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Gardasil vaccine helps bring new research to life

Thursday 06 August 2020

The cervical cancer vaccine Gardasil co-founded by Professor Ian Frazer at the PA Hospital (PAH) continues to not only save thousands of lives but also continues to contribute and shape further cancer research.

Led by PAH Senior Radiation Oncologist Professor Sandro Porceddu in collaboration with Prof Frazer, a world-first trial of a human papillomavirus (HPV) vaccine combined with an immune checkpoint inhibitor to treat people with HPV throat cancer is taking place at the PAH campus.

Alarmingly, HPV associated throat cancers are rising fast among men, highlighting the need for research and the PAH and Translational Research Institute (TRI) led trial, which will see patients who have already overcome a throat cancer diagnosis given the HPV vaccine co-founded by Prof Frazer and the checkpoint inhibitor, which is a drug designed to enhance the body's immune system.

"Initially we did a study (at PAH) to check that the vaccine is safe, that was in 12 patients. It took us a little over a year, and once we showed it was safe, we now want to take it to people where the cancer has come back, and vaccinate them, as well as give them a drug that enhances the immune system," Prof Porceddu said.

"The goal of the trial is to try to attack the cancer and reduce it, give people a longer quality of life and in the most extreme possibility, cure a cancer which would otherwise have been incurable.

As the chair of the Cancer Alliance Queensland Head and Neck Committee, which collects data on head and neck cancer patients, Prof Porceddu said he had seen head and neck cancers shift from being primarily oral cancers to cancers related to the HPV virus.

"For many, many years, the most common head and neck cancer was cancer of the mouth, or what we call oral cavity cancer. In our last review, which looked at the period of 2011 onwards, what has happened is throat cancer, cancers arising from the tonsil and the back of the tongue have now become the most common cancer, that's predominately driven by the HPV virus," he said.

"We recently compared cancers of the head and neck before 2011 and cancers after 2011, and there has essentially been a 160% increase in cancers of the tonsil and the back of the tongue in men. That's a huge jump and that jump has been due to the HPV virus.

"In women, it has also increased though not by as much, in line with about 40%. That makes HPV related throat cancer a very important cancer, especially in my field, because it does represent an overwhelming number of patients with this disease."

Prof Porceddu, who is also currently funded by the PA Research Foundation for research into Head and Neck Lymphedema, said his passion for improving the quality of life for people with head and neck cancers came more by professional development than a personal connection to the disease.

"I trained in Melbourne at the Peter Mac Cancer Centre, which is a standalone cancer facility. That's where I developed an interest in both head and neck cancer and skin cancer. They're my two main areas of interest and expertise, both clinically and from a research perspective.

"I was invited to work with a world-leading authority in this area, so I took that opportunity, and then that led to me developing an interest in it. I just found I enjoyed the work and it's a technically very challenging area. Because both the anatomy and designing radiation was very complex, but also these are patients that do develop lots of symptoms, side effects, and need to be managed. I like that aspect as well, managing complex patients."

Prof Porceddu who has been at PAH for 15 years, said his long relationship with the PA Research Foundation, who also helped support Professor Frazer's cervical cancer vaccine research, has helped him greatly over the years to drive work that has a true focus on improving outcomes for patients.

"The PA Foundation has supported my research for over 10 years. That's an important thing, it's a long track record. Sometimes to acquire larger funding from big organisations, you need seed funding to get the trial going, to demonstrate that the studies are feasible, you need some sort of runs on the board," he said.

"The Foundation comes in at that level to provide us with assistance to get things up and running, which then helps promote success rates to attract larger grants. Even if we say that there was a seed grant of $20,000, it was only $20,000, but that $20,000 may ultimately be leveraged to get a $2,000,000 grant.

"The other thing is that because the PA Foundation is funding clinicians that are doing research, many of the findings are rapidly translated into clinical practice, and that is very important to donors and patients."

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