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Spotlight on advanced solid cancers

Dr Kortnye Smith is a medical oncologist involved in Melbourne Genomics’ advanced solid cancers project, which is providing genomic sequencing to selected patients and assessing the impact of this on patient care. The project is being led by Dr Jayesh Desai, from Peter MacCallum Cancer Centre and the Royal Melbourne Hospital.

We asked Kortnye a few questions about the project.

What are solid cancers, and why are genes important in treating them?

Solid tumours are growths of cancerous cells that can occur in many parts of the body.

We have gained tremendous insights into cancer over recent decades by investigating how genetic changes in cells drive the growth of tumours. Having a detailed understanding of the specific genes that are changed in an individual cancer is now providing the opportunity to apply treatments specifically targeted to those changes (this is often called ‘personalised medicine’).

Our project will conduct genomic testing of an individual patient’s cancer, identify the genetic changes that are helping drive that cancer’s growth, with the aim of targeting these with a specific drug therapy, where available.

We are focusing on a number of cancers, including melanoma (skin cancer), lung cancer, childhood cancers and rare cancers. Patients will be recruited from all Alliance member hospitals: The Peter MacCallum Cancer Centre, The Royal Melbourne Hospital, Monash Health, Austin Health and The Royal Children’s Hospital.

What is your role in the solid cancers project?

I co-ordinate the recruitment of patients to the project, as well the review and delivery of genomic sequencing results to clinicians and to patients. I also see cancer patients within the Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, as part of the project.

For some patients, delivery of their genomic sequencing results is relatively straightforward. For others, a multi-disciplinary tumour board – including a team of clinicians, pathologists and scientists from across Victoria and Australia – will examine the latest evidence in cancer genomics and how this can be used to better understand and treat the patient’s cancer.

What excites you about this work?

Improved understanding of the molecular drivers guiding tumour biology has led to a new era of personalised cancer medicine, and an increase in genomically-targeted therapies. Projects like ours are an exciting chance to identify a best-practice approach to deliver this new technology in a way that is beneficial to both clinicians and patients.

What do you hope to achieve?

Genomic sequencing in advanced solid cancers may lead to more accurate diagnosis, and the ability to personalise the treatment strategy for each individual. We hope that this may also enable tailored pre-selection for clinical trials or access to new treatments via compassionate drug access schemes.

The use of genomic sequencing in cancer is rapidly increasing, but interpretation of results and their use in the clinical environment is challenging. We hope to examine a model of care which allows patients to receive testing, education and their results delivered by a team expert in genomic medicine.

Can you tell us a bit about you?

I am a medical oncologist based at the Peter MacCallum Cancer Centre. I am completing a Masters of Philosophy (Medicine) at the University of Melbourne. I started my medical studies in Adelaide, before moving to Melbourne to pursue further training in Medical Oncology.