If the pandemic has revealed anything about medical research, it is its capacity to embrace a pernicious global health challenge and to respond quickly. But our concentration on the coronavirus has, in some ways, obscured the depth of knowledge our researchers are acquiring about other diseases that are then helping to drive new treatments and approaches to some of our most lethal ailments.
Left to right: Sasha & James Wilson, Guy & Pennie Callaghan,
Blood cancers – leukemia, myeloma, and lymphoma – are immensely challenging, and there are no preventative measures. They are caused by genes that turn off or send confused messages to the cells they control, so understanding more about those genes is a vital part of diagnosis and treatment. Genomic testing has emerged as the best way to find a personalised treatment option for those battling blood cancers.
Dr David Westerman, Head of Haematopathology at the Peter MacCallum Cancer Centre in Melbourne, summarises the situation this way: “The knowledge of the diseases is increasing faster than the treatments, but you need to have that knowledge before you can investigate treatments.’’
That knowledge is built on the development of genomic testing that enables targeted treatments. And an important element in the accumulation and application of that knowledge is philanthropy.
That’s where the Snowdome Foundation comes in. The Foundation is the common link between two significant blood cancer projects – the four-year-old Wilson Centre for Blood Cancer Genomics at the Peter MacCallum Cancer Centre and the Epworth Centre for Immunotherapies, which was jointly launched with Snowdome Laboratories in March.
A few months ago, the Wilson family pledged $3.5 million to the Foundation as part of its ongoing support of the Wilson Centre for Blood Cancer Genomics at the Peter MacCallum Cancer Centre in Melbourne. In 2017, Bruce and Christine Wilson donated $5.5 million to establish the centre. Sadly, in 2018, Christine passed away. Yet the family’s legacy continues, and their recent gift brings their total donation to Snowdome to more than $9 million. That has translated in to more than 4000 Australians receiving free genomic testing, as well as Fellowships and research collaborations that led to international breakthroughs in understanding blood cancer treatment resistance.
As David points out, understanding the molecular characteristics of a tumour is the foundation of patient care.
“I use the analogy, [that] it’s like looking at an electrical wiring box of a major multi-storey building –the wiring is incredibly complex – and that’s what our cells are like, and tumours even more complex, with abnormal wiring and signalling,’’ David says.
“And so, what we’re able to do with our molecular techniques is to dissect out that abnormal wiring… It helps both with the diagnosis of our diseases, the prognosis of our diseases and potentially, in many cases, the treatments. The algorithms we use for our diseases traditionally have been standard chemotherapy. More and more, targeted therapies towards specific abnormalities in those wiring systems is a modality used,’’ he says.
One of the reasons that the molecular testing has now reached this level of sophistication has been advances in the molecular pathology machinery and developments in computational capacity that has helped data analysis. Now, molecular knowledge of blood and non-blood cancers has improved significantly. “Ten years ago, if you were diagnosed with acute myeloid leukemia, we would have a look at maybe two genes,’’ David says. “What we’re able to do now is we’re able to look at 30 to 50 genes at the same time. It’s a completely different playing field, and with the ability to interrogate tumours in a detailed fashion the knowledge landscape of these tumours has dramatically increased.’’
Snowdome Foundation Chair John Salvaris believes there’s no reason why the current level of activity around genomic testing for blood cancers can’t continue. And part of the reason is the willingness of donors to make a pledge to the cause.
“Two years ago, we had not raised any funds for the Epworth Centre and now it’s hopefully not too far away from treating its first patient,’’ John says.
The ambitions of the Snowdome Foundation in this regard are clear – it’s a leading not-for-profit organisation dedicated to raising funds to support translational research into blood cancers. As John describes the organisation, Snowdome doesn’t “over-engineer’’ its operations: its Melbourne headquarters are provided by Helen and Tony Gandel, there are few fixed costs and the organisation’s purpose is clear, a real benefit for blood cancer patients. The result – aside from the medical research breakthroughs – is that for the past three years the Foundation has been ranked in the High-Growth Companies Asia-Pacific top 500 fastest growing companies in the region. The real success though is being able to demonstrate to a donor how they can make a difference.
“When people can see that their donation goes to funding a Fellow who has gone and found a potential new form of treatment…or testing of a genomic sequence to provide the best possible diagnosis …or the ability to access world class treatments, I think this gives people enormous satisfaction knowing that their funds are going towards making a real difference and saving the lives of people. Our donors really trust us, and we are ever so grateful to them for that trust,’’ John explains.
Central to this are the personal stories – particularly Chloe Rutherford, who was diagnosed with leukemia in 2007. During one of her early trips to the Royal Children’s Hospital, Chloe thought she saw a collection of snowdomes in a gift shop window. It wasn’t a gift shop but a nurses’ station in the middle of the ward. To Chloe, it was magical and beautiful, and she sought out a snowdome of her own. During the more than 250 visits to the hospital, Chloe’s collection of snowdomes grew, sent from around the nation and the globe, gifts from family, friends and the nurses who cared for her. For a time, it seemed Chloe had beaten leukemia, but in 2009, she relapsed and contracted pneumonia, passing away from complications brought on by the pneumonia. But ‘snowdome’ has stayed, as the Foundation name.
“Our vision is to give every Australia blood cancer patient the best opportunity for a cure. We hope that blood cancer is a manageable condition that someone can live a long and happy life with,’’ John says.
The evidence from the Wilson Centre – considered one of the world’s best facilities - and soon, when the Epworth becomes fully operational, points to that vision becoming reality.
“We’re proving again and again that you can make a difference…and that’s where I think Snowdome is so powerful,’’ John says. “By ensuring the funds we raise go to life changing dreams that become reality, like the Wilson Centre or research projects that our diverse Board and executive team prosecute before deciding to grant, …we put our effort to where we think results can be achieved.’’
It will inevitably be a collaborative approach, around the globe: many researchers will be working on the next breakthrough. “There will no doubt be new mutations that will be discovered that will need their own research but what I would like to hope is that sometime in the next 10 years, for a large number of the blood cancers that the treatments continue to develop at least at the same speed they have over the past five years and that blood cancers do become conditions that people can live with,’’ John says. “We like to aim big and if we have the capacity to fund in the right areas, we should be able to continue to achieve the outcomes that impact the most.’’
For David, the impact of the Wilson Family grant has been remarkable.’’ It’s enabled us to recruit appropriate scientific, medical, and computational experts, and grant co-ordinators,’’ he says. “The infrastructure that this philanthropic grant has been able to do is really quite incredible and the outputs from the team have been remarkable with over 60 publications lead by Dr Piers Blombery in the past four years, not to mention the impact of genomic testing for standard patient care.’
And he knows that there is so much more to know about genomic testing and its potential to improve blood cancer outcomes. “It’s like taking a photograph. That represents now, it doesn’t represent tomorrow or next year or the next five years and so on,’’ he says.