Our fourth Idea Generation Workshop was held virtually on Friday 20 August, where innovative ideas for research and trials in Hepatocellular Carcinoma (HCC) were presented. It was facilitated seamlessly by Professor Andrew Kneebone and Professor John Olynyk and held in collaboration with TROG Cancer Research, the Liver Cancer Collaborative and the Gastroenterological Society of Australia. With the challenges the COVID-19 outbreaks around the country are currently causing for health professionals, we were grateful to have more than 80 HCC experts able to join us online for the workshop.
Launched in 2019, Idea Generation Workshops enable us to deliver on our strategic goals to accelerate the pace of discovery and connect researchers. They serve as a platform to elevate ideas and encourages participants to offer constructive advice, as well as ways of improving the proposed ideas.
Participants were invited to consider the many aspects of the ideas presented, including potential impact, requirements to ensure its success, potential to become AGITG studies and more. They then voted on the level of enthusiasm for each idea. Finally, participants had to indicate their interest in assisting to refine and improve the proposed studies.
Take a look below at a snapshot of each idea presented on the day.
Idea 1: Presented by Associate Professor Adnan Nagrial
Title: Role of definitive treatment of the primary lesion in patients with met HCC who are eligible for Bev/Atezo.
“Explore the potential role of definitive treatment of the primary lesion in patients with met HCC who are eligible for Bev/Atezo and whether treating the primary lesion before or after the initiation of systemic therapy could help prolong survival”
Idea 2: Presented by Associate Professor David Pryor
Title: Phase II RCT, radiation therapy in combination with PD-L1 inhibition in locally advanced or oligometastatic HCC.
“Can radiation therapy improve outcomes for advanced Hepatocellular Carcinoma in the immunotherapy era? Our drug BromAc removes Muc 1 from other cancer cells (gastric, colorectal, pancreatic) and profoundly increases sensitivity of HCC cell lines to gemcitabine or doxorubicin in invitro culture. We can co-load BromAc and these chemo agents into microspheres and have invitro efficacy and animal safety.”
Idea 3: Presented by Dr Tim Squire
Title: Utilisation of the MR-linear accelerator
“Utilisation of the MR-linear accelerator to provide definitive radiotherapy to HCC via adapt to position and adapt to shape techniques. Feasibility study in the first instance to assess image quality and time to delivery.”
Idea 4: Presented by Dr Yuvnik Trada
Title: Tailoring liver SBRT using multiparametric MRI in HCC patients with borderline liver function.
“We propose to build on our previous work which used multiparametric liver MRI to spatially quantify liver function. We aim to tailor individual and personalised SBRT plans by prioritising radiation dose to low functioning over high functioning liver regions using a baseline MRI. We aim to generate ideas in relation to optimal patient selection and develop the methodology for a prospective tolerability study.”
Idea 5: Presented by Dr David Morris
Title: BromAC in HCC
“We now have a critical mass of centres within ANZ that can deliver high quality stereotactic radiation therapy to the liver and limited extrahepatic disease. The primary hypothesis for this phase 2 RCT is that radiation therapy in combination with PD-L1 inhibition will improve PFS over current standard of care combination therapies (currently PD-L1 – VEGF combo) in locally advanced or oligometastatic”
Idea 6: Presented by Dr Ben Dwyer
Title: Platform for high throughput HCC drug screening
“Our idea is to develop defined, precision bio-printed patient-derived in vitro models of hepatocellular carcinoma incorporating tumour and stromal cells for high throughput drug screening. We discussed strategies to generate critical data to enable clinical trial authorisation for niche-targeted therapies for HCC.”
Idea 7: Presented by Professor Geoff McCaughan
Title: Immune checkpoint inhibitors as neoadjuvant therapy in patients with surgically resectable HCC
“The main aims of this study will be to evaluate the pathologic and immune features of HCC tumour response to administration of ICI therapy for 6 weeks prior to surgical resection, in relation to pre-treatment biopsies. We would examine biopsies and the resected HCC for immune mediated tumour clearance examining features of immune activation, tumour cell death and tissue repair.”
Idea 8: Presented by Dr Muhammad Ali
Title: Neoadjuvant Stereotactic Ablative Radiotherapy and immunotherapy prior to local resection for HCC
“Discussing the benefits of liver resection for large HCC associated with significant local and distant relapse, as Neoadjuvant SABR plus IO will result in immune-modulation which can improve outcome.”
Progressing the workshop ideas
Proceeding the workshop, the ideas presented will be progressed through our research development pathway into research concepts, before being presented to the Upper GI Working Party. The AGITG and collaborative groups were very impressed with the ideas generated from the day, and look forward to progressing these concepts further.