Learning to do better
One of the common misconceptions of clinical trials is that they are always testing new drugs. Creating new drugs is an expensive process mostly undertaken by pharmaceutical companies who will develop a drug in-house, in their own labs, and take it through the pre-clinical testing stages. Flinders may be involved in Phase I of initial patient testing, but generally it’s later in a Phase III trial on an international scale. The whole process costs the company over $100 million and Flinders is one of many sites—sometimes there are over 100 of them across the globe.
However, Flinders also initiates in-house research and clinical trials. These trials are more likely to focus on how existing treatments work together, how to improve health outcomes using lifestyle changes, or how to improve current treatment processes.
In one of the clinical trials Chris is about to start, a potentially unnecessary operation will be eliminated for patients with bowel cancer. Usually patients are given chemotherapy and radiotherapy before surgery is used to remove a portion of the bowel—after which some patients are left with a permanent colostomy bag. Chris and his team suspect that around 70% of patients don’t actually need the operation, and the subsequent 30% could be detected in a follow-up. Hopefully this clinical trial could lead to a change in how bowel cancer is treated, removing a surgery with unnecessary risks for the people who don’t need it.
A significant change
When asked to reflect on the biggest clinical trial of his career, Chris remembers another bowel cancer trial at Flinders. It was an international study where he was the Australian lead investigator. The trial tested a new antibody drug that was hugely effective against bowel cancer in some cases and completely ineffective in others. Before this trial, they didn’t know why. What they uncovered was that DNA in the cancer cell could mutate. About 40% of bowel cancer patients had the DNA mutation in their cancer and for them, the treatment didn’t work.
Oncologists can now tell which patients will benefit from the drug and which won’t. ‘I was part of something that changed medical practice,’ Chris says. ‘It affected hundreds of thousands of people and policy around the world.’
Every decision Chris makes comes back to helping people. Clinical trials allow him to achieve better outcomes and processes for his patients and anyone who might be diagnosed in the future. He says, ‘There’s lots more to do, but I can look back on my career and feel that I’ve contributed to making a major difference. At an individual level I do that every day, but I’ve also helped to improve the way the health care system deals with cancer.’