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Study to help more NZ cancer patients access clinical trials remotely

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Dr Michelle Wilson (left) and Dr Nicky Lawrence

Dr Michelle Wilson (left) and Dr Nicky Lawrence.

A newly funded study led by oncologists at Auckland City Hospital will test a novel model for running clinical trials, with the aim of helping New Zealand cancer patients access trials no matter where they live.

The Health Research Council of New Zealand (HRC) announced funding for this study today as part of its 2024 Project and Programme funding rounds, awarding 26 grants* worth a combined total of $50.34 million.

These grants are designed to support excellent research ideas with strong potential for impact, innovation and improving health outcomes. They sit alongside the HRC’s other investments, which include support for research that directly informs healthcare policies, and funding to develop critical health research skills and expertise in New Zealand. 

Auckland City Hospital and University of Auckland oncologists Dr Michelle Wilson and Dr Nicola Lawrence are co-leading this study to increase patients’ access to cancer clinical trials throughout New Zealand with a highly experienced team of medical oncologists and researchers. The team will use an ongoing clinical trial (Cancer Molecular Screening and Therapeutics or MoST) at Auckland City Hospital that offers genomic (DNA) testing for patients with rare cancers as the basis for the study. 

Even though these cancers have been classified as rare, collectively, Dr Wilson says they make up a significant – and increasing – burden of disease across the country. Using a decentralised clinical trial model, the team will expand the trial to include patients in Northland and Canterbury to ensure the model works for both small and large sites covering large population areas with wide geographical spread.

“Clinical trials traditionally involve patients and their whānau having to attend hospitals in-person with trial staff. This can be a significant social, financial and time barrier for those who live outside of major regional cancer centres – which is more than 35 percent of New Zealand’s population – with many patients having to leave their family and support network, take time off work, and pay to travel to the trial site,” says Dr Wilson.

International guidelines recommend that participation in clinical trials is considered part of standard management as it can be the best treatment option for many cancer patients. However, despite this, very few patients have access to clinical trials in New Zealand, with smaller hospitals and rural areas having almost no patients enrolled on clinical trials.

“Everything we do in oncology has come from previous clinical trial results. For some people, clinical trials can give them access to medicines they wouldn’t otherwise be able to afford or have access to. For others, it may provide different treatment options with better tolerability but same efficacy. Clinical trials do not guarantee benefit, but they help us find the best options to enable people to live longer and better,” says Dr Wilson.

The decentralised clinical trial model the research team are testing will take the trial to the patient, with trial activities performed at patients’ homes and/or at local healthcare facilities with the oncology team they are familiar with. The primary trial site – in this case, Auckland City Hospital – will work collaboratively with the smaller ‘satellite’ sites in Northland and Canterbury to enrol, consent and treat patients for the trial. Remote monitoring and data collection via telehealth and testing using local laboratories will reduce logistical difficulties in accessing the trial location. 

This model has been successfully used across Australia, Canada and the UK to increase access to clinical trials at rural and remote sites.

“One of the challenges with the majority of cancer clinical trials is that they only recruit one or two patients from different sites. Thanks to this funding, we’ll be able to recruit 150 participants to the MoST clinical trial from Northland and Canterbury over three years without them having to travel to Auckland. This will help us enormously to work out how we can make this model work best for patients nationally.”

“Ultimately, our goal is to reduce the burden for cancer patients and their whānau, increase enrolment and retention in clinical trials, particularly for those currently underrepresented, and to preserve quality of life,” says Dr Wilson.

HRC Chief Executive Professor Sunny Collings says increasing New Zealanders access to cancer clinical trials is a potential win-win for both patients and clinicians.

“If the decentralised clinical model developed through this study proves successful, the pathways and processes developed could be applicable to any area of medicine. 

“Another potential advantage of this model is the opportunity it gives clinicians in smaller centres, who don’t have access to research infrastructure, to engage in research and create networks across New Zealand,” says Professor Collings. 

See below for the list* of 2024 Project and Programme grant recipients. 

*Please note that some of the Project and Programme grants awarded have not been included in the list below as the funding contracts are still being finalised.

Recipients of the HRC’s 2024 Programme Grants

Professor Dr Sue Crengle, University of Otago
Te Oranga Pūkahukahu: Future directions for lung cancer screening in Aotearoa
54 months, $4,999,898

Dr Colin McArthur, Medical Research Institute of New Zealand
REMAP-CAP: Improving treatment for pneumonia, influenza and pandemic infections
60 months, $4,998,510

Professor El-Shadan Tautolo, Auckland University of Technology
Lifecourse Trajectories for Young Pasifika in Aotearoa (PIF: ATP)
60 months, $4,994,413

Recipients of the HRC’s 2024 Project Grants

Dr Timothy Angeli-Gordon, the University of Auckland
Minimally invasive gastric ablation for GI disorders
36 months, $1,199,996

Dr Jerram Bateman, University of Otago
Returning to productive life and work: an investigation of the impacts of cancer
36 months, $1,193,292

Dr Rosemary Brown, University of Otago
Protecting Mum: hormone-driven neural plasticity to regulate mood and behaviour
36 months, $1,199,922

Dr Laird Cameron, the University of Auckland
Optimising immunotherapy for Māori with advanced non-small cell lung cancer
36 months, $1,199,987

Dr Thomas Hills, Medical Research Institute of New Zealand and Dr Simon Young, Te Whatu Ora - Waitematā
RandOmised Arthroplasty infection worlDwide Multidomain Adaptive Platform Trial
60 months, $1,438,097

Dr Megan Leask, University of Otago
Translational 'omics of the hidden genome for equitable precision medicine
36 months, $1,199,988

Dr Rebbecca Lilley, University of Otago
From health crisis to balance: Evaluation of a national falls prevention pathway
36 months, $1,199,894

Associate Professor Nicole Moreland, the University of Auckland
Mapping childhood immunity to Strep A
36 months, $1,199,999

Dr Natalie Netzler, the University of Auckland, and Dr Victoria Woolner, Victoria University of Wellington
Harnessing the antiviral activities of Samoan traditional medicines
48 months, $1,166,908

Professor Gail Pacheco and Dr Nadia Charania, Auckland University of Technology
Beyond the pandemic: Applying complexity science in child immunisation services
36 months, $1,199,727

Dr Debbie Ryan, Pacific Perspectives, and Dr Jacqueline Cumming, Private Practice
Enhancing Pacific strategy, policy and implementation
42 months, $1,199,927

Dr Julia Shanks and Associate Professor Rohit Ramchandra, the University of Auckland
Increasing cardiac vagal activity as a novel treatment for heart failure
36 months, $1,199,996

Dr Kenneth Taiapa and Dr Christina McKerchar, University of Otago
Exploring the mental health impacts of climate change on kai sovereignty
36 months, $1,199,912

Dr Seini Taufa, Moana Connect
The pathway to healing: Pacific child injury outcomes
36 months, $1,197,475

Associate Professor Andrew Waa and Ms Lani Teddy, University of Otago
Te Hao Hou: Rangatahi Māori experiences and perceptions of smoking and vaping
36 months, $1,199,950

Dr Michelle Wilson, Te Whatu Ora - Te Toka Tumai Auckland, and Dr Nicola Lawrence, the University of Auckland
Evaluation of the implementation of decentralised clinical trial methodology
36 months, $1,199,999