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Vol 26, No. 02, February 2022   |   Issue PDF view/purchase
COLUMNS
Why Research Is Vital to Find a Cure for Australia’s Most Devastating Cancer
Cure Brain Cancer Foundation is Australia’s leading organisation for brain cancer research, advocacy, and awareness.

Find out how this not-for-profit is collaborating with researchers and industry to accelerate treatments to patients in the effort to rapidly increase brain cancer survival and improve the quality of life for people living with this disease.

by Lance Kawaguchi

Cure Brain Cancer Foundation is the largest dedicated funder of brain cancer research in Australia. We fund research grants designed to improve survival outcomes for people with brain cancer, including project grants and fellowships.

To date, we have invested over $21 million into brain cancer research including clinical trials and pre-clinical research efforts across paediatric and adult brain cancers. Cure Brain Cancer Foundation fills a gap in the current research commercialisation landscape by funding translational research in brain cancer, to get new treatments as quickly as possible. Importantly, we have worked to build global collaboration between researchers, industry, investors, and the philanthropic sector to realise tangible outcomes for people living with and impacted by brain cancer to ultimately find a cure.

Overview

Around 1,896 people are diagnosed with brain cancer in Australia annually and approximately 1,528 die from the disease every year.1 Brain cancer kills more children in Australia than any other disease and more people under 40 than any other cancer.

Brain cancer has the highest total burden of disease for adolescents and young adults in Australia, with a cost of $1.7 million per person - the highest cost to society of all cancers.2 This is because brain cancer is highly debilitating, affects people in their prime, and often means family members cannot work if they become carers. Overall, it is estimated that brain cancer affects 7.2 persons per 100,000 in Australia.1

Survival rates for brain cancer are low and have barely changed for 30 years, despite significant increases in survival for Australians diagnosed with other types of cancer, such as prostate and breast cancer. The five-year survival rate of prostate cancer has increased from 60 per cent to over 90 per cent and breast cancer survival has increased from 72 per cent to over 90 per cent, whilst the five-year survival rate for brain cancer has remained almost unchanged for nearly 30 years, at just 22 per cent.3 Unfortunately for some types of brain cancer, survival is much lower. For glioblastoma – the most common primary brain cancer in adults – only 5 per cent of people survive five years post-diagnosis.4

It is not known what causes brain cancer and it appears to occur randomly. For the vast majority of people with a brain tumour, no outside cause can be clearly identified.

What Is Brain Cancer?

Brain tumours can be either benign or malignant. A malignant brain tumour is referred to as brain cancer.

However, unlike many other cancers, even benign tumours can be dangerous. Since the brain is enclosed in the skull, and the skull can’t expand to make room for a growing tumour, a tumour may press on or damage delicate brain tissue, sometimes becoming life-threatening.

Malignant brain tumours vary widely, both in the way they grow and the way they respond to treatment. Some are neatly contained within a capsule (encapsulated) and are relatively easy to remove. Others have long, thin filaments spreading throughout the brain, like the roots of a plant.

Many types of brain cancer can affect people of all ages. Cancer in children is different from adults. Childhood tumours frequently appear in distinct locations and behave differently when compared to brain tumours in adults.

Why Research Is Vital

Brain cancer is one of the hardest cancers to treat given the unique environment of the brain as compared to other organs. The survival rates of brain cancer are abysmally low with just 2 in 10 people surviving for five years past their diagnosis. Currently, the standard treatment is a combination of three regimes:

Surgery

  • If possible, this is usually the first form of treatment. However, depending on where the tumour is located in the brain, oftentimes it is too dangerous to operate. When surgery is possible, great care must be taken to minimise damage to surrounding healthy brain tissue. Surgeons may be able to “de-bulk” a portion of the tumour but are unable to take out all the cells, thereby requiring other treatments to remove the remaining cancer cells.

Chemotherapy

  • Chemotherapy has been the standard of care for many brain cancers for the last 30 years. However, many patients develop a resistance to the treatment. Research efforts are therefore focused on improving patient response to treatment, in addition to finding new treatments that can be used instead of, or alongside standard chemotherapy to improve survival.

Radiation therapy

  • Radiation therapy is commonly used for treating brain cancer. This form of therapy uses high energy x-rays to kill cancer cells and works by damaging the DNA of quickly dividing cells. Whilst many tumours respond well to this treatment, others develop resistance to this form of therapy.

Apart from these above forms of treatment and their exhaustion, there are no other standard treatment options available for brain cancer patients. Research is vital to not only improve the current forms of treatment so that they are more effective, but also to investigate and bring to the market new therapies for this devastating disease.

What Are the Challenges?

Developing new therapies to treat brain cancer is further complicated by the blood-brain barrier. The blood-brain barrier surrounds the brain and protects it from foreign substances. The protective blockade often prevents cancer drugs from entering the brain and successfully reaching the tumour.

Most drugs are designed not to cross the blood-brain barrier to protect the brain, however, in the case of brain cancer, we need drugs that can penetrate the brain to access the tumour. This means that drugs used to treat other cancers often cannot be repurposed for brain cancer. Brain cancer drugs need to be specifically designed to access the tumour site, and great care must be taken to ensure they do not compromise our most sensitive and important organ.

Barriers to Research

Brain cancer is classified as a “rare” cancer, with almost 1,900 new cases diagnosed each year in Australia. Rare cancers are disproportionately underfunded and under-researched compared to common cancers, like breast cancer and lung cancer.

For these reasons, brain cancer research and therapy development has been historically underfunded and put into the “too hard basket”. As such, we have barely seen any change to standards of care for brain cancer in the last 30 years, and survival has remained static at around 22 per cent from that period. Therefore, for the first time, Cure Brain Cancer Foundation has launched a Clinical Accelerator, which will award funds to support research discoveries in brain cancer through commercialisation and ultimately, accelerate treatments to Australian patients.

Cure Brain Cancer Foundation aims to de-risk investment for pharmaceutical companies, to encourage them to develop their most promising agents in brain cancer and enables leading researchers to advance their pioneering ideas into clinical development. The Clinical Accelerator program fills a gap in the current research commercialisation landscape by funding translational research in brain cancer. This progresses ideas from early-stage, pre-clinical research, into a product that shows proof of concept and viability for industry partnerships and investment.

Research – The Missing Link

We need to improve survival rates and quality of life, and for that we need to invest in research now, both to identify new treatments and to improve the efficacy of already existing treatments. It must be a concentrated effort between researchers, industry, and philanthropic organisations to accelerate brain cancer research to make any significant change to survival rates.

The pathway to developing a drug, from initial discovery and development in the lab to implementing clinical trials in humans, is not an easy one, taking many years and millions of dollars. This transition from the lab to the clinic, generally referred to as the “Valley of Death” is common throughout all drug development, representing the risks involved in translation, which are often too high to receive sophisticated investment and too late for government grant support. This challenge is exasperated with the added complexity of developing treatments for brain cancer.

Opportunity for Industry

Brain cancer has untapped market potential. The market size for glioblastoma, the most common primary brain cancer in adults, is expected to reach US$4.2 billion by 2028. We are starting to see biotech’s focus on brain cancer and develop much-needed therapies both in Australia and overseas. At Cure Brain Cancer Foundation, we want to encourage and support our industry partners in developing and progressing new treatments for patients.

Research is the Foundation’s greatest annual investment, and our research strategy is designed to get new treatments to patients faster, by funding across the entire research pathway. The “research pathway” refers to pre-clinical research done in the lab, all the way to clinical research done in humans. We endeavour to fund research that is looking for solutions to address some of the most invasive and fatal childhood cancers, in addition to supporting research on different forms of adult brain cancer, recognising the unique challenges in both.

Developing and testing novel and innovative treatments is the only way to improve survival and quality of life for people affected by the disease. Cure Brain Cancer Foundation believes every person diagnosed with brain cancer in Australia should be able to access new treatments through world-class clinical trials.

Working to Bridge the Gap

Cure Brain Cancer Foundation has committed over $21 million to brain cancer research. We work with our international partners to bring clinical trials to Australia as soon as they’re available overseas, and we support ground-breaking trials right here at home. We also support Australian and New Zealand pre-clinical research efforts to increase our understanding of the disease and develop the models required to translate therapies into the clinic.

A core focus of the Foundation is our Brilliant Minds programme, which aims to support early and mid-career researchers in brain cancer and provide them with stability through multi-year funding. This capacity building programme encourages bright young researchers to begin a career in brain cancer and supports mid-career researchers to continue their research in brain cancer.

All research programmes are thoroughly reviewed and recommended for funding by our Scientific Advisory Committee – an internationally-renowned group of expert brain cancer researchers and clinicians with the important role of ensuring the organisation only funds the highest quality research that will deliver the greatest impact for people with brain cancer. They make decisions about research in an international context and provide a transparent, impartial platform for decision-making to ensure good governance and safeguard best practices in research funding.

Our grant and funding applications undergo a rigorous, transparent review to ensure all funded research programmes align with our purpose, are of high scientific quality and merit, and have the potential to provide the greatest impact to people living with brain cancer.

Cure Brain Cancer Foundation offers the following funding opportunities to progress brain cancer research, and ultimately find a cure for the disease:

Clinical Accelerator5

Applications opened in November 2021 for our first-ever Clinical Accelerator. Worth up to $2 million, this is the world’s largest brain cancer-dedicated Clinical Accelerator programme, with an aim to translate new therapies into the clinic for patients.

The Clinical Accelerator programme targets the “Valley of Death” and aims to de-risk investment for pharmaceutical and biotechnology companies to progress their treatments into the clinic.

We want to see Australia lead the way in the development and commercialisation of market-ready drugs and devices that will bridge the gap between innovative, early-stage cancer research and the successful development of high-impact therapeutic products.

Our $2 million investment will act as leverage for researchers and industry partners, so they can develop the necessary proof of concept data, which can then be used for securing larger, sophisticated investments and partnerships.

This program will enable leading researchers to advance their pioneering ideas into clinical development and will support biotechnology and pharmaceutical industry partners to progress new, urgently needed treatments for brain cancer.

Brilliant Minds

Cure Brain Cancer Foundation’s Brilliant Minds programme aims to attract the brightest minds to pursue a career in brain cancer and supports existing researchers to retain top talent in the field. A consistent and dedicated workforce is essential to find better treatments and a cure for brain cancer.

In Australia, it is rare for early and mid-career researchers to be employed on a full time or permanent contract. In fact, many researchers must apply for funding on an ongoing basis to maintain their salary and have the funds to conduct research projects. This grant writing is incredibly time consuming and minimises the time available to perform cutting edge research. In addition, brain cancer is a rare cancer that is historically underfunded, meaning the funding opportunities for researchers are minimal.

• Early Career Fellowship6

Since 2017, Cure Brain Cancer Foundation has awarded the Early Career Fellowships to encourage bright, talented, young researchers into the field of brain cancer.

Our Early Career Fellowship is different to many others as it runs over three years (rather than one or two years as is typical), providing longer-term stability in the research role. This in turn allows those starting their career to focus on their research efforts, improve their networks, and develop suitable pilot data that can be used to leverage future funding.

In 2021, Cure Brain Cancer Foundation awarded its Early Career Fellowship of $345,000 to Dr. Yolanda Colino Sanguino at the Cancer Epigenetic Biology and Therapeutics Group, Children’s Cancer Institute. Dr. Sanguino’s winning project focuses on diffuse intrinsic pontine glioma (DIPG), the most aggressive brain tumour in children. The project, Epigenetic Therapy in DIPG, will generate critical new knowledge on how tumour mutations drive cancer growth, to identify new drug targets, and novel therapies for the currently incurable DIPG.

• Mid-Career Fellowship

It is estimated that only 3.5 per cent of mid-career researchers will continue their careers in research, with many moving to academia or the private sector due to a lack of stability and funding opportunities in the field.

We recognise that to make research progress, we need the best researchers. We are committed to helping researchers continue their careers in brain cancer, to ultimately enable them to progress their work into new treatments for patients.

Our first Mid-Career Fellowship will be launched in 2022, worth $420,000 each which will provide three years of support across both salary and project funding.

By investing in researchers through these Fellowships, we take the burden off researchers having to apply for government or other philanthropic funding, so they can focus on improving outcomes for patients and families.

Get Involved

Funding is an integral part of our ability to accelerate access to new treatments for people living with brain cancer, by supporting vital research, advocacy, and awareness for children and adults impacted by brain cancer.

Donations not only help us fund grant opportunities such as those outlined above, but also support our ground-breaking advocacy work. This includes the campaign that saw the cancer drug Avastin listed on the Pharmaceutical Benefits Scheme, saving patient treatment costs of up to $20,000.

Additionally, we recognise that to work effectively and expedite new treatments for brain cancer we need to work collaboratively. We are always looking for opportunities to partner with researchers, industry, investors, and other global philanthropic organisations to achieve our mission and ultimately find a cure for brain cancer. Please contact our team for partnership or collaboration opportunities: [email protected].

To find out more about the Clinical Accelerator and other future funding opportunities for biotech’s, research institutions, and industry partners, please contact [email protected].

To donate, or to find out more about grant opportunities available, please visit our website: www.curebraincancer.org.au.

References

  1. Australian Institute of Health and Welfare 2021. Cancer data in Australia. Cat. no. CAN 122. Canberra: AIHW.
  2. CanTeen Australia 2017. The economic cost of cancer in adolescents and young adults.
  3. Australian Institute of Health and Welfare 2021. Cancer data in Australia. Cat. no. CAN 122. Canberra: AIHW
  4. Australian Institute of Health and Welfare 2017. Brain and other central nervous system cancers. Cat. no. CAN 106. Canberra: AIHW.
  5. World’s largest brain cancer-dedicated Clinical Accelerator program. Cure Brain Cancer Foundation. (n.d.). Retrieved from https://www.curebraincancer.org.au/about-us/news/worlds-largest-brain-cancer-dedicated-clinical-accelerator-program.
  6. 2021 Early Career Fellow Announced. Cure Brain Cancer Foundation. (2021). Retrieved from https://www.curebraincancer.org.au/about-us/news/2021-early-career-fellow-announced.

About the Author

Dr Galileo Violini

Mr Lance Kawaguchi, CEO, Cure Brain Cancer Foundation, is an internationally recognised executive leader and board member, with over 25 years of global finance and banking experience, including living and working throughout North America, Europe, Asia Pacific, and the Middle East.

He has a strong advocational vision for supporting people and families living with brain cancer, while advancing the Foundation’s visibility and objectives with like-minded members of the global corporate and scientific community.

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