If we just had more time…

In 2011, Canberra mother Melanie Swan, discovered a lump while breastfeeding her baby girl. Although this marked just the beginning of her shocking discovery, Melanie’s cancer was at that moment already Stage 4; advanced, aggressive and ultimately considered terminal.

Mel was just 38 years old when she was diagnosed with metastatic breast cancer. She fought her disease bravely until she passed away, leaving behind her loving family and parents, David and Coral Swan, and forged a connection with a researcher dedicated to preventing others from suffering from breast cancer. According to Mel’s father David:

‘Mel enjoyed robust good health so her breast cancer diagnosis came as a complete shock to her and the family. From then until her passing it was a roller coaster ride broken by an 18 month period of remission. Unfortunately, once the cancer had metastasised, there was a progressive decline in her health and, with all existing treatments exhausted, the end seemed inevitable’

Mel was surprised to find when investigating research into breast cancer how little funding proportionately appeared to be directed to metastatic breast cancer. This was despite its high incidence and poor survival rate.

Mel was a steadfast advocate of pioneering medical research and connecting researchers more
closely to oncologists at the frontline of cancer treatment. Even though the breast cancer had spread to her bones, and well-meaning medical professionals gently advised she should enjoy her final days as comfortably as possible, Mel wasn’t ready to give up.

Through a friend’s connection, Mel heard about the work of Professor Sudha Rao who was about to begin conducting clinical research into how to stop the spread of metastatic breast cancer. This research involved developing a blood test to detect treatment-resistant cells, identifying and measuring them, then using the information to help inform a more precise drug treatment and allow more patients access to new, better forms of therapy such as immunotherapy wherein the bodies own immune system is used to kill the cancer.

The meeting between Mel and Professor Rao marked the beginning of an inspirational, deeply personal journey for Professor Sudha Rao, and one that Mel’s family are still an integral part of today.

In 2020, nine years after that initial meeting between the two women, around 20,0001 women are expected to be diagnosed with breast cancer in Australia. While there is a 91% chance of surviving at least 5 years, if the cancer has spread to other parts of the body, known as ‘metastatic breast cancer’, the chances of survival are low, and likely survival time is only three years.

Metastatic breast cancer is not yet curable, but it can be treated to improve the quality and length of life. However, it can behave and respond differently in each patient, making it very difficult to treat, and in many cases, resistant to commonly used treatments.

Professor Rao and her team are at the forefront of developing new epigenetic based treatments to overcome resistance to revolutionary treatments like immunotherapy, this epi-therapy allows better survival and better quality of life for cancer patients. Professor Rao has developed companion biomarkers for this epi-therapy that helps predict whether or not patients will respond to treatments based on analysing bio markers in their blood, via a non-invasive liquid biopsy test.

The information from the tests can help determine which specific drugs can successfully target resistant cells, providing personalised medicine specific for each cancer patient, saving precious time that could have been wasted on a pursuing an unsuccessful treatment. If intervention is early enough, we can give patients and their families what they desperately want – more time.

At the time of treating Melanie, Professor Rao’s personalised approach was very new, and to be ultimately successful, must be employed as early as possible. Yet, Mel and her family remain hopeful.

Mel’s was the first liquid biopsy that Professor Rao’s team performed in their trial; a bittersweet memory that Professor Rao reflects upon often. The cancer had spread to Melanie’s bones, and then to her liver. While results from the trial at the time did show the positive news that there was no new cancer growth, it was tragically too late for Melanie, who passed away in October 2016.

Melanie’s parents believed that Professor Rao’s work could have helped their daughter if it had been applied earlier in her cancer treatment.

Professor Sudha Rao has now established the Gene Regulation and Translational Medicine lab at QIMR Berghofer, where she and her team worked quickly to establish strong connections with oncologists and hospitals such as the Royal Brisbane and Women’s Hospital, for collection of crucial blood samples from cancer patients, to continue clinical trials in breast cancer patients.

In Professor Rao’s words, ‘The early intervention happens by developing blood tests where you can monitor these cancer stem cells in the blood, well before the metastasis, the spread, has happened.

‘This revolutionary approach could stop cancer in its tracks. We are currently focussed on metastatic breast cancer, but it could be applicable to other aggressive cancers.’

Professor Rao and her team at QIMR Berghofer have just completed an early phase clinical trial with metastatic breast cancer patients at the Canberra Hospital, sponsored by EpiAxis Therapeutics.

Working with the hospitals’s Director of Oncology Professor Desmond Yip, the trial utilised a drug that targets an enzyme called LSD1 which is linked to aggressive breast cancer. Although results of the groundbreaking study are soon to be published; initial results have showed significant promise benefiting patients and patient’s families by giving them more time with family and loved ones.

‘Shortly before Mel died I said to her, “You were here for a reason, because without you I would not have had the same momentum. I now have a purpose to succeed,” said Professor Rao. ‘It’s because of her that we are here—we won’t let her down.’

‘Melanie was an amazing woman, and instrumental in helping me get people on board for the trial, and I am forever grateful that I met her and can continue to work towards a better future for other women. But we’ve still got a long way to go.’

We urgently need funds so that we can help cancer patients to give them more time with loved ones, family and friends. Mel and her family deserved more time together. Your generosity can give the gift of time to other families facing the loss of a mother, sister or daughter.

‘I dedicate 2021 to my friend, Melanie Swan, who passed away from metastatic breast cancer.

My team remains dedicated to bring to the clinic new classes of drugs and non-invasive blood tests to overcome resistance to immunotherapy and increase survival of cancer patients with metastatic cancers.’
– Professor Sudha Rao
QIMR Berghofer

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