A/Prof Wendy Cooper received funding from the NFMRI between 2012 to 2015. A/Prof Cooper’s research focussed on lung cancer and identifying biomarkers that could predict responses to particular treatments.
This is important as some lung cancer patients with specific changes in the genes of the cancer cells could be targeted with new smart drugs that are more effective and had less side effects than traditional chemotherapy (personalised medicine).
The challenge lied in finding these targetable or druggable gene changes in patients. Despite having new technology capable of testing many genes at once, Massively Parallel Sequencing (MPS), there were significant logistical challenges involved in dealing with the complex testing and large amounts of data generated from MPS and no centres in Australia offering this approach.
Seizing this identified opportunity and working in quality assured labs that would facilitate the translation of the research, A/Prof Cooper and her team received support from the Foundation to collaborate with bioinformatics experts to develop protocols and guidelines to overcome the barriers to implementing MPS in lung cancer and contribute to improving the poor prognosis of this disease. Since then, A/Prof Cooper has studied and tested tumours from patients with specific clinical characteristics that make them more likely to harbour targetable mutations. Specifically, they studied a group of lung cancer cases that could be targeted by new drugs. With an emphasis on developing cost effective means of identifying actionable mutations in lung cancer, A/Prof Cooper’s research has helped leverage further research funding of over $585,000.
A/Prof Cooper’s team now routinely screen all lung adenocarcinoma cases.
Another important component of this research is to assist in determining whether new therapies and concurrent diagnostics may become accessible and reimbursable. This process involves approval by the Medical Services Advisory Committee (MSAC) and Pharmaceutical Benefits Advisory Committee (PBAC).
Targeted therapy is currently reimbursed for other indications, but is presently under MSAC/PBAC consideration for reimbursement. A/Prof Cooper’s data is also being used in submissions for the approval of new diagnostic uses and associated therapies with pharmaceutical companies such as Pfizer. Although tumours associated with the biomarker ROS1+ are uncommon, they mostly occur in young, non-smoking patients who are desperate for targeted therapies that have fewer side effects than conventional chemotherapy to potentially increase survival rates.
Another biomarker (PD-L1) study was funded by Merck as this data will be useful to support their submission for PBS funding for their anti-PD1 drug, pembrolizumab, which has shown to improve overall survival in the first line setting in non-small cell lung cancer that has the PDL1+. Biomarker. A/Prof Cooper’s study shows that pathologists can reliably score PD-L1 at specific thresholds to determine positivity. This will be important data for MSAC in evaluating PDL1 IHC as a co- dependent test to obtain access to PBS prescriptions. Without this sort of data, MSAC/PBAC will often defer decisions, potentially leading to delays in patients having access to these treatments.
It also means A/Prof Cooper’s hospital and team will have fully optimised and validated their assay so they are ready to go if PDL1 IHC comes into routine practice to access pembrolizumab (or similar immunotherapeutic agents).
In 2017, Prof Cooper was the inaugural recipient of NFMRI’s Dr John Raftos Medal.
