0.6 FTE)

Translational Research and Biobanking

Prof Anna deFazio (Head) Catherine Kennedy (Gynae-Biobamk and Research Manager) Researchers: Jessica Boros BSc (Hons),Yoke-Eng Chiew BSc (Hons), Catherine Emmanuel PhD (P/T), Maiken Lise Marcker Espersen PhD, Dr Bo Gao MBBS MSc FRACP PhD, Natalie Gava PhD

6

(P/T), David Goldsbury MPH, Casina Kan PhD, Ying Lei PhD, Nikilyn Nevins MSc, Svetlana Pianova MSc, Pamela Provan BAppSci (Hons), MBA, Dashni Srirangan MSc

Multidisciplinary Team

The multidisciplinary team maintains a close working relationship with the Departments of Radiation Oncology, Medical Oncology, Tissue Pathology and Diagnostic Oncology, Supportive and Palliative Medicine, Cancer Genetics, Psycho-oncology and Diagnostic Imaging. Medical Oncology Prof Paul Harnett Dr Bo Gao

Radiation Oncology Dr Viet Do Dr Jennifer Chard (on maternity leave from Oct 2017)

Tissue Pathology and Diagnostic Oncology A/Prof Jane Armes A/Prof Raghwa Sharma Dr King Tan Dr Anita Achan Dr Spinder Samra Dr Jennifer Kim

Supportive and Palliative Medicine Dr Phillip Lee (until Jul 2017)

Cancer Genetics A/Prof Judy Kirk

Psycho-oncology Dr Cathy Mason

Diagnostic Imaging Dr David Farlow (PET and Ultrasound) Dr Kevin Cheung (PET and Ultrasound) Dr Simon Gruenewald (PET and Ultrasound) Dr Luke Baker (CT and MRI) Dr Tony Peduto (CT and MRI)

Affiliations with Other Cancer Centres

The Gynaecological Oncology Department, as a tertiary referral service, draws referrals from within and across Local Health Districts. Where possible, patients requiring further treatment are referred to other Cancer Centres for chemotherapy and radiotherapy.

The Department maintains a close affiliation, in particular, with the following centres:

Nepean Cancer Care Centre

Blacktown Haematology and Oncology Centre

Central West Cancer Service

Riverina Cancer Centre

7

SUMMARY OF DEPARTMENT ACTIVITY FOR 2017

Out-patient Occasions of Service

The unit provided an average of 12 clinic sessions per fortnight (combined clinics for new and follow-up patient visits). The number of new patients increased by 5% to 499 (472 in 2016) but the number of follow-up visits has decreased due to an increase in shared care with GPs and general gynaecologists.

No. New Patient Visits

No. Follow-up Visits

Total No. Clinic Visits

499 1,858 2,357

In-patient Admissions

The unit has two full operating days available each week. All patients are admitted on the day of surgery and, where possible, are admitted to the Women’s Health Ward post-operatively, unless planned for admission to a High Dependency or Intensive Care Unit.

No. Surgical Admissions

(non-malignant)

No. Surgical Admissions (malignant)

No. Medical Admissions

Total No. Admissions

Average Length of Stay (ALOS)

136 (33%) 247 (59%) 37 (9%) 420 2.7 days

Of the 137 surgical admissions for non-malignant conditions, 69 (50%) had benign pathology, 36 (26%) were for treatment of precursor conditions, 11 (8%) had borderline tumours and 21 (15%) were for risk-reduction surgery.

Of the 37 medical admissions, 22 (59%) were for post-operative complications, most commonly wound breakdowns; 10 (27%) were for symptom management or palliation; and 5 (13%) were as a result of a planned procedure being cancelled on the day of surgery (out of operating theatre time [4], patient absconded [1]).

Surgery / Procedure Breakdown

Laparoscopic procedures, other than for diagnostic purposes, have been included in the ‘major surgery’ category. This is the same as for the previous 2 years.

No. Minor Procedures No. Major Procedures Total Number Procedures

119 (31%) 264 (69%) 383

Multidisciplinary Team (MDT) Case Reviews

No. Diagnostic Reviews (eg. curette / biopsy)

No. Reviews for Definitive Management

Plan

No. Diagnostic Imaging or General Discussion Reviews (no path)

No. Cases Discussed *

389 355 88 802

NB (*): Not all cases scheduled and written up for meetings are able to be discussed on the day (4%) - H+E slides may not have arrived from outside laboratories, or in-house cases may still require further work-up, such as immunohistochemistry, to confirm diagnosis.

8

Bio-banking

The Gynaecological Oncology Bio-bank at Westmead (GynBiobank) began in the 1990s and provides services for the procurement, storage and distribution of bio-specimens for research.

Tumour, normal tissue and blood are collected from consented patients undergoing surgery where cancer is a possible or confirmed diagnosis. The GynBiobank has samples banked from over 1,200 patients and includes formalin fixed paraffin embedded tissue (302 samples), fresh frozen tissue (1,077 samples), blood products (270 samples) and tissue microarrays.

In 2017 there were samples collected from 56 consented patients, the majority of these being from patients with an ovarian cancer diagnosis.

A total of 7 publications arose from collaborations with other national and international research bodies.

9

SUMMARY OF ACTIVITY TRENDS (2001- 2017)

Out-patient Occasions of Service

The number of new patients seen in 2017 increased by 5% compared to 2016, despite a reduction in gynaecological oncologist FTE hours to run clinics. The number of patients seen in follow-up has decreased due to an increase in shared-care with either other specialists or GPs, and discharging patients with benign or pre-invasive disease back to their referring doctor.

Admissions and Bed Days

0

500

1000

1500

2000

2500

3000

3500

New patients

F/U patients

Total

0

500

1000

1500

2000

2500

3000

Admissions

Bed Days

10

Average Length of Stay (ALOS)

There has been a significant decrease in ALOS since the introduction of fast-track surgery in 2008. This continues to decrease further with an increase in the number of laparoscopic procedures performed (ALOS 2.7 days for 2017).

Cases Discussed at Multidisciplinary Team (MDT) Meetings

There were 47 MDT meetings held by the Multidisciplinary Team during 2017. Eight hundred and two cases were discussed with an average of 17 cases per meeting. All cancer cases are discussed.

Initial diagnostic histology and cytology specimens (eg. curettes, core biopsies and ascites) are reviewed as well as histology from primary or interval debulking surgery in order to help inform an evidence-based clinical management plan for patients.

There has been an increase in involvement of the Diagnostic Imaging Services (mostly PET and CT) from 62 cases in 2016 to 88 cases in 2017.

0

1

2

3

4

5

6

7

8

ALOS

0

100

200

300

400

500

600

700

800

900

11

CASEMIX TREATED BY THE DEPARTMENT A total of 432 new patients were entered into the database for 2017. Two patients had synchronous primary gynaecological cancers and 5 others had a second non-gynaecological primary cancer diagnosed at or near the same. A further 62 patients have not been included as they were only referred to the MDT meeting for histopathology review or discussion.

Diagnosis of Malignancy by Site of Disease

Patients with a diagnosis of malignancy, excluding low-malignant-potential (LMP) tumours accounted for 57% of cases treated or managed. When including LMP tumours, it was 60%. This is a slight increase since 2016 where it was 53% and 57% respectively.

Primary Site of Malignancy No. Cases (%) 2016 No. Cases (%) 2017

Cervix 42 (16) 38 (15)

Uterus 124 (49) 114 (46)

Ovary / Fallopian Tube / Peritoneum 58 (23) 59 (24)

Vulva / Vagina 15 (6) 22 (9)

Gestational Trophoblastic Disease 3 (1) 4 (2)

Other (eg. primary GIT, metastatic breast, ACUP, recurrence etc.)

13 (5) 13 (5)

Total 255 250

Cervical malignancies

Stage of Disease No. Cases (%) 2016 No. Cases (%) 2017

I 21 (51) 21 (55)

II 10 (24) 11 (29)

III 5 (12) 4 (10)

IV 5 (12) 1 (3)

Un-staged 1 (2) 1 (3)

Uterine malignancies


I 83 (67) 78 (68)

II 10 (8) 5 (4)

III 16 (13) 11 (10)

IV 5 (4) 9 (8)

12

Un-staged 10 (8) 11 (10)

Of the 11 patients who were un-staged, 7 (64%) did not have staging surgery because of age, co-morbidities, or advanced disease. The other 4 patients were referred to the unit by general gynaecologists, having already had (non-staging) surgery performed. Ovarian, fallopian tube and primary peritoneal malignancies


I 15 (26) 15 (25)

II 10 (17) 7 (12)

III 27 (47) 15 (25)

IV 1 (2) 9 (15)

Un-staged 5 (9) 13 (22)

Non-cancer Diagnosis

Patients with a non-cancer diagnosis accounted for 42% of cases managed by the Department. When removing LMP tumours, this was 40% compared to 45% on 2016.

Site of Disease No. (%) Cases 2016 No. (%) Cases 2017

LMP tumours 22 (10) 14 (8)

High grade dysplasia, complex atypical hyperplasia, carcinoma in situ

33 (14) 39 (20)

Benign, suspicious masses, complex pelvic surgery or low grade dysplasia

135 (59) 96 (54)

Prophylactic 38 (17) 39 (18)

Total 228 188

13

MORBIDITY / MORTALITY REVIEW

GOSPICE Clinical Indicators

The Gynaecological Oncology Department presents its morbidity / mortality cases on a biennial basis at the Women’s Health and Newborn Care Divisional meetings which are held weekly. Up until the end of 2017 the Department has used the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Gynaecological Oncology Sub-speciality Practice Improvement Critical Event (GOSPICE) criteria, and these are reported for the 2017 Annual Report. For the 12-month period in 2017 there were a total of 44 events recorded for 31 patients.

Total Number Surgical Admissions 333 370 385

Critical Event No. Events 2015 No. Events - 2016 No. Events - 2017

Unplanned return to operating theatre 3 5 6

Death within 30 days of surgery 1 1 1

Post-operative fistula 1 1 0

Intra-operative haemorrhage requiring > 6 unit blood transfusion

0 0 0

Unplanned transfer to Intensive Care Unit 4 6 2

Post-operative stay > 21 days 2 2 3

Hospital acquired infection after 5th post-operative day/SSI

4 7 10

Post-operative pulmonary embolus 2 0 1

Anastomotic leak after bowel surgery 1 0 0

Any unplanned readmissions within 30 days# 21 (6.3%) 14 (3.7%) 12 (3.1%)

Other 9 8 9

Total No. Events (No. Patients) 48 (45 patients) 44 (26 patients) 44 (31 patients)

# includes unplanned readmissions to Westmead and any other hospital. ‘Other’ critical events included intra-operative organ / vessel / nerve / tissue injury (6), intra-op NSTEMI (1), slow return of bladder function (1) and premature labour with loss of foetus 1 week after surgery (1).

Important Key Surgical Performance Indicators

The percentage of patients having laparoscopic surgery for uterine malignancy was 70%. This has continued to increase dramatically over the last 2 years – up from 20% in 2015 and 39% in 2016. There were only 2 conversions from laparoscopy to open surgery.

The percentage of laparoscopic surgical procedures involving adnexa for benign conditions or for risk-reduction, which was performed as a day-only procedure, was 73%. This is up from 68% in 2015 but down from 81% in 2016. However, it should be noted that all laparoscopic risk-reducing procedures were done as day only cases.

14

The percentage of patients who had major surgery and had a post-operative length of stay > 7 days was 2% (6/268 patients – range 9-50 days). This is slightly better than previous years (4% in 2016 and 5% in 2015).

Data was not routinely collected (although is documented in Operation Reports) for patients having an intra-operative blood transfusion > 2 units.

Thirty six of the 59 patients (62%) with ovarian, fallopian tube or primary peritoneal cancers had advanced stage disease (Stage 3 or 4). One patient died before receiving any cancer-related treatment. Eleven patients (31%) received neo-adjuvant chemotherapy but were not considered to be suitable candidates for interval debulking surgery and so continued with chemotherapy alone. This is an increase from 18% in previous years. Almost 80% of patients who had debulking surgery were optimally debulked down to </= 1cm residual tumour. This remains similar to previous years; however, it is important to note that there was improvement in the number of patients left with no macroscopic residual disease (46% compared to around 35% in previous years).

No macro residual disease (11/24) 46%

</= 1cm residual disease (8/24) 33%

> 1cm residual disease (5/24) 21%

Upfront surgery Interval debulk Upfront surgery Interval debulk Upfront surgery Interval debulk

6 (55%) 5 (45%) 4 (50%) 4 (50%) 4 (80%) 1 (20%)

Moving Forward - National Clinical Quality Benchmarking

It has been recognised for some time that the RANZCOG GOSPICE clinical indicators were somewhat out-dated and needed to be reviewed. The Department is one of 6 units nationally to be involved in a pilot study of the National Gynae-Oncology Registry (NGOR) which is a clinical quality registry established to monitor and improve the quality of care provided to women with gynaecological cancers. Data collection relating to ovarian, tubal and peritoneal (OTP) cancers commenced in January 2018. This is an important move forward and will enable meaningful national clinical quality benchmarking.

The pilot NGOR clinical quality indicators are:

% of patients with apparent early stage (I, II, IIIA) who are appropriately surgically staged

% of patients with newly-diagnosed OTP cancer who are presented at an MDT meeting during which a treatment plan was made

% of patients who receive a histological or cytological confirmation of an OTP cancer diagnosis prior to receiving neo-adjuvant chemotherapy

% of women with OTP cancer who receive platinum-based 1st line chemotherapy

% of patients with advanced (Stages IIB, IIIB, IIIC and IV) OTP cancers who undergo primary cytoreductive / debulking surgery who have optimal debulking to (i) no macroscopic residual cancer OR to (ii) < 1cm macroscopic residual cancer

% of patients with advanced (Stages IIB, IIIB, IIIC and IV) OTP cancers who undergo interval cytoreductive / debulking surgery who have optimal debulking to (i) no macroscopic residual cancer OR to (ii) < 1cm macroscopic residual cancer

% of major OTP operations with intra-operative complications (organ / vascular / nerve injury and blood loss requiring >/= 2-unit blood transfusion)

15

% of major OTP operations with any other adverse event (in general these include unplanned return to OT / ICU / CCU, death within 30 days of surgery, unplanned readmission within 30 days, wound dehiscence, anastomotic leak, abdominal / pelvic collection, prolonged ileus / small bowel obstruction, post-operative haemorrhage, delayed return of bladder function, infection requiring IV antibiotics, thromboembolism, development of lymphocyst)

% of women with newly diagnosed OTP cancer who receives a referral for genetic testing.

Additional data items to be collected include: primary tumour site, date of diagnosis, diagnostic method, date of 1st anti-tumour treatment, histopathology, tumour grade, FIGO stage, age, BMI, ECOG status, surgical complexity score, and significant co-morbidities

16

SOCIODEMOGRAPHIC CHARACTERISTICS OF OUR PATIENTS

Country of Birth

Just over half (58%) of all new patients were born in Australia, whilst 66% were born in either Australia or another English-speaking country (see *). Of the 250 patients born in Australia, 9 (4%) identified as being Aboriginal and/or Torres Strait Islander. This is similar to 2016.

Country of Birth

No. Patients

Country of Birth

No. Patients

Country of Birth

No. Patients

Afghanistan 4 Hungary 1 Sierra Leone 2

Aruba 1 India 17 Slovenia 1

Australia * 250 Indonesia 3 Somalia 1

Austria 1 Iran 4 South Africa * 2

Bangladesh 4 Iraq 4 Sri Lanka 4

Bosnia 2 Ireland * 2 Sudan 1

Canada* 1 Italy 4 Syria 2

China 9 Jordan 1 Tanzania 1

Croatia 1 Lebanon 7 Thailand 3

Cyprus 1 Malaysia 1 Tonga 1

Denmark 1 Malta 1 Turkey 4

Ecuador 1 Mauritius 1 U.S. of America * 2

England * 17 Nepal 2 Uruguay 1

Fiji 10 New Zealand * 11 Vietnam 3

France 1 Philippines 21 Wales 1

Germany 2 Poland 1 Yugoslavia 1

Greece 1 Portugal 1 Zimbabwe 2

Holland 1 Samoa 5 Not known 1

Hong Kong 1 Scotland * 1 430

Age Distribution

This is similar to 2016.

Age Range (years) No. Patients %

< 20 2 < 1

20 – 29 10 2

30 – 39 47 11

40 – 49 93 22

50 – 59 88 20

60 – 69 92 22

70 – 79 66 15

80 – 89 28 7

> 89 4 1

17

Body Mass Index (BMI)

BMI was unable to be calculated from the department files for 58 patients (14%). (Data was unavailable for 25% of patients in 2016). For the 86% of patients where BMI was calculated, 74% had a BMI higher than the normal range, and 48% were obese or morbidly obese, the highest BMI recorded being 90 (208kg). There has been a 3% shift across the weight ranges from overweight to obese to morbidly obese since the 2016 report.

BMI No. (%) % Overweight % Obese % Morbidly Obese

< 20 17 (5)

20-25 81 (22)

>25 – 30 96 (26) 74

>30 – 35 78 (21) 48

>35 – 40 45 (12) 27

>40 – 50 41 (11)

>50 – 60 9 (2)

>60 7 (2)

NB: Normal range 20-25 Overweight > 25-30 Obese > 30-35 Morbidly obese > 35

Referral Base

The majority of patients (73%) are referred to the Department from within Western Sydney Local Health District (LHD) or the adjacent Nepean Blue Mountains LHD. Rural and regional referrals account for almost 20% of all patients, with the majority of these being referred from Western NSW and Murrumbidgee LHDs. There has been a significant drop in referrals from Illawarra Shoalhaven LHD (previously (6%), but an increase in referrals from Murrumbidgee LHD (previously 2%).

Local Health District (LHD) No. Patients %

Western Sydney LHD 210 49

Nepean Blue Mountains LHD 106 25

South Western Sydney LHD 22 5

Northern Sydney LHD 5 1

Sydney LHD 3 <1

South Eastern Sydney LHD 2 <1

Illawarra Shoalhaven LHD 3 <1

Central Coast LHD 0 0

Western NSW LHD 40 9

Murrumbidgee LHD 22 5

Southern NSW LHD 8 2

Hunter New England LHD 4 <1

Mid North Coast LHD 3 0

Northern NSW LHD 0 0

Far West LHD 0 0

Interstate 2 <1

18

CLINICAL TRIALS AND STUDIES

The Department of Gynaecological Oncology conducts a numbers of clinical trials exploring

better treatment options for patients with a gynaecological cancer. The Department

participates in a number of phase II and III trials and maintains a balance of investigator

initiated trials and those sponsored by pharmaceutical companies. It has a strong

association with the Australia and New Zealand Gynaecological Oncology Group

(ANZGOG). ANZGOG is the peak clinical trials research group for gynaecological cancers in

Australia and New Zealand.

Additionally, the Department has a strong translational research and basic science research

group. Laboratory research is carried out in the Westmead Institute for Medical Research.

The Department is affiliated with the University of Sydney and is a member of the Sydney

West Translational Cancer Research Centre (SW-TCRC), striving to rapidly translate our

research findings into new tests and treatments that will eventually be of direct benefit to our

patients.

The Department’s participation in clinical trials and research studies involves specific

research into ovarian, fallopian tube and primary peritoneal cancers; cancer of the cervix,

uterus, vulva and vagina; as well as research into the overall impact and management of a

cancer diagnosis and involves patients, carers and clinicians.

Trials / Research Studies Open to Recruitment in 2017

Name Trial / Research Study / Audit

Local PI(s) Status No. patients recruited

Total / 2017

GynaeOnc Biobank Research Study

Prof Anna deFazio A/Prof Alison Brand Dr Robyn Sayer Prof Paul Harnett Dr Bo Gao

Open to recruitment

1,266 / 56

SUPER Solving Unknown Primary Cancer

Research Study

Prof Anna deFazio Open to recruitment

34 / 3

WHAM Impact of risk-reducing BSO on non-cancer outcomes in young high-risk women

Trial

A/Prof Judy Kirk

A/Prof Alison Brand

Open to

recruitment

25 / 6

Sentinel Node Audit Prospective audit of sentinel node biopsy for vulvar carcinoma in Australia and New Zealand

Audit A/Prof Alison Brand Open to recruitment

7/4

VESPA A phase 2 study of the use of vaginal oestriol to prevent vaginal stenosis in patients treated with pelvic radiotherapy for gynaecological, rectal and anal malignancies

Trial A/Prof Alison Brand Dr Viet Do

Open to recruitment

12 / 7

19

Determining sleep phenotypes in cancer cohorts: interactions with cancer biology and impacts on quality of life

Research study

A/Prof Kristina Kairaitis

Prof Anna deFazio

Open to recruitment

84/ 49

INOVATe To implement molecular testing as routine for ovarian cancer patients, not including borderline cases

Research study

Prof Anna deFazio A/Prof Alison Brand Dr Robyn Sayer Prof Paul Harnett

Open to recruitment

112 / 80

Millenium / Takeda A phase 2, randomized study of MLN0128 (a dual TORC1/2 inhibitor), MLN0128 + MLN1117 (a P13Kα inhibitor), weekly paclitaxel, or the combination of weekly paclitaxel and MLN0128 in women with advanced, recurrent or persistent endometrial cancer

Trial Dr Bo Gao Open to recruitment

2/2

MOCOG Long-term survival in ovarian cancer

Research study

Prof Anna deFazio Contacting patients

N/A

ECHO A phase 2 randomised, controlled trial evaluating an exercise intervention among women undergoing chemotherapy for ovarian cancer.

Portfolio trial A/Prof Alison Brand Open to recruitment

6/6

CTCs in Cancer Management Ovarian epithelial-mesenchymal transition circulating tumour cell study

Research study

Prof Paul Harnett Open to recruitment

1/1

POACH

Pre-clinical optimization of adoptive cellular therapy for HPV-associated high-grade lesions and malignancies

HPV Cancer Cohort

WT1 Ovary Cohort

Research study

Prof Paul Harnett Open to recruitment

18/3

11/11

Cantrixil NOVOGEN Phase I study of intra-peritoneal Cantrixil in patients with refractory or recurrent ovarian cancer, fallopian tube or primary peritoneal cancer

Trial Prof Paul Harnett Open to recruitment

1/1

STATEC

A randomized trial of non-selective versus selective therapy in high-risk stage I endometrial cancer

Portfolio trial A/Prof Alison Brand Dr Robyn Sayer

Open to recruitment

1/1

Detecting nutritional risk and malnutrition in ovarian and endometrial cancer

Research study

A/Prof Alison Brand Dr Amy Jamieson

Closed Dec 2017

125/125

Phase I/II PD1 inhibitor and IDO-1 inhibitor combination in solid tumours

Trial Dr Bo Gao Closed Dec 2017

6/6

REZOLVE A phase 2 study to evaluate the safety and potential palliative benefit of intra-peritoneal Bevucizumab in patients with symptomatic ascites due to advanced chemotherapy-resistant ovarian cancer

Trial Prof Paul Harnett Closed Dec 2017

0 / 0

20

Prevalence of psychological distress and unmet needs. Investigation of a possible link between unmet needs and the prevalence of psychological distress and affective disturbance in patients with gynaecological cancers at Westmead Hospital.

Research study

Suparna Karpe Kim Hobbs A/Prof Alison Brand Dr Cathy Mason

Closed Dec 2017

50/50

BGB Combo A phase 1b, open label, multiple-dose, dose-escalation and expansion study to investigate the safety, pharmacokinetics and anti-tumour activity of the anti-PD-1 monoclonal antibody BGB-A317 in combination with the PARP inhibitor BGB-290 in subjects with advanced solid tumours

Trial Dr Bo Gao Closed May 2017. Trial moved to Blacktown Hospital

7/2

VELIA Phase 3 placebo-controlled study of carboplatin / paclitaxel with or without concurrent and continuation maintenance Velaparib (PARP inhibitor) in newly diagnosed subjects with previously untreated Stages III or IV high grade serous epithelial ovarian, fallopian tube or primary peritoneal cancer

Trial Dr Bo Gao Closed May 2017

3/3

OUTBACK

Phase 3 trial of adjuvant chemotherapy following chemo-radiation as primary treatment for locally advanced cervix cancer compared to chemo-radiation alone

Portfiolio trial Dr Viet Do

A/Prof Alison Brand

Closed to recruitment June 2017

3/0

LACE Long-term follow up Laparoscopic approach to carcinoma of the endometrium – survival outcomes

Research study

A/Prof Alison Brand Data collection completed

N/A

Health literacy among adult patients of Allied Health at Westmead Hospital: an observational, survey-based study

Research study

Kim Hobbs (PI) Data collection completed

N/A

Social work interventions in cancer care: a national, multicentre QA study using clinical data mining methodology

Quality assurance study

Kim Hobbs (AI) Data collection completed

N/A

Towards systematic monitoring of the experiences of care of Aboriginal and Torres Strait Islander people with cancer: Phase One

Research study

Prof Paul Harnett Kim Hobbs

Data collection completed

N/A

Trials / Research Studies Closed With Patients Still in Long-term Follow-up

OPAL Improving outcomes from ovarian cancer: building the evidence to help women help them selves

Research study

A/Prof Alison Brand

38 patients in follow-up

N/A

AOCS I Australian Ovarian Cancer Study

Research study

Prof Anna deFazio A/Prof Alison Brand

7 patients in follow up

N/A

21

ARIEL 3 CO-338-014. A multi-centre, randomised, double-blind, placebo-controlled phase 3 study of rucaparib as switch maintenance following platinum-based chemotherapy in patients with platinum-sensitive, high-grade serous or endometrioid epithelial ovarian, primary peritoneal or fallopian tube cancer

Trial Prof Paul Harnett 7 patients in follow-up

N/A

MILO A multi-national, randomized, open-label phase 3 study of MEK162 versus physician’s choice of chemotherapy in patients with recurrent or persistent low-grade serous carcinomas of the ovary, fallopian tube or primary peritoneum

Trial Prof Paul Harnett Closed at interim analysis Apr 2016

2 patients in follow up

N/A

Meki 12 Phase 2 randomised, double-blind trial of combination of Pimasertib with SAR245409 or of Pimasertib with SAR245409 placebo in subjects with previously treated unresectable low grade ovarian cancer

Trial

Prof Paul Harnett 2 patients in follow-up

N/A

PORTEC 3 Randomised phase 3 trial comparing concurrent chemo-radiation and adjuvant chemotherapy with pelvic radiation alone in high-risk and advanced stage endometrial carcinoma

Trial A/Prof Alison Brand Prof Paul Harnett Dr Viet Do


N/A

ICON 8

An international phase 3 randomised trial of dose-fractionated 5hemotherapy compared to standard three-weekly chemotherapy following immediate primary surgery or as part of delayed primary surgery, for women with newly diagnosed epithelial ovarian, fallopian tube or primary peritoneal cancer

Trial A/Prof Alison Brand Prof Paul Harnett

Dr Bo Gao


N/A

22

GRANTS HELD

New Grants Awarded in 2017

Funding Source

Title

Investigators

Grant Period and

Amount

ResMed Foundation

Research Grant

Obstructive sleep apnoea in cancer cohorts: interactions with cancer biology

Kairaitis, K (PI) Amis T deFazio A Brand A Mann G Howle J Carlino M Wong E, Clarke C Elder E French J

2017 – 2019

$200,000

National Breast Cancer Foundation

National Infrastructure Grant

The Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab).

Fox, S Chenevix-Trench, G Lindeman, C deFazio, A Campbell, I Milne, R Kirk, J Spurdle, A Deb, S Tassell, M

2017 – 2021

$1,250,000

NHMRC Project Grant

APP1120431

The Ovarian Cancer Prognosis and Lifestyle (OPAL) Study: Long-term outcomes

Webb, P deFazio, A Obermair, A Smith, D Grant, P Beesley, V Nagle, C

2017 – 2021

$871,657

Cancer Institute NSW Translational Program Grant

Transforming protein quantitation technology to improve cancer diagnosis and treatment decisions

Reddel, R Robinson, P Balleine, R Bowling, F Dalla Pozza, L deFazio, A Harnett, P Mann, G Morton, R Spillane, A

2017 – 2021

$3,750,000

CINSW Early Career Fellowship

Clinical proteomics and personalised treatment of ovarian cancer

Maiken Espersen 2017 – 2019

$416,665

Astra Zeneca Pty Ltd Outcomes of Treatment for Women Diagnosed with High-Grade Serous Cancer (HGSC) – AOCS II

Bowtell, D, deFazio, A Webb, P Fereday, S Traficante, N Alsop, K Young, M-A

2016 – 2020

$1,772,000

Total $8,260,322

23

Previous Grants Awarded and Still Held in 2017

Funding Source

Title

Investigators

Grant Period and

Amount

Cancer Institute NSW Translational Research Centre Grant

15/TRC/1-01

Sydney West Translational Cancer Research Centre (SW-TCRC)

Harnett, P deFazio, A Shaw, T Balleine, R George, J Mann, G Flynn, P

2016 – 2021

$6,496,912

Cancer Institute NSW. NSW Cancer Biobanking Stakeholder Network Project

15 BIO 1-02

Towards “research-ready” integrated clinical data for NSW Cancer Biobanks through data linkage

Project Champion:

deFazio, A

2016

$67,000

Department of Defence. U.S Army Medical and Material Command. Congressionally Directed Medical Research Programs. Ovarian Cancer Research Program.

Outcomes Consortium Development Award

Multidisciplinary ovarian cancer outcomes group (MOCOG)

PI:

Malcolm Pike Sub-recipient PI: deFazio, A

2016 - 2019 $US3,929,384

$US305,229 $AU399,850

Australia and New Zealand Gynaecological Oncology Group (ANZGOG)

New Research Fund

Testing individual Interventions to optimise Peri-operative care in ovarian cancer Surgery (TIPSStudy)

Brand, A Lindemann, K

2017 – 2018

$50,000

Australian Society of Gynaecologic Oncologists (ASGO)

New Research Fund

Testing individual Interventions to optimise Peri-operative care in ovarian cancer Surgery (TIPSStudy)

Brand, A Lindemann, K

2017 – 2018

$12,500


New Research Fund

Production of Wilm’s tumour protein (WT1) T cells for adoptive cellular therapy of WT1

Harnett, P Gao, B Brand A

2017 – 2018

$50,000


New Research Fund

EXCISE study: excisional treatment comparison for in situ endocervical adenocarcinoma

Cohen, P Brand, A

2017 – 2018

$50,000

24

National Health and Medical Research Council (NHMRC)

Grant APP 1122290

STICs and STONes: a randomised, phase 11, double-blind, placebo-controlled trial of aspirin in chemo-prevention of ovarian cancer in women with BRCA1 and BRCA2 mutations

Phillips, K … Brand, A

2017 – 2021

$653,892


Grant APP 1120431

OPAL: the ovarian cancer prognosis and lifestyle study: Long-term outcomes

PI:

Webb, P

AI:

Brand A

2017 – 2021

$871,657

Cancer Council NSW

RG-15-23

Novel treatment targets in low-grade serous ovarian cancer

deFazio, A Bowtell, D Harnett, P Balleine, R Rizos, H

2015 – 2017

$358,715

Cancer Australia

APP1082604

RECUPERATE

Can REaltime molecular profiling in Carcinoma of Unknown Primary improvE tReAtment ouTcomEs?

Mileshkin, L Bowtell, D Schofield, P Karapetis, C deFazio, A Tattersall, M

2015 - 2017

$599,602

Cancer Institute NSW

14/TPG/1-15

INOVATe

Individualised ovarian cancer treatment through integration of genomic pathology into multidisciplinary care

CIs

deFazio, A Harnett, P Friedlander, M Balleine, R Bowtell, D Samimi, G Brand, A (replacing Wain, G) Hacker, N Marsh, D Beale, P

2015 - 2020

$3,746,690

Cancer Institute NSW

15/RIG/1-16

Next-generation cancer biobanking: Adding value to the SW-TCRC Gynaecological Oncology Biobank at Westmead

deFazio, A 2015 - 2018

$288,812

Cancer Australia ICON 9

A phase 3 randomised trial of cediranib and olaparib maintenance in patients with relapsed platinum sensitive ovarian cancer

Brand A, CI (B) Mileshkin, L Ledermann, J Rischin, D Beale, P Quinn, M Coward, J Viney, R Martyn, J

2016 – 2019

$600,000


Grant APP 1080706

STATEC

Selective Targeting of Adjuvant Therapy for Endometrial Cancer:

Brand A, CI (A)

2015-2019

$1,271,183

Total $15,516,183

25

GRAND TOTAL

$23,776,505

26

MULTIDISCIPLINARY TEAM PROFILE

Gynaecological Oncologists

A/Professor Alison Brand MD, MMEd, FRCS(C), FRANZCOG, CGO: Director

Professional Memberships

Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)



Australian Medical Association (AMA)

Clinical Oncology Society of Australia (COSA)

International Gynecologic Cancer Society (IGCS)

Royal College of Physicians and Surgeons of Canada (RCPSC)

Society of Obstetricians and Gynaecologists of Canada (SOGC)

Gynaecologic Oncologists of Canada (GOC)

Committee Appointments

Australia and New Zealand Gynaecological Oncology Group (ANZGOG) Chair, ANZGOG

Board Member, ANZGOG Member, Research Advisory Committee Member, Quality Assurance Committee Member, Trial Management Committee, PORTEC-3

ANZGOG representative, GCIG Board of Directors

RANZCOG FRANZCOG Written Revision Course Examiner, Certification in Gynaecological Oncology

Cancer Australia Working Group Member, Ovarian Cancer Position Statement(s) Working Group Member, Position statement on genetic testing in women diagnosed with ovarian cancer Workshop Participant, Shared follow-up care for women with low-risk endometrial cancer, 16 May 2017

Member Scientific Advisory Committee, Pathways to a cancer-free future

Clinical Oncology Society of Australia (COSA), Council Member

Senior Editor, International Journal of Gynaecological Cancer

Reviewer, Australian and New Zealand Journal of Obstetrics and Gynaecology

Gynaecological Oncology Biobank at Westmead, Management Committee Supervision, RANZCOG Trainee Research Projects in 2017

Jamieson A. Detecting nutritional risk and malnutrition in ovarian and endometrial cancer (Ongoing)

Chattergee U, Kaparubandara. Enhanced recovery after laparoscopic hysterectomy: A comparison of ERAS and conventional models of surgical care in a tertiary gynaecology unit (Ongoing)

Thangavel D. Patient satisfaction with fast track surgery in gynaecological oncology (Completed)

Thirunavukarasu A. Evaluation of extended VTE prophylaxis in gynaecological cancer patients (Completed)

27

Dr Robyn Sayer: BA, MD, FACOG, FRANZCOG, CGO





Fellow, American College of Obstetricians and Gynecologists (FACOG)

Clinical Fellow

Dr Amy Jamieson MBBS





Supervision

Registrars and Resident Medical Officers rotating through Gynaecological Oncology

Department as part of Women’s and Newborn Health and RANZCOG training

program

Nursing and Allied Health

Letitia Lancaster RN, BHSc (Nsng), Oncology Cert, FACN: Clinical Nurse Consultant



Australian College of Nursing (ACN)

International Society of Nurses in Cancer Care (ISNCC)

Cancer Nurses Society of Australia (CNSA)


NSW Agency for Clinical Innovation (ACI), Gynaecological Oncology Nurses Group (GONG)


International Society of Nurses in Cancer Care Member, Nominations and Award Committee Member, Membership Committee Co-editor, Australian Journal of Cancer Nursing

Member, Editorial Board, Cancer Forum Journal

Cancer Australia Working Group Member, Supporting women to live well with gynaecological cancer Working Group Member, Endometrial cancer shared follow-up care

Westmead Hospital Clinical Board Safe Use of Medicine Committee

Awards

Conferred membership of the Westmead Hospital Nursing and Midwifery Research Honour Society

28

Kim Hobbs BSocStuds (Hons), MSW: Specialist Clinical Social Worker



Oncology Social Work Australia (OSWA)

NSW Social Workers Oncology Group (SWOGO

Psycho-Oncology Co-operative Research Group (PoCoG)


Honorary Associate, Faculty of Health, University of Technology Sydney


Australian Association of Social Workers, National Research Committee OSWA representative COSA Council OSWA Executive Committee

Member, PoCoG Scientific Advisory Committee

Co-chair, Gynaecological Oncology Network Executive Committee - Agency for Clinical Inovation (ACI)

Social Work representative, Sydney West LHD Allied and Community Health Research Steering Committee

Cancer Australia Member, Gynaecological Cancer Advisory Group (GCAG)

Working Group Member, Supporting women to live well with gynaecological cancer

Steering Committee Member, Supportive care needs assessment tool for Indigenous people (SCNAT-IP)

Awards

2017 Crown Princess Mary Cancer Centre Travel Fellow

Suparna Karpe MA (Clin Psych), MPhil (Clin Psych): Clinical Psychologist


Australian Psychological Society (APS)

American Psycho-oncology Society

Psycho-Oncology Co-operative Research Group (PoCoG)

Association for Contextual Behavioral Science (ANZ-ACBS)

Agency for Clinical Inovation (ACI)

Australia and New Zealand Gynaecological Oncology Group (ANZGOG) Sydney West Translational Cancer Research Centre (SW-TCRC)

Supervision

Clinical Psychology registrars Clinical Masters students

Translational Research and Bio-banking

Prof Anna deFazio PhD: Chair - Sydney West Translational Cancer Research Centre

(SW-TCRC) and Honorary Professor, Western Sydney Local Health District


American Society for Clinical Oncology (ASCO)

American Association for Cancer Research (AACR)

Australian Society for Medical Research (ASMR)

29


Australasian Biospecimen Network Association (ABNA)

The Endocrine Society

Society for Gynecologic Investigation


Australian Gynaecological Cancer Foundation, Scientific Advisory Committee

Australian Ovarian Cancer Study (AOCS)

Management Committee

Access Committees

Cancer Council NSW, Research Committee – Chair (to June 2017)

Cancer Institute NSW, Biospecimen Stakeholder Network

CellBank Australia, Scientific Advisory Committee

kConFab (Kathleen Cuningham Consortium into Familial Breast Cancer)

Chair, Biospecimen Committee

Executive Committee

National Health and Medical Research Council Assigners Academy, Project Grants

University of Sydney, Cancer SPARC Steering Committee

National Breast Cancer Foundation, Investigator Initiated Research Scheme Review Committee

Westmead Institute for Medical Research (WIMR) Faculty

Sydney-West Translational Cancer Research Centre, Executive Committee

Gynaecological Oncology Biobank at Westmead

Management and Access Committees

Research Supervision

Dr Cristina Mapagu, PhD Candidature, Molecular and genetic features underlying

treatment response in recurrent ovarian cancer

Dr Tania Moujaber. PhD Candidature, Molecular pathways in low-grade serous

ovarian cancer

Dr Joseph Po, PhD Candidature, Biology of circulating tumour cells in patients with

advanced ovarian cancer: Does epithelial to mesenchymal transition (EMT) contribute

to chemoresistance?

Meng Hwei (Erainia) Wu, MD Project. Carcinosarcoma of the ovary: clinical

epidemiology, genomics and new treatment targets.

Catherine Kennedy BSc (Hons), Dip Ed: Gynae-Biobank and Research Manager


Australasian Biospecimen Network Association (ABNA)

International Society for Biological and Environmental Repositories (ISBER)



Australasian Biospecimen Network Association (ABNA) President, ABNA Conference Organising Committee

International Society for Biological and Environmental Repositories (ISBER) Scientific Program Committee International Tissue Repository Locator Working Group

30

Gynae Oncology Biobank at Westmead Management and Access Committees

Proteome of Human Cancer (ProCan) Sample Source Review Committee - Children’s Medical Research Institute (CMRI)

31

PUBLICATIONS

Jung MS, Russell AJ, deFazio A, … Henderson MJ. An 18-gene Myc activity signature predicts

poor clinical outcome in multiple Myc-associated cancer types. Cancer Res, 2017 Feb

15;77(4):971-981

Janda M, Gebski V, Davies L, Brand A … Obermair A. Effect of total laparoscopic hysterectomy vs total abdominal hysterectomy on disease-free survival among women with stage I endometrial cancer: A randomised clinical trial. JAMA, 2017 Mar 28;317(12):1224-1233

Phelan CM, Kuchenbaecker KB, Tyrer JP… Australian Ovarian Cancer Study Group … Chiew Y-E … deFazio A … Kennedy CJ, Pharoah PDP. Identification of 12 new susceptibility loci for different histotypes of epithelial ovarian cancer. Nat Genet, 2017 March; 49: 680-91

McGee J, Bookman M, Harter P … Brand A …Ochiai K. 5th Ovarian Cancer Consensus Conference: Individualised therapy and patient factors. Annals Oncology, 2017 Apr 1;28(4):702-710

Dixon SC, Nagle CM, Wentzensen N … deFazio A, Australian Ovarian Cancer Study Group

… Webb PM. Use of common analgesic medications and ovarian cancer survival: Results from

a pooled analysis in the Ovarian Cancer Association Consortium. Br J Cancer, 2017 Apr

25;116(9):1223-1228

Morris L*, Do V, Chard J, Brand AH. Radiation-induced vaginal stenosis: Current perspectives. Int J Womens Health, 2017 May;9:273-279 [* Advanced Trainee, Radiation Oncology, CPMCC]

Babic A, Cramer DW, Kelemen … deFazio A … Terry KL. Predictors of pre-treatment CA125

at ovarian cancer diagnosis: A pooled analysis in the Ovarian Cancer Association Consortium.

Cancer Causes Control, 2017 May;28(5):459-468

Minlikeeva AN, Freudenheim JL, Cannioto … de Fazio A, Australian Ovarian Cancer Study

Group … Moysich KB, Ovarian Cancer Association Consortium. History of hypertension, heart

disease, and diabetes and ovarian cancer patient survival: Evidence from the Australian

Ovarian Cancer Study Group. Cancer Causes Control, 2017 May;28(5):469-486

Praestegaard C, Jensen A, Jensen SM … deFazio A, Australian Ovarian Cancer Study Group

… Kjaer SK, Ovarian Cancer Association Consortium. Cigarette smoking is associated with

adverse survival among women with ovarian cancer: Results from a pooled analysis of 19

studies. Int J Cancer, 2017 Jun 1;140(11):2422-2435

Bonaventura A, O'Connell RL, Mapagu C … deFazio A, Scurry J, Friedlander ML. Paragon

(ANZGOG-0903): Phase 2 study of Anastrozole in women with estrogen or progesterone

receptor-positive platinum-resistant or -refractory recurrent ovarian cancer. Int J Gynecol

Cancer, 2017 June;(27): 900-6

Glubb DM, Johnatty SE, Quinn MCJ … Gao B … Australian Ovarian Cancer Study Group,

deFazio A, Kennedy CJ … Chenevix-Trench G. Analyses of germline variants associated

with ovarian cancer survival identify functional candidates at the 1q22 and 19p12 outcome loci.

Oncotarget, 2017 Jun 15;8(39):64670-64684

32

Lindemann K*, Kok PS, Stockler M, Sykes P, Brand A. Enhanced recovery after surgery for suspected ovarian malignancy: A survey of peri-opertive practice in Australia and New Zealand to inform a clinical trial. Int J Gynecol Cance,r 2017 Jun;27(5):1046-1050 [* Visiting international medical graduate 2016]

Lindemann K*, Kok PS, Stockler M, Jaaback K, Brand A. Enhanced recovery after surgery for advanced ovarian cancer: A systematic review of interventions trialled. Int J Gynecol Cancer 2017 Jul;27(6):1274-1282 [* Visiting international medical graduate 2016]

Etemadmoghadam D, Azar WJ, Lei Y, Moujaber T, Garsed DW, Kennedy CJ … Chiew YE

… Australian Ovarian Cancer Study Group, Sharma R, Harnett PR … deFazio A. EIF1AX

and NRAS mutations co-occur and cooperate in low-grade serous ovarian carcinomas. Cancer

Res, 2017 Aug 15;77(16):4268-4278

Jamieson A, Sykes P, Eva L, Bergzoll C, Simcock B. Sub-types of stage IV ovarian cancer: Response to treatment and patterns of disease recurrence. Gynecol Oncol, 2017 Aug;146(2):273-278

Cohen PA, Brand A, Sykes P … Stoyles P. Excisional treatment in women with cervical adenocarcinoma in situ (AIS): A prospective randomised controlled non-inferiority trial to compare AIS persistence / recurrence after loop electrosurgical excision procedure with cold knife cone biopsy: protocol for a pilot study. BMJ Open, 2017 Aug;28:7(8)

Minlikeeva AN, Freudenheim JL, Cannioto RA … deFazio A … Moysich KB. History of thyroid

disease and survival of ovarian cancer patients: Results from the Ovarian Cancer Association

Consortium: A brief report. Br J Cancer, 2017 Sep 26;117(7):1063-1069

Minlikeeva AN, Freudenheim JL, Eng KH … deFazio A … Ovarian Cancer Association

Consortium, Australian Ovarian Cancer Study Group. History of comorbidities and survival of

ovarian cancer patients: Results from the Ovarian Cancer Association Consortium. Cancer

Epidemiol Biomarkers Prev, 2017 Sep;26(9):1470-1473

Robinson T, Janssen A, Kirk J, deFazio A, Goodwin A, Tucker K, Shaw T. New approaches to continuing medical education: A QStream (spaced education) program for research translation in ovarian cancer. J Cancer Educ, 2017 Sept;(3): 476–482

Ovarian Tumor Tissue Analysis Consortium, Goode EL, Block MS, Kalli KR … Gao B, Kennedy CJ … Harnett PR … deFazio A… Ramus SJ. Dose-response association of CD8+ tumor-infiltrating lymphocytes and survival time in high-grade serous ovarian cancer. JAMA Oncol, 2017: e173290; (published online Oct 12, 2017)

Johnatty SE, Tan Y, Buchanan DD … Brand A. … Kirk JA … Spurdle AB. A family history of cancer predicts endometrial cancer risk independently of Lynch Syndrome: implications for

genetic counselling. Gynecologic Oncology 2017 Nov;147(2):381-387

Brand AH, DiSilvestro PA, Sehouli J, Berek JS. Cytoreductive surgery for ovarian cancer: Quality assessment. Annals of Oncology, 2017 Nov 1;28(suppl_8):viii25-viii29

Henry CE, Emmanuel C, Lambie N, Loo C, Kan B, Kennedy CJ, de Fazio A, Hacker NF, Ford CE. Distinct patterns of stromal and tumor expression of ROR1 and ROR2 in histological subtypes of epithelial ovarian cancer. Transl Oncol, 2017 Dec 22;10:346-56

33

Garsed DW, Alsop K, Fereday S, Emmanuel C, Kennedy C, Etemadmoghadam D, Gao B, … Chiew YE … Sharma R … Brand A … Harnett P … deFazio A. Homologous recombination DNA repair pathway disruption and retinoblastoma protein loss are associated with exceptional survival in high-grade serous ovarian cancer. Clin Cancer Res, 2017 (In Press)

Block M, Vierkant R, Rambau P … Kennedy C … Harnett P … Australian Ovarian Cancer Study Group … deFazio A … Goode EL. Expression of MyD88 and TLR4 in epithelial ovarian cancer. Mayo Clin Proc, 2017 (In press)

Book Chapters

Brand A, Hammond I, Mountford J, Roeske L. Screening in pregnancy. Cancer Council

Australia Cervical Cancer Screening Guidelines Working Party. National Cervical Screening

Program: Guidelines for the management of screen-detected abnormalities, screening in

specific populations and investigations into abnormal vaginal bleeding. Sydney: Cancer

Council Australia. [Version URL:

https://wiki.cancer.org.au/australiawiki/index.php?oldid=174048, cited 2017 Dec 6]. Available

from https://wiki.cancer.org.au/australia.Guidelines:Cervical_cancer.Screening

Brand A, Hammond I, Mountford J, Whop L. National Cervical Screening Program.

Screening in Aboriginal and Torres Strait Islander women. Ibid

Brand A, Hammons I, Pather S, Roeske L, Wrede. National Cervical Screening Program

Screening in immune deficient women. Ibid

Wrede D, Brand A, Hammons I. National Cervical Screening Program. Colposcopy. Ibid

Bateson D, Brand A, Hammond I, Mountford J, Whop L. National Cervical Screening

Program. Investigation of abnormal bleeding. Ibid

Armstrong B, Brand A, Hammond I, Wright G. National Cervical Screening Program.

Screening in DES women. Ibid

Bateson D, Brand A, Hammond I, Mountford J, Saville M. National Cervical Screening

Program. Screening after hysterectomy. Ibid

Armstrong B, Brand A, Canfel K, Hammond I, Saville M. National Cervical Screening

Program. Management of oncogenic HPV types. Ibid

https://wiki.cancer.org.au/australiawiki/index.php?oldid=174048

https://wiki.cancer.org.au/australia.Guidelines:Cervical_cancer.Screening

34

CONFERENCES

Invited Speaker / Panelist

Kim Hobbs. Psychological and psychosexual issues in endometrial cancer. Nurses Workshop, Australia and New Zealand Gynaecological Oncology Group (ANZGOG) Annual Scientific Meeting. Melbourne, 29 March – 1 April 2017 (Invited Speaker)

Kim Hobbs. Improving quality of life. Australia and New Zealand Gynaecological Oncology Group (ANZGOG) Annual Scientific Meeting. Melbourne, 29 March – 1 April 2017 (Panel Member)

Anna deFazio. Translational-ANZGOG: Enabling translational research for ANZGOG clinical

trials. Australia and New Zealand Gynaecological Oncology Group (ANZGOG) Annual

Scientific Meeting. Melbourne, 29 March – 1 April 2017 (Invited Speaker)

Kim Hobbs. Anger after cancer. Cancer Council NSW. Sydney, April 2017 (Webinar Panel Member)

Catherine Kennedy. International Society for Biological and Environmental Repositories, Annual Conference (ISBER), Toronto, 9-12 May 2017 (Session Chair)

Anna deFazio. Ovarian Cancer: Basic research embedded in multi-disciplinary cancer care. Cancer Implementation Science Community of Practice and Sydney Vital TCRC Workshop. Kolling Institute, RNS Hospital, Sydney, 17 May 2017 (Invited Speaker)

Kim Hobbs. Assessment of health literacy in a Western Sydney out-patient population. 12th

National Allied Health Conference, Sydney, 26-29 August 2017 (Invited Speaker)

Anna deFazio. Opening address. St Vincent’s Campus 25th Anniversary Research

Symposium. Garvan Institute, Darlinghurst, 14 – 15 September 2017 (Invited Speaker)

Kim Hobbs. Oncology social work down under. Aarhus University Hospital Denmark, September 2017 (Invited Speaker)

Anna deFazio. INOVATe: a step closer towards individualised treatment for women with

ovarian cancer. Australasian Biospecimen Network Association (ABNA), 15th Annual

Meeting, Brisbane, 12th - 13th October 2017 (Invited Speaker)

Catherine Kennedy. Australasian Biospecimen Network Association (ABNA), 15th Annual Meeting, Brisbane, 12-13th October 2017 (Session Chair)

Anna deFazio. Using genomics to understand treatment response and resistance in women

with ovarian cancer. 13th Indo-Australian Biotechnology Conference, ‘Omics in Health’.

Brisbane, 30-31 October 2017 (Invited Speaker)

Alison Brand. Familial aspects of gynaecological cancer and risk reduction surgery. FRANZCOG Written Revision Course. Sydney, October 2017 (Invited Speaker)

Alison Brand. Quality sssurance overview, Gynaecological Cancer Intergroup (GCIG) QA Brainstorming forum. Vienna Austria, 2-3 November 2017 (Panel Member)

35

Alison Brand. Complex patient multidisciplinary teams. NSW Agency for Clinical Innovation (ACI) Stakeholder Forum: Integrated surgical care for older people. Sydney, November 2017 (Invited Speaker)

Letitia Lancaster. Social determinants of treatment adherence. 44th Annual Scientific Meeting, Clinical Oncology Society of Australia (COSA). Sydney, 13 – 15 November 2017 (Invited Speaker)

Kim Hobbs. The effects of financial toxicity on treatment compliance. 44th Annual Scientific Meeting, Clinical Oncology Society of Australia (COSA). Sydney, 13 – 15 November 2017 (Invited Speaker)

Kim Hobbs. Carers: The silent partners in the cancer treatment experience. 44th Annual Scientific Meeting, Clinical Oncology Society of Australia (COSA). Sydney, 13 – 15 November 2017 (Invited Speaker)

Kim Hobbs. Danish enlightment: Comparisons and contrasts. 6th Annual Crown Princess Mary Cancer Centre Symposium. Sydney, 24 November 2017 (Invited Speaker)

Anna deFazio. Ovarian cancer genomics: Preparing for prime-time. 6th Annual Crown

Princess Mary Cancer Centre Symposium. Sydney, 24 November 2017 (Invited Speaker)

Organising / Chairing Conference Sessions

Alison Brand. Australia and New Zealand Gynaecologic Oncology Group (ANZGOG) Annual Scientific Meeting, Melbourne, April 2017 (Session Chair)

Alison Brand. Australia and New Zeland Gynaecologic Oncology Group (ANZGOG) Annual Scientific Meeting, Melbourne, April 2017 (Organiser)

Catherine Kennedy. International Society for Biological and Environmental Repositories (ISBER) Annual Conference, Toronto, 9-12 May 2017 (Session Chair)

Alison Brand. Australian Society of Gynaecological Oncologists (ASGO) Annual Scientific Meeting, Broome WA, May 2017 (Session Chair)

Anna deFazio. Hospital Week Research Symposium, Westmead Sydney, August 2017

(Convenor)

Catherine Kennedy. Australasian Biospecimen Network Association (ABNA) Annual

Conference, Brisbane, 12-13 Oct 2017 (Session Chair)

Alison Brand. Co-chair, Gynaecological Cancer Intergroup (GCIG) QA Brainstorming Meeting, Vienna, Austria, November 2017 (Co-chair)

Anna deFazio. 6th Annual Crown Princess Mary Cancer Centre Symposium, Sydney, 24

November 2017 (Organising Committee)

36

Oral Presentations / Posters

Mapagu C, Fereday S, Australian Ovarian Cancer Study Group, Bowtell D, Harnett P, deFazio A. Identifying predictive markers of endocrine response in high-grade serous ovarian cancer using RNA sequencing. American Association for Cancer Research (AACR) Annual Conference, Washington DC, 1-5 April 2017 (Poster)

Meagher N, Budden T, Millstein J, Koebel M, Doherty J, Cohen P, Gorringe K, deFazio A, Friedlander M, Ramus S. Mucinous ovarian cancer: a strange and separate beast? Australia and New Zealand Gynaecological Oncology Group (ANZGOG) Annual Scientific Meeting. Melbourne 29 March - 1 April 2017 (Poster)

Jamieson A, Sykes P, Eva L, Bergzoll C, Simcock B. Sub-types of stage IV ovarian cancer: response to treatment and patterns of disease recurrence – the New Zealand experience. Australian Society of Gynaecological Oncologists (ASGO) Annual Scientific meeting. Broome WA, 3-7 May 2017 (Oral Presentation)

Mapagu C, Fereday S, Australian Ovarian Cancer Study Group, Bowtell D, Harnett P, deFazio A. Identifying predictive markers of endocrine response in high-grade serous ovarian cancer using RNA sequencing. Australian Society for Medical Research (ASMR), NSW State Meeting. Sydney, 2 June 2017 (Poster)

Provan P, Harnett P, Friedlander M, Balleine R, Bowtell D, Samimi G, Brand A, Hacker N, Marsh D, Beale P, Bergzoll C, Boros J, Chiew Y-E, Gao B, Jamieson A, Kan C, Kennedy C, Lei Y, Mapagu C, Mirochnik O, Nevins N, Pianova S, Sayer R, Sharma R, Stenlake A, Srirangan D, Baron-Hay S, Diakos C, Gard G, Hogg R, Maidens J, Nevell D, Phillips K, Pillai U, Valmadre S, Ashrafy A, Shannon J, Stevanovic A, deFazio A, for the INOVATe Investigators. INOVATe - Individualised Ovarian Cancer Treatment through Integration of Genomic Pathology into Multidisciplinary Care. Westmead Hospital Research Symposium. Sydney, 16-18 August, 2017 (Poster)

deFazio A, Harnett H, Friedlander M, Balleine R, Bowtell D, Samimi G, Brand A, Hacker N, Marsh D, Beale P, on behalf of the INOVATe investigators. Individualised Ovarian Cancer Treatment through Integration of Genomic Pathology into Multidisciplinary Care - An Analysis of the First Year of Recruitment to the INOVATe Study. Cancer Institute NSW - Innovations in Cancer Treatment and Care Conference. Sydney, 14 September 2017 (Poster)

Provan P, Harnett P, Friedlander M, Balleine R, Bowtell D, Samimi G, Brand A, Hacker N, Marsh D, Beale P, Bergzoll C, Boros J, Chiew Y-E, Gao B, Jamieson A, Kan C, Kennedy C, Kirk J, Lei Y, Mapagu C, Mirochnik O, Moujaber T, Nevins N, Pattnaik S, Pianova S, Sayer R, Sharma R, Stenlake A, Srirangan D, Tan K, Baron-Hay S, Diakos C, Gard G, Hogg R, Maidens J, Nevell D, Phillips K, Pillai U, Valmadre S, Ashrafy A, Shannon J, Stevanovic A, Farrell R, Newton E, Norris C, Rao A, Robertson G, Webber K, deFazio A, for the INOVATe Investigators. Biobanking to Support Translational Research and Precision Medicine: The INOVATe Study. Bridging the gap - from the clinic to the biobank. Australasian Biospecimen Network Association (ABNA) Annual Conference. Brisbane, 12-13 October 2017 (Poster)

Meagher N, deFazio A, Russell K, Voss A, Ramus S, Friedlander M. Mucinous ovarian cancers of uncertain primary (MO-CUP) - does the site of origin really matter? 44th Annual Scientific Meeting Clinical Oncological Society of Australia (COSA). Sydney, 13 – 15 November 2017 (Oral Presentation)

37

Meagher N, Marsh D, Goode S, Spring K, deFazio A, Pimanda J. Enabling near real-time clinical data capture for biobanks using electronic medical records. Flipping the record: Using Clinical Data to Transform Cancer Care, Translational Cancer Research Network (TCNR) Conference. Sydney, 21 July 2017 (Rapid Fire Oral)

Moujaber T. Molecular pathways in low-grade serous ovarian cancer. Post Graduate Seminar Finals, Westmead Hospital, Nov 2017. (Oral Presentation – Awarded Best Presentation & Winner of the Jerry Koutts Young Investigator of the Year)

Espersen M, Mahboob S, Care N, Tempe V, Tully B, Patrick E, Harnett P, Robinson P, Balleine R, deFazio A. Sampling for proteomic analysis in ovarian cancer. 6th Annual Crown Princess Mary Cancer Centre Symposium. Sydney, 24 November 2017, Sydney (Poster)

Kan C, Harnett P, Friedlander M, Balleine R, Bowtell D, Samimi G, Brand A, Hacker N, Marsh D, Beale P, Bergzoll C, Boros J, Chiew Y-E, Gao B, Jamieson A, Kennedy C, Kirk J, Lei Y, Mapagu C, Mirochnik O, Moujaber T, Nevins N, Pattnaik S, Pianova S, Provan P, Sayer R, Sharma R, Stenlake A, Srirangan D, Tan K, Baron-Hay S, Diakos C, Gard G, Hogg R, Maidens J, Nevell D, Phillips K, Pillai U, Valmadre S, Ashrafy A, Shannon J, Stevanovic A, Farrell R, Newton E, Norris C, Rao A, Robertson G, Webber, deFazio A, for the INOVATe Investigators. INOVATe – Individualised Ovarian Cancer Treatment through Integration of Genomic Pathology into Multidisciplinary Care. 6th Annual Crown Princess Mary Cancer Centre Symposium. Sydney, 24 November 2017 (Poster)

Moujaber T, Etemadmoghadam D, Kennedy C, Chiew Y-E, Balleine R, Saunders C, Wain G, Gao B, Hogg R, Srirangan D, Kan C, Fereday S, Nadia Traficante for the Australian Ovarian Cancer Study, Bowtell D, Harnett P, DeFazio A. BRAF mutations in low-grade serous ovarian cancer and response to BRAF inhibition. 6th Annual Crown Princess Mary Cancer Centre Symposium. Sydney, 24 November 2017 (Poster – Winner of Poster Prize & People’s Choice Award)

38

CONSUMER AND COMMUNITY ENGAGEMENT

Gynaecological Cancer Support Group

Support groups are held monthly and are convened by Kim Hobbs (Specialist Clinical Social Worker) and Suparna Karpe (Clinical Psychologist). These are free and open to all patients who have been diagnosed with a gynaecological cancer, regardless of where they are receiving care.

Guest speakers are invited to the meeting and topics cover a wide range of issues from cancer research updates, cancer genetics, coping with cancer, natural therapies, access to community services, and entitlements to statutory benefits. Following the presentations by guest speakers, there is an opportunity to ask questions and meet others over morning or afternoon tea. This also provides an opportunity for the sharing of support and experiences.

Narelle Holden, Westmead Hospital’s Aboriginal Liaison Officer (ALO) also runs a Support Group for Indigenous patients with a cancer diagnosis.

Mindefulness-based Stress Management Programs

Suparna Karpe (Clinical Psychologist) helped to run 3 mindfulness-based courses over the year with the aim of providing patients and carers an opportunity to explore and experience a variety of mindfulness-based techniques, and to discover new ways to cope with stress and illness. Each course runs for a 90-minute session over 4 consecutive weeks, with an average of 10 participants per program.

Consumer and Media Forums

Alison Brand. Interview with Jill Emberson and Liz Cotter. Cancer down under. ABC Radio Newcastle, 4 May 2017

Anna deFazio. Gynaecological Cancer Research. Gynaecological Cancer Patient Support

Group. Westmead Hospital, 20 October 2017

Consumer and Community Representation on Research Committees

Again, we are very grateful for the time and effort the following people have afforded, not only to our local Westmead gynaecological oncology research unit, but also to our larger peak gynaecological oncology research body, Australia and New Zealand Gynaecological Oncology Group (ANZGOG). Westmead Translational Research and Bio-banking

Alison Harris

Sapna Lazarus Australia and New Zealand Gynaecological Oncology Group (ANZGOG)

Cheryl Waller

Rhonda Beach

Both are members of the Consumer and Community Committee (CCC) and the Research Advisory Committee (RAC)

39

Fundraising for Research

February is Ovarian Cancer Awareness Month and for the past 9 years the Department has hosted fundraising events in support of Ovarian Cancer Research at Westmead and for our patients through the Gynaecological Cancer Support Group and Ovarian Cancer Australia. In 2017 we raised a total of $7,500 from the ‘Morning Teal’ (teal represents the ribbon colour for gynaecological cancer) event held at the Westmead Institute for Medical Research (WIMR), as well as from generous donations from patients and a cake sale at the NSW Forensic Analytical Science Service at Lidcombe. We are most grateful to Burwood Chemist Warehouse, the Westmead Hospital Florist and the girls from Burwood Mecca for their continued sponsorship of this event through their donation of raffle prizes. And a big thank you, also, to some of our very talented and ‘crafty’ staff members for their hand-made items for raffle prizes … and to ALL the team for providing such an amazing selection of food for all to enjoy! We hope that, by raising the profile of gynaecological cancers through fundraising, we can let our patients know that we are working for and with them in the laboratory, in the clinical setting, and in the community.

40

Morning Teal is served!

41

Department of Gynaecological Oncology Westmead Hospital

(Cnr Hawkesbury & Darcy Roads, Westmead) PO Box 533

Wentworthville NSW 2145 AUSTRALIA

Phone: +61 2 8890 6801 Fax: +61 2 8890 8311

http://www.wslhd.health.nsw.gov.au/WNH/Clinics---services/Gynaecological-cancer

Documents

ANNUAL REPORT 2017 Department of Gynaecological Oncology