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The Newsletter of ANZUP Cancer Trials Group Limited


From humble beginnings, ANZUP is now recognised nationally and internationally for its genitourinary clinical trials. ANZUP was formed by the merger of the Australian Prostate and Urogenital cancer Group (APUG) and Australia & New Zealand Germ Cell Trials Group (ANZGCTG) in 2008. Since then, ANZUP has come a very long way. We have grown from 150 members in 2008 to more than 1,300 members across more than 20 disciplines in 2018. We have active clinical trials across all of the cancers we represent. We work closely with those doing basic or translational research, supportive care research, health economics and other health outcomes work, and many others. We have established collaborations with trials groups in Australia, New Zealand, Ireland, UK, Europe, USA, Canada, and others planned. We have built relationships with key stakeholders including those involved in community support, advocacy and fundraising. We are frequently and visibly present at major international meetings, sharing and promoting our work. The future of research in Australia depends on bringing young scientists and clinicians together to set the research agenda to ensure we continue to improve outcomes. ANZUP’s ASM provides an ideal platform to discuss and present the latest updates in cancer diagnosis, treatment, research and supportive care. In addition, we have grown our concept development to annual full day workshops mentoring and fostering people early in their careers. If this wasn’t enough, we have expanded our educational program to include MDT Masterclasses, the PCFA ANZUP Nurses Symposium, GU Preceptorships, Best of ANZUP and more! I would like to acknowledge and recognise our fearless leaders and pioneers Ian Davis and Guy Toner along with our incredibly hard working Board, SAC, CAP, Subcommittees and our membership. Without your generosity, hard work and tireless commitment, we would not be celebrating this milestone 10th anniversary. Thank you. MARGARET MCJANNETT, ANZUP CEO


Our members say, ANZUP is… “…[an] outstanding clinical trial cooperative group; but also now a most valuable player in all aspects of GU Oncology – education, grants, networking etc. Internationally recognised; fantastic leadership and administration; and fun to engage with.” “…a vibrant international urology clinical trials group that focuses on getting the best for patients/carers and healthcare professionals through robust innovative clinical trials.” “…an inclusive community of very intelligent people advancing the care of people with GU cancers.”

Join us at ANZUP’s 10th anniversary Annual Scientific Meeting at the Hyatt Regency in Sydney on 8-10 July. “Popular sessions will return this year, however delegates can also expect to be wowed with novel ways of content delivery. When we think about the way we approach cancer, it’s ever changing and so should the way we share and deliver educational content. If nothing else, know you should expect the unexpected!” – Henry Woo, Convenor Earlybird registrations close 9 May (see back page) ANZUP UPdate Autumn 2018 | 1

HELLO, WELCOME TO ‘UPDATE’ Contents: 10 years of ANZUP . . . . . . . . . . . . . . 1 Message from the Chair . . . . . . . . . 2 Trial news . . . . . . . . . . . . . . . . . . . . . 5 Concept Development Workshops . . . . . . . . . . . . . . . . . . . . 6 APAC Advanced Prostate Cancer Consensus Conference . . . . . . . . . . 8 2018 Melbourne Below the Belt Pedalthon . . . . . . . . . . . . . . . . 10 Grants and Awards . . . . . . . . . . . . 12 Updates from SAC and Subcommittees . . . . . . . . . . . . . . . 13 2018 Member survey results . . . . . 18 Meeting news . . . . . . . . . . . . . . . . 20 Upcoming 2018 events . . . . . . . . . 21 Other news . . . . . . . . . . . . . . . . . . . 22 Thanks to our 2018 Corporate Partners and Supporters . . . . . . . . 23 2018 ANZUP ASM . . . . . . . . . . . . . 24

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MESSAGE FROM THE CHAIR Welcome to this edition of UPdate, the newsletter of the Australian & New Zealand Urogenital and Prostate Cancer Trials Group Ltd (ANZUP). It is an exciting time for all of us as we celebrate our tenth year of existence. Our projects and activities keep growing; there is always another opportunity to become more involved in ANZUP. Behind all of this is our reason for existence: we are here to improve outcomes for everyone affected by genitourinary cancers. We already have a wealth of knowledge, and more information coming every day. It takes time for this to result in changes to health care policy and practice, which means the potential benefits of the research are deferred: the information cannot help if we do not change what we do. Most people continue to think of the main gaps being discovery at one end of the process, and funding and other necessary resourcing at the other end. We in ANZUP and other groups like us know that the circuit cannot be completed until we demonstrate the clinical benefits in well-designed clinical trials, and along with that we must be thinking about how we will lobby for changes in practice. It’s not enough just to publish research or present it at a conference. We must break habits of thinking in ourselves and in others; work within the constraints of resourcechallenged health care systems; navigate unfamiliar systems of approval; and even work with and through industry and the media. ANZUP has many examples of this, perhaps best demonstrated in the germ cell cancer setting. Years ago, our predecessor ANZ Germ Cell Trials Group (led by the extraordinary Guy Toner) did what no-one else had the inspiration or energy to do, and showed that one of the common variations of treatment of metastatic germ cell cancer was better than another. That has now transformed practice around the world. ANZUP has also surveyed our members for their views on management of early stage testicular cancer and reconciled this information with the


development, together with important initiatives in quality published literature. That led to an important publication of life and supportive care, translational research, health synthesising the information into recommendations for economics, and a proposed project coming from the how these patients should be managed. Importantly this Consumer Advisory Panel. This is a remarkable level of was recognised by other key bodies and is now adopted activity and could not happen without the dedication and into the EviQ guidelines. When my hospital asks me what hard work of a very large group of people: you. our standard practice is in this situation, I point to the national guideline, which is all ANZUP work. You might ANZUP is involved in a great many other activities. Our think this does not compare to discovery of a new gene or inaugural Melbourne Below the Belt Pedalthon was held a new drug, but don’t be fooled: all the new discoveries in on 18 March at Sandown, the world mean nothing if we thanks to the generous do not bring them together to support from our event inform and change practice, partner, the Melbourne Racing and ensure our guiding Club Foundation and our standards reflect the highest It’s not enough just to wonderful Platinum Sponsor quality information. Bristol-Myers Squibb and publish research or present Silver Sponsor Lendlease. We are a cancer trials group it at a conference. We must The weather kept us all on though, and trials are what break habits of thinking in our toes (or just on our bikes/ we do best. The level of trial ourselves and in others; rickshaws) and despite all activity at the moment is the elements, 30 teams took quite amazing, especially for work within the constraints to the track completing an a group just turning 10 years of resource-challenged amazing 2120 laps (6572km) old. Our ENZAMET trial of health care systems; showing their dedication 1,125 men is now in follow-up to the cause. Thank you to and, remarkably and unusually, navigate unfamiliar systems everyone who participated the underlying question is of approval; and even work and either donated or actually not only still relevant, it is with and through industry put the muscle burn where probably even more important and the media. your mouth is to make sure it now than it was when the trial was a success. We have raised was designed. The world is nearly $80,000 with funds still watching with great interest rolling in. This will join the and waiting impatiently for the pooled funds in the Below the Belt Research Fund (where results. Our ENZARAD trial is closing in on its target of over $1M has already been raised through the Sydney 800 and is likely to close in the second quarter of 2018. Pedalthon) and will be reinvested to support research Our BCG-mitomycin trial in non-muscle-invasive bladder projects that are intended to lead to future ANZUP trials. cancer has reached its first stage accrual target and This might be a good time to put 18 September in your continues to accrue well. Pain Free TRUS B (prostate) is diaries for the 5th Sydney Pedalthon at Eastern Creek – accruing well, with a recent surge thanks to New Zealand surely we can top Melbourne’s Ben Tran and his rickshaw! participation. The UNISoN non-clear-cell kidney cancer immunotherapy trial is accruing much faster than we had The ANZUP Concept Development Workshops are taking projected. Several of our other trials are accruing less place throughout April and May. Last year a large number rapidly but will still answer important questions. And of of strong concepts came out of these initiatives, several course we have recently opened the TheraP prostate of which have now gone on further in the process towards cancer theranostic study, with 7 patients already accrued. becoming full active trials. The TheraP study was one of On top of that we have a number of new protocols these, a concept that came to the 2016 meeting and is across our various disease types at different stages of ANZUP UPdate Autumn 2018 | 3

MESSAGE FROM THE CHAIR I can never thank our team enough. Our CEO / orchestra now yet another ANZUP trial that will answer a key clinical conductor / master magician Marg McJannett leads question and inform prostate cancer care internationally. a fantastic team of Lucy Byers, Michelle Bowers, Gill You do not have to have the complete idea sorted out; Bailey, and Christine Garforth. We have farewelled the workshops are about brainstorming ideas, working Anne Woollett, who takes up a role at VCCC after out which ones align with what we need to be doing, helping us set up some robust and effective systems for and setting up the systems that will later flesh them out internal trial management and and resource them. Please sponsor functions. A very warm feel free to submit any ideas welcome to Simran Chawla, you have. You can also do this our new Clinical Trial Project through the various ANZUP You do not have to Manager and Nima Amatya, subcommittees at any time our new Database Coordinator. during the year. have the complete idea Both Simran and Nima will sorted out; the [concept Our 10th anniversary Annual help us continue to grow our Scientific Meeting is coming development] workshops capacity and capability. Thanks up fast. Another one for you to also to our previous fellow are about brainstorming put in your diaries right now: Nicky Lawrence, who left on ideas, working out which 8-10 July at the Hyatt Regency maternity leave and will return in Sydney. The theme of the ones align with what we to New Zealand later this year. meeting is ‘Putting People need to be doing, and Congratulations to Nicky and First,’ a simple but powerful Nat on the arrival of their baby setting up the systems statement that underpins Theo – we are still wondering that will later flesh them everything we do. We hope to why our suggestion of “ANZUP” see you there for yet another out and resource them. for a middle name was not taken exhausting, exhilarating, up! Welcome also to our ANZUP exciting, exceptional, and fellow Alison Zhang. Thanks to extraordinary meeting. our wonderful volunteers Jo Stubbs and Lesley Tinkler, and our great colleagues and The rest of the year of course is completely quiet. collaborators at NHMRC Clinical Trials Centre and at Except for the subcommittee meetings, the planned Centre of Biostatistics and Clinical Trials (BaCT). non-prostate Preceptorship, the Best of GU, and the many opportunities all of us have to come together to complement each other and grow something bigger than all of our individual parts. All the “ex’s” in the previous paragraph keep on coming! We have a strong and stable Board, who all contribute far more than anyone could reasonably expect. The Board directors took time out of their lives at one of the busiest times of year just before Christmas 2017 to spend a day reviewing our progress against the previous strategic plan, and producing the next iteration which will take ANZUP forward through the next several years. We are grateful to Trevor Back who once again gave up his time to facilitate this very productive day. The Board has overseen several other new initiatives over the last year or so, and you will hear about all of these at the Annual General Meeting on 9 July at the Sydney ASM. 4 | ANZUP UPdate Autumn 2018

Lastly, as always, thanks to all of you. What a joy it is to work with people from so many diverse disciplines and backgrounds but all working towards the same goals. I am amazed and humbled by the generosity of time, expertise, money and other resources that people contribute to ANZUP. Clearly many people agree that what we are doing is important but it is not often in life this translates into such comprehensive and effective support. You are making a difference for people who really need it. Please enjoy this edition of UPdate. IAN DAVIS Chair

TRIAL NEWS Recruitment Over the past four months, ANZUP has opened three new trials, taking the current trial portfolio to 11 active studies. The highly significant TheraP advanced prostate cancer trial opened at Royal Brisbane and Women’s Hospital, St Vincent’s Hospital and Moorabin of Monash Health, with 7 patients recruited. A further six sites are expected to open in the next quarter.

The UNISoN non-clear cell renal cell trial (which opened in October) continues to track ahead of projections with 20 patients enrolled across 12 active sites. Recruitment also remains strong for ENZARAD with 5 new sites opening in Europe since December and 771 of 800 patients now enrolled. Congratulations to all involved in reaching these significant milestones.

The KEYPAD clear cell renal cell trial opened in December and is now recruiting at eight sites with 3 patients enrolled.

Staying in touch with the latest information In February ANZUP launched trial-specific newsletters for the UNISoN and PCR MIB studies, with publications in the pipeline for KEYPAD and TheraP. The newsletters aim to keep sites updated with recruitment data, registration processes and tips and protocol administration on a quarterly basis.

Upon joining ANZUP, all members automatically receive a copy of the monthly Trial UPdates email listing principal investigators, trial descriptions and up to date recruitment figures. The update is distributed on the first Friday of the month. For a copy of the latest version, email anzup@anzup.org.au.

Each issue is distributed by email to relevant trial coordinators and investigators and can also be found under the member resources section of the ANZUP website (see Publications > Trials).

You can also follow us: @ANZUPtrials

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CONCEPT DEVELOPMENT WORKSHOPS Sowing the seeds for new trials

CDW calendar

The starting point for every new clinical trial or study is an idea or concept. How that idea is nurtured can mean the difference between it becoming a high quality innovative proposal, or being discarded no matter how much promise it might show.

Workshop date: Wednesday, 11 April 2018, 9.30am – 4pm

The seeds for ANZUP clinical trials are often first sown at one of four disease-specific face-to-face Concept Development Workshops. Held annually in the second quarter of the year, ANZUP’s CDWs provide an invaluable opportunity to discuss GU oncology ideas or concepts with a multidisciplinary team.

Bladder CDW

Formally established in 2014, the CDW series is designed to facilitate and support active ANZUP members who have an idea/concept they would like to put forward for discussion and, if supported, to further develop into a future grant application.

Germ Cell CDW

Emerging research, trainee and recent graduate members are also strongly encouraged to attend the workshop(s) as an educational opportunity, even if they are not presenting a concept themselves. Last year’s CDWs were attended by almost 100 multidisciplinary members and provided thoughtprovoking discussion on both the scientific merit and practicalities of the proposals put forward.

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Renal CDW Venue: Pullman Sydney Airport, 191 O’Riordan Street, Mascot, NSW Concept submissions closed

Workshop date: Friday, 20 April 2018, 9.30am – 4pm Venue: Pullman Sydney Airport, 191 O’Riordan Street, Mascot, NSW Concept submissions closed

Workshop date: Monday, 30 April 2018, 9.30am – 4pm Venue: Chris O’Brien Lifehouse, 119 – 143 Missenden Road, Camperdown, NSW Concept submissions closed

Prostate CDW Workshop date: Tuesday, 15 May 2018, 9.30am – 4pm Venue: Park Royal Melbourne Airport, Arrival Dr, Tullamarine, VIC Concept submission deadline: Tuesday, 24 April 2018


If you have an idea/concept you would like to submit please complete the ANZUP Concept Outline Submission Form found online and return to anzup@anzup.org.au by the deadlines detailed on the previous page. Funding is available to support attendance for successful applicants if it is required. 2017 PROSTATE CONCEPT DEVELOPMENT WORKSHOP


At the time of concept submission back in 2016, Lutetium-177 PSMA was a highly novel approach with very limited experience globally. We presented our early promising pilot data and a proposal for a multi-centre Australian randomised control trial. Unlike other grant opportunities where a detailed protocol is required, the Concept Development Workshop enabled the proposal to be discussed rapidly. With the assistance of ANZUP’s highly experienced clinical trialists, it enabled a rapid change in the initial proposal to one that was more feasible. Michael Hofman, PI TheraP Trial (ANZUP 1603) ANZUP UPdate Autumn 2018 | 7

APAC ADVANCED PROSTATE CANCER CONSENSUS CONFERENCE ANZUP hosts first APCCC Asia-Pacific Satellite Symposium On 23 February, ANZUP hosted Australia’s first Asia Pacific Advanced Prostate Cancer Consensus Conference (APCCC) Satellite Symposium. Held in Melbourne, the symposium brought together 20 experts from 15 APAC countries to discuss real-world application of consensus statements from the APCCC held in St Gallen in 2017. With the endorsement of the St Gallen leadership, the Satellite Symposium – convened by Edmund Chiong and Declan Murphy – focused on five of the top issues arising from APCCC 2017: • m  anagement of castration-sensitive/naive prostate cancer • m  anagement of castration-resistant prostate cancer (CRPC): sequencing/combination treatment for mCRPC • m  anagement of high risk and locally advanced prostate cancer

We know that the diversity of health systems, available technologies, and differences in genetics, environment, lifestyle and culture all have a significant impact on how the disease is managed in the APAC region. Bringing together key opinion leaders allowed us to discuss these topics and their implications for practice. Edmund Chiong

• oligometastatic and oligo-progressive prostate cancer • g  lobal access to prostate cancer drugs and treatment in countries with limited resources. The meeting generated significant engagement from the invited experts, with an almost 100% acceptance rate, including a video conference presentation by Makarand Khochikar from India. All panellists undertook substantial pre-work with most collaborating on their self-nominated issue across time zones before meeting in Melbourne. A dynamic discussion led by Malaysia’s Teng Ong set the scene for what would be a day of active participation


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from a highly engaged group committed to ongoing discussion and collaboration across the region. A key theme was the impact that cost and access to contemporary treatments and technologies has on therapeutic decision making in the APAC region. While developments in technologies and treatments present new opportunities for the diagnosis and treatment of advanced prostate cancer, it was noted that differences in genetics and epidemiology affect the sideeffect profiles of some drugs and influence prescribing. Underpinning the discussions were strong themes reflecting contemporary cancer care including the critical importance of a multidisciplinary team-based approach to treatment planning




and care, delivery of best-practice care by clinicians with appropriate expertise, and the importance of patient information and support for informed patient choice. Presentations by Australia’s Susan Evans and Japan’s Akaza Hideyuki also highlighted the value of clinical registries as a mechanism to provide real world information on patterns of care as well as comparisons of clinical and patient-reported outcomes. The initial APAC APCCC symposium findings were presented by Edmund Chiong at the USANZ Annual Scientific Meeting in Melbourne from 24-27 February. A subsequent paper will also be submitted for publication. Chair Ian Davis said ANZUP was delighted to have had the opportunity to host the symposium: “It is vital for our shared research to consider real world issues and we will continue to build on the strong foundation and commitment to collaboration established by this group.”


“Thank you very much for the wonderful experience. It was enlightening to be at the meeting with the authorities on prostate cancer in the Asia Pacific.” Dr Jason Letran (Philippines) “… It was a great pleasure to be part of the experience.” Prof Levent Türkeri (Turkey) “…I learnt a lot from the meeting and look forward to further collaboration in future.” Prof Anthony Ng (Hong Kong) “The APAC APCCC was really meaningful and gave us a future insight of the way to go. Hopefully, the symposium will be done again based on the APAC’s own evidence …” Prof Akaza Hideyuki (Japan) “It really is my honour and pleasure having had the chance to talk with you in the meeting, which was very insightful and fruitful.” Prof Yeong-Shiau Pu (Taiwan) “… It was very rewarding to be part of an amazing day meeting many experts in the field and sharing our experiences.” Kath Schubach (Australia) “… It was fascinating to hear the challenges everyone is facing in their own environments and how that has shaped their treatment pathways.” Dr Nick Buchan (New Zealand)

ANZUP gratefully acknowledges sponsors Astellas, AstraZeneca, Ipsen, Janssen and Tolmar for making the APAC APCCC 2018 meeting possible. “Thank you very much for the



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$79k+ RAISED

Four seasons in one day The inaugural Melbourne Pedalthon on Sunday 18 March was a huge success with more than 30 teams pumping out 2,120 laps (or 6,572 km) and pushing the fundraising total to more than $75,000* by day’s end! They say Melbourne has four seasons in one day and it was certainly true as the Pedalthon unfolded at Sandown Racecourse. Riders were battered by wind, rain and the odd clap of thunder before the moody grey sky cleared to cloudless blue as the youngest riders took to the track for the first ever family challenge. The weather gods allowed just enough time for the families to enjoy a few laps and nine of the best to line up for the intense two-lap sprint challenge before the dark clouds and gusting winds returned forcing the awards presentation into the garages. Despite the unbelievable conditions, almost all the riders pedalled for the full three hours, showing their grit and tenacity in defeating below the belt cancers. The spirit of the day was summed up by race director Kent Williams who said the riders are so connected with the cause “they will just keep going whatever the weather”. Thank you to every rider and volunteer who joined us out at Sandown Racecourse. Our thanks also go to the Melbourne Racing Club Foundation for their generous support in giving ANZUP the opportunity to take the 10 | ANZUP UPdate Autumn 2018

Pedalthon to Victoria and to sponsors Bristol-Myers Squibb and Lendlease. ANZUP is also very grateful to Melbourne Ambassador Jonathan Cantwell, for his energy, passion and support for the cause. And finally, we were delighted to see so many members getting behind the Pedalthon by signing up teams, making donations, promoting the event and pulling on the Lycra themselves. Special thanks to David Pook and Jeremy Shapiro for initiating the idea to take the Pedalthon to Melbourne and to Andrew Weickhardt and Ben Tran for sharing important updates about where the funds go. All four were in the saddle on the day, with Ben bringing along a rickshaw to increase his degree of cycling difficulty. Our CAP Chair Belinda Jago also played a massive role helping with the event set up and signing up four ‘Bec’s Troops’ teams of family and friends – with ‘The MAMs’ raising more than $6,000! *Fundraising total stands at $79,004 at the time of publication.



RESULTS & PHOTOS Full results and the Pedalthon photo album can be found on the Below the Belt Facebook page. Please like and tag yourself in the album and send any photos from the day to pedalthon@anzup.org.au so they can be added.

“Thank you for putting on such an incredible day. Yes sure, Melbourne was in all its glory today... but other than that it was a truly great event filled with lots of wonderful people and what I found most, an overall sense of happiness and warmth.” Luke Farrugia


2,120 LAPS

6,572 KMS

“So many folks are saying they are keen for next year – especially those who bought bikes just for the day. We will be there – and all proudly flying the “official” prostate committee flag that was unveiled today. Eloise is super excited to talk about the event at school tomorrow and says she wants to sleep in her ANZUP cap and shirt! She probably will now she has grabbed an iPad, typed in “ANZUP” and found the Twitter feed with a photo of us in it. She is stoked that is on the “news”, so we will go with that…” Scott Williams, Prostate Subcommittee Chair “I love working in health care, I love spending time with my family and I love riding my bike. Today I got to do all three.” Simon Higgins, Bristol-Myers Squibb “I’m extremely proud and honoured to be the ambassador for the Below the Belt Pedalthon... With over 100 riders all tackling the brutal wind and rain it was amazing to see everyone stick together and get through as a united team… Congrats again to everyone who participated and let’s make next year even bigger.” Jonathan Cantwell, ex-Tour de France cyclist

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$50k Call for applications Thanks to the money raised by the Below the Belt Pedalthon (see page 10), the Below the Belt Research Fund is able to provide support to ANZUP members in the development of investigator-initiated studies. Grants of up to $50,000 are available for successful applicants. In 2017, much needed seed funding was provided to assist seven ANZUP members in progressing new trial




ideas to the point of becoming full scale studies. Find out more about the work our members are doing on our website under Grants & Awards > BTB Research Fund (http://www.anzup.org.au/content. aspx?page=btbresearchfund). 2018 Below the Belt Research Fund grant applications are now open. Eligible research projects may include pilot studies, translational research that may lead to an ANZUP project or form part of an existing project,

innovative sub-studies, and seed funding to start a high priority ANZUP study that has a high likelihood of receiving ongoing funding from another source. For full details about eligible projects, assessment and notifications visit the ANZUP website (http:// www.anzup.org.au/content. aspx?page=btbresearchfund applications). Submissions close COB 18 May 2018.

ANZUP Astellas Young Investigator Award The Astellas Young Investigator of the Year Award recognises an outstanding early career researcher in prostate cancer clinical trials research with up to $10,000 to support his/her attendance at an international GU meeting and the ANZUP ASM. Applications close Friday 1 June.

ANZUP Trial Coordinator Scholarships ANZUP encourages and supports study coordinators working on ANZUP trials to attend the 2018 ASM by providing a full conference registration. To be considered eligible for a scholarship you must be an ANZUP member. Visit www.anzup.org.au to join ANZUP. Log in to the Grants & Awards page for application details. Applications close Friday 4 May.

ANZUP/AstraZeneca Travel Fellowships Travel fellowships are open to members who have had an abstract accepted for either an oral or poster presentation at the 2018 ASM. Fellowships will be awarded up to the value of $800 for travel expenses incurred to attend the ASM in July. Applications close Friday 4 May.

ANZUP Tolmar Fellowship


Tolmar Australia and ANZUP are again partnering to support the Uro-Oncology Clinical Research Fellowship (CRF) valued at $60,000. The Tolmar ANZUP CRF supports an early/mid-career clinician or researcher of any health care discipline. Applications close 1 June with the Tolmar Fellow announced at the 2018 ANZUP ASM.

For more information see the ANZUP website under Grants & Awards > Awards & Fellowships (http://www.anzup.org.au/content.aspx?page=awardsandfellowships). 12 | ANZUP UPdate Autumn 2018

UPDATES FROM SAC & SUBCOMMITTEES Scientific Advisory Committee (SAC) Scientific Advisory Committee The ANZUP Scientific Advisory Committee (SAC) met by teleconference in November and again in March. The SAC comprises members of various professional groups appointed by the Board on the recommendation of their groups. This ensures a diversity of opinion and expertise and allows us to continue to think broadly whenever new ideas come up. The SAC held a strategic planning day late in 2016 and came up with several new ideas for how it should operate and facilitate the various scientific processes of ANZUP. Some of these changes are reflected in the agenda, where the SAC now concentrates less on reports about active trials and spends more time on higher level strategic issues and new trial proposals coming from the membership and committees. The SAC plans to hold another strategic planning day just prior to the 2018 ASM and will consider the new strategic plan and what the implications of that will be for our scientific direction.

Subcommittee news The chairs of the subcommittees are also members of the SAC. Peter Grimison has been a stalwart for ANZUP for many years, most recently as chair of the Germ Cell subcommittee. Peter has now stepped back from this role but has led the committee with distinction and great effectiveness during his tenure. Several germ cell cancer initiatives remain active or in various stages of planning. Thanks Peter for all your fantastic work in this role and we look forward to continuing to work with you as your circumstances change in the near future. The Board is pleased to confirm the appointment of the previous deputy chair of the committee, Ben Tran, as the new chair, and we welcome Ben onto the SAC in this role. Carmel Pezaro has been deputy chair of the prostate subcommittee for several years and also has now stepped down from this position. Thanks also to Carmel

for her work in that role and the many other areas of ANZUP’s activities where she has stamped her unique and wonderfully constructive signature. All of this means that we are now looking for new deputy chairs for the Germ Cell and Prostate subcommittees. Perhaps it’s time for you to take on one of these roles or otherwise become more active in the committee’s functions?

Below the Belt Research Fund The SAC also sees the benefits unfolding of the Below the Belt Research Fund, where money raised through the Pedalthon is reinvested to support new research projects which aim to lead to future ANZUP trials. Members of the SAC are involved in review and selection of the Research Fund applications, and also provide input into development of the projects, often providing mentorship to junior researchers. This is a great initiative that has already borne fruit and will ensure a steady stream of new ideas while also supporting the next generation of researchers in genitourinary cancers.

Thank you Thanks to all of our SAC members, and to all of you who contribute to the scientific work of ANZUP by participating in the subcommittee activities, the Concept Development Workshops, the Research Fund, and the support and mentorship provided to everyone – not only the young or new ones! We welcome everybody to participate in these processes at whatever level you feel appropriate for you. IAN DAVIS Chair, ANZUP Scientific Advisory Committee ANZUP UPdate Autumn 2018 | 13

Bladder Cancer

Germ Cell

Recent news 1. BCG MM (BCG vs BCG alternating with Mitomycin for high-risk non-muscle invasive bladder cancer) has completed Stage 1 recruitment (130 participants) – and in fact has now recruited a further 25 of the planned 370 Stage 2 participants. Results from Stage 1 of the trial are expected to be available in early 2019. Funding applications have been submitted to help continue the accrual and follow-up over the next 5 years. 2. PCR-MIB (Pembroluzimab with chemo-radiotherapy for muscle-invasive bladder cancer) has accrued 4 of a planned 30 participants. The trial is now open at 4 centres. Referral of suitable and interested patients is being sought. 3. ACCEPT cystectomy database: continues to accrue data from Fiona Stanley Hospital in WA, with ethics and governance being finalised at a number of other sites. This project is funded by a Below the Belt Research Fund grant. 4. NMIBC-SI (Non-muscle invasive bladder cancer symptom index) is nearing completion of Field test 1, after which the questionnaire will be refined in preparation for moving into Field test 2.

Coming up The Bladder Concept Development Workshop will be held at the Pullman, Sydney Airport, Mascot, on Friday 20 April. Although the deadline for concept submission has passed, all interested bladder cancer researchers are invited to attend even without a specific concept. SHOMIK SENGUPTA Deputy Chair, Bladder Cancer Subcommittee

Recent news 1. P3BEP trial, comparing accelerated BEP to standard BEP in intermediate/poor prognosis germ cell tumour patients, has opened at sites outside of Australia – recruitment still going strong. Funding applications have been submitted to complete Stage 2. 2. ANZUP contributed data to IGCCCG 2.0 – update of prognostication in metastatic germ cell tumour patients. 3. e-TC, an eHealth intervention for testicular cancer survivors led by Ben Smith and Louise Heniger, continues to recruit patients with significant anxiety and/or depression. So far we have 33/40 participants signed up to e-TC.

Coming up 1. TIGER, pivotal study in refractory germ cell tumour patients comparing TIP (standard of care) versus TICE (high dose chemo and stem cell transplant), is likely to open in Australia in 2018. 2. iTestis will begin to collect Real World Data from Australian patients with germ cell tumours in early 2018. This project is funded by a Below the Belt Research Fund grant. 3. ANZUP continues to play pivotal roles in Movember Global Action Plan projects in germ cell tumours, with key sites contributing to the detection of a biomarker of platinum refractory patients, and in developing a useful tool for patients to support acute anxiety associated with diagnosis and/or recurrence. Ongoing discussion at the Concept Development Workshop on Monday 30 April will centre on how ANZUP can make meaningful contributions to the data around detection and treatment of subclinical hypogonadism in germ cell tumour survivors and how that might impact their short-, medium- and long-term outcomes. BEN TRAN Deputy Chair, Germ Cell Subcommittee

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Renal Cell

Prostate Cancer

Recent news 1. UNISoN nonclear cell RCC trial open and recruiting strongly. 2. KEYPAD clear cell RCC trial open with recruitment currently at 3 patients. 3. Several new collaborations with pharmaceutical companies, some of whom have not worked with ANZUP before.

Coming up 1. Trials are being developed for patients who progress on UNISoN. 2. Trials are being developed to replace UNISoN when it completes recruitment. It is a very exciting time in the management of kidney cancer as multiple combinations of agents are entering clinical trials simultaneously with the expectation being that management of this disease will be completely transformed within the next few years. At the Concept Development Workshop on 11 April, three concepts were presented in non-clear cell renal cell carcinoma. This is a huge area of need in Australia and New Zealand as we have no funded treatment options for one in five patients with kidney cancer. We are actively looking for more concepts, especially in the surgical and radiotherapy space. The workshop will be a supportive place to share ideas and get advice on turning ideas into clinical trials. DAVID POOK Deputy Chair, RCC Subcommittee

Recent news 1. ENZARAD has now recruited over 770 men to the study. This suggests full accrual by midyear which is a fantastic success due to a highly collaborative international team, following on the success of ENZAMET. It is important to keep the momentum going with this collaborative network and discussions about follow-up studies. The ENZA International Trials Steering Committee was held prior to ASCO GU with ANZUP well represented. 2. The ENZAMET and ENZARAD studies are continuing to generate considerable global interest – both in anticipated results but also in concepts for use of the considerable bioresource associated with the studies now. 3. TheraP has randomised 7 patients. Four sites (Peter MacCallum, royal Brisban and Women’s Hospital, St Vincent’s Hospital and Moorabin of Monash Health) and hopefully more soon. 4. ANZUP is leading the health economic substudy of the ICECaP initiative together with Richard De Abreu Lourenço and a team of economists and clinicians. Work is expected to start soon. 5. PainFree TRUS B is now recruiting well now (thanks New Zealand!) and proPSMA (co-badged with ARTnet and ANZUP) is accruing very well. Thank you to everyone who has contributed to these significant achievements.

Coming up 1. Recruitment is expected to end for ENZARAD soon, with the trial moving into the follow up phase. 2. The Prostate Concept Development Workshop has gone from strength to strength. It is a great day of ideas and interaction and is open to all – we are multidisciplinary at heart, and I particularly encourage surgeons and rad oncs to submit ideas for our localised disease discussion session. Regardless of what stage of your career you’re in, everyone has a valuable contribution to make. If you feel you don’t have the time or skills to fully populate the concept form, please send in what you can by articulating the concept or clinical scenario where there is a need to fill a knowledge gap and we are very happy to work it up from there. The CDW will be held on Tuesday 15 May with concept submissions closing on 24 April. SCOTT WILLIAMS Chair, Prostate Cancer Subcommittee

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Translational Research Recent news 1. Translational Research Subcommittee has generated a ‘timeline’ for short-term and long-term grant proposals using biological specimens collected from ENZAMET and ENZARAD. The first targeted grant submission is the PCF Challenge Award in late April and will focus on the molecular and genomic landscape of metastatic hormone-sensitive prostate cancer.

Coming up 1. The Translational Research Symposium at the 2018 ANZUP ASM will feature talks from Monty Pal and a fantastic line up of local speakers. This was a major success last year and we think this year’s program is going to be even better. 2. Grant submissions in 2018 and 2019 will centre on biological specimens collected for ENZAMET and ENZARAD.

2. Efforts are ongoing to finalise and implement translational research studies for KEYPAD and UNISoN.

3. The Translational Research Subcommittee will be represented at this year’s Concept Development Workshops and are keen to offer input/advice/ suggestions.

3. Specimen collection is ongoing for recruiting ANZUPled trials including but not limited to ENZARAD, P3BEP, BCGMM, PCR-MIB and TheraP.

I would like to thank, once again, my Deputy Chair Anthony Joshua, the CTC especially Martin Stockler and Sonia Yip and the ANZUP team led by Marg McJannett. ARUN AZAD Chair, Translational Research Subcommittee

Consumer Advisory Panel (CAP) Recent news It was great to see a number of CAP members out in force supporting the inaugural Melbourne Pedalthon. Well done to Colin O’Brien and his team the Roderick Insurance CAP All Stars who rode 130 laps (or 403 km) and raised more than $3,000 for the Below the Belt Research Fund. While fundraising is not part of the CAP’s remit, it is great to be able to support the Pedalthon and contribute to the growth of ANZUP’s research portfolio to help improve outcomes for cancer patients and their families.

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Coming up The CAP had its first meeting for the year in late March and worked through an interesting agenda. We are also looking forward to being part of the upcoming disease specific Concept Development Workshops and the 10th anniversary ASM in July. Work on the clinical trials awareness and engagement video campaign continues with the CAP actively involved in its development. The CAP really enjoys being able to support ANZUP’s research from a consumer point of view. BELINDA JAGO Chair, Consumer Advisory Panel

Quality of Life and Supportive Care Delivering personalised and evidence-based exercise support to men with metastatic prostate cancer via the internet - A pilot RCT examining intervention impact on behaviour change and quality of life The project is progressing well. The exercise videos have been recorded and decision rules regarding who should receive what exercise demonstrations have been drafted. These components are now with the computer programmer for testing. To inform the behaviour change content we have conducted 19 qualitative interviews with men with metastatic prostate cancer, and this is helping us to ensure the content we upload considers men’s needs and preferences. We’ve recruited an experienced exercise physiologist, Holly Evans, to work on the project as part of her PhD. Holly will be running a supervised test of the intervention with some of the participants from the qualitative interviews before we commence the RCT. This will allow us to ensure that the intervention is running as intended and is safe. For more information please

BTB Research Fund in action Exercise medicine prior to open radical cystectomy: Feasibility and preliminary efficacy By Dennis Taaffe Study aim: To improve the functional status of patients prior to cystectomy and improve patient outcomes following surgery. Study amendment: Due to the increased use of neoadjuvant chemotherapy in clinical practice, patients undergoing chemotherapy prior to cystectomy will also be eligible to be admitted to the trial. As a result, for those undergoing cystectomy only, up to a 4-week supervised exercise program (based on scheduling for surgery) will be implemented. For those undergoing chemotherapy prior

contact the lead researcher Camille Short on camille.short@adelaide.edu.au.

Supportive care intervention for advanced prostate cancer The manuscript describing men’s key concerns and preferences for care has been published in BMJ Open (Chambers SK, Hyde M, Laurie K, Legg M, Frydenberg M, Davis ID, Lowe A, Dunn J. (2018) The experiences of Australian men diagnosed with advanced prostate cancer: a qualitative study. BMJ Open. doi: 10.1136/ bmjopen-2017-019917). In further progress of this project, an intervention frame work has been developed (ProsCare) which has been presented to focus groups of prostate cancer specialist nurses from across Australia and regional nurses in south west regional Queensland and has been identified as adaptable and simple to implement while also meeting the needs of men with advanced prostate cancer and providing clinicians treating these men with a model for support during their treatment. Contact for this project is Suzanne Chambers at suzanne.chambers@griffith.edu.au. SUZANNE CHAMBERS Chair, Quality of Life and Supportive Care Subcommittee

to surgery, the exercise program will be for the duration of chemotherapy which is usually up to 12 weeks. Given the longer duration of exercise for those undergoing neoadjuvant chemotherapy, we anticipate better outcomes in this patient group for all of the outcome measures. Progress to date: Staffing: Study coordinator Cailyn Rogers and two accredited exercise physiologists from the Exercise Medicine Research Institute at Edith Cowan University have been assigned to the trial to undertake the exercise training and testing sessions. Ethics approval and governance: Edith Cowan University and Fiona Stanley Hospital ethics have been approved. Ethics and governance has also been submitted to St John of God Murdoch Hospital. Once governance has been approved at the respective hospitals, we will start recruiting patients into the trial (subject to patients presenting to the study’s two urologists).

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2018 MEMBER SURVEY A big thank you to everyone who completed our 2018 membership survey. Member surveys play a critical part in helping us better understand and improve the way we support you in your research endeavours.












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A little below the belt











just to be additive, with regard to the individual benefit of each drug, but synergistic.

With global debates more complex than ever, the American Society of Clinical Oncology (ASCO) genitourinary meeting held in February focused mostly on shaking up the sequencing of treatments and trying to shed light on what patient groups are most likely to benefit.

The treatment of prostate cancer has become an equal minefield with respect to sequencing of treatments, with more powerful agents vying for their place earlier and earlier in the disease course. It has been well established that the addition of chemotherapy or androgen receptor targeted therapies (such as abiraterone) to androgen deprivation at the time of diagnosis, for the majority of men with overt metastatic disease, improves time to progression, quality of life and overall survival. A more difficult question has been whether men with non-metastatic (or M0) castrate resistant disease would benefit from the addition of an androgen receptor targeted therapy early compared with the current standard of initiating treatment when there is clear evidence of disease progression / measurable disease.

The last couple of years have seen a tremendous increase in treatment options for clear cell kidney cancer. The METEOR study as second line treatment, demonstrated a significant improvement in disease control and overall survival with the use of cabozantonib. The CHECKMATE 025 study compared nivolumab (PD-1 inhibitor immunotherapy) to everolimus, with a small but significant proportion of patients deriving a durable or complete response with the use of immunotherapy. However, there is no consensus as to how we may best predict those that will respond over those patients that don’t. IMmotion 151 evaluated the role of first line combination immunotherapy (atezolizumab) with a VEGF inhibitor (avastin) in patients with ‘PD-1 positive’ clear cell renal cancer in comparison to sunitinib. The combination demonstrated significant improvements in progression free survival and response rates. It is too early to see how this translates to overall survival. Similar studies, using novel combinations of immunotherapy / VEGF doublets are under way and initial data is equally positive with acceptable side effect profiles. This approach appears not

Education and networking at USANZ The 71st USANZ Annual Scientific Meeting (ASM) in conjunction with the 23rd ASM of the Australian & New Zealand Urological Nurses Society was held in Melbourne from 24–27 February. Convenor Nathan Lawrentschuk and Scientific Program Director Declan Murphy characteristically put together a full and engaging program. The joint ANZUP session, which has become a regular highlight, featured an impressive array of international and local guests speaking on cutting-edge prostate cancer research. From Robert Nam’s exposition of salvage vs adjuvant radiation decision-making, to a range of presentations on precision medicine, pelvic node dissection and intra-ductal carcinoma, the session reached a climax with an entertaining and thought-provoking debate

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There is also a tidal wave of new targets and therapies in bladder cancer, including immunotherapy which is clearly changing prognosis for some patients with advanced disease. One area of neglect has been whether we can improve the outcome for patients with upper tract urothelial carcinomas who have undergone radical nephrouretectomy with curative intent. We have solid evidence to support the use of neo or adjuvant chemotherapy for bladder cancers, with modest but worthwhile reductions in relapse rates and improvement in overall survival. BY LAURENCE KRIEGER

between Monty Pal and Joseph Ischia as to who should be managing men with metastatic prostate cancer. The plenary session included a range of state-of-the-art presentations on genito-urinary oncology – again featuring hot topics in prostate cancer such as MRI and PSMA based imaging and post-treatment sexual rehabilitation. Initial findings from ANZUP’s recent Asia-Pacific Advanced Prostate Cancer Consensus Conference were also presented by Edmund Chiong (see page 8). Non-prostate topics included surgery for caval extension of renal cell carcinoma and neo-adjuvant chemotherapy for muscle invasive bladder cancer. Additionally there were numerous breakout sessions featuring exciting scientific presentations on GU cancers, often from trainees and fellows, as well as informative talks from invited guests. BY SHOMIK SENGUPTA
































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OTHER NEWS Hello and goodbye Welcome Simran and Nima In April, we welcomed Simran Chawla into the Clinical Trials Project Manager role. Simran has extensive experience in clinical research across the Asia Pacific with specific expertise in project management, resource planning, stakeholder management, process optimisation and business development. We were also pleased to be joined by Nima Amatya, who takes up the new role of Database and Administration Coordinator. Nima’s role includes maintenance, coordination and administration of ANZUP’s clinical trials, membership and donor / stakeholder databases. She brings broad experience in administrative processes and data management, including six years in a number of roles at the Mary MacKillop Foundation.

Farewell Anne We were sad to say goodbye to Clinical Trials Project Manager Anne Woollett in March. Anne joined ANZUP to support our expanding clinical trials portfolio and we thank her for her significant contribution over the past two years. Anne has helped us build and effectively manage our growing sponsor functions by setting up a number of robust and effective systems for internal trial management. We wish Anne all the best in her new ventures.

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A new chair for the Germ Cell Subcommittee and deputy chair call for expressions of interest In early 2018, our Germ Cell Subcommittee Chair, Peter Grimison made the decision to step down to allow, in his own words, “renewal and fresh ideas, as well as leadership opportunities for other ANZUP members”. In announcing his decision, Peter said it had been an honour to serve ANZUP in the role since December 2011. Peter remains an active and committed member of ANZUP, in particular as Study Chair of ANZUP’s P3 BEP and TIGER trials, and as an ongoing contributor to other current studies and planned concepts. We sincerely thank Peter for his commitment and contribution to ANZUP. Following a call for expressions of interest at the first Germ Cell Subcommittee meeting on 1 March, we are delighted to welcome new Chair Ben Tran. As Ben moves up from the deputy chair role, expressions of interest are now sought for this position.

Prostate Subcommittee deputy chair call for expressions of interest In October last year, Carmel Pezaro also announced her resignation as Deputy Chair of the Prostate Subcommittee. We are now calling for expressions of interest to fill the deputy chair position. We thank Carmel for her contribution, ideas and constructive input. While deputy, Carmel also took on the role of ASM Convenor, and was the driving force behind one of our best ASMs to date in Melbourne last year.

OUR THANKS Thank you to our 2018 Corporate Partners and Supporters We are very grateful for the infrastructure support we receive from Cancer Australia; however the funds are not sufficient to support ANZUP’s increasing research activities. In 2017/18 many of our events, grants and activities required significant help. Fortunately our Corporate Supporter program has continued to grow. For an extraordinary year of partnerships we thank Active Display Group, AFI Branding, The Saturday Paper and Bloke as well as our fantastic corporate partners:

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8-10 JULY 2018



Putting People First Program highlights include:

Our outstanding international faculty includes:

• Leading international and Australian experts

Tamim Niazi – Radiation Oncologist at the Jewish General Hospital, Montreal, Canada

• U  p-to-date management and research for prostate and other genitourinary cancers • PCFA ANZUP Nurses Symposium • Translational Research Symposium • Clinical trial Concept Development Workshop • Overviews of current and planned ANZUP trials • ANZUP MDT Masterclasses with expert panels • Community Engagement Forum: A little below the belt • Travel fellowships available for ANZUP members supported by AstraZeneca • Best of the Best Awards supported by Bristol-Myers Squibb


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Angie Smith – Assistant Professor of Urology at the UNC Department of Urology, North Carolina, US Laurence Albiges – Medical Oncologist and Head of Genitourinary Unit of the Department of Cancer Medicine, Gustave Roussy, France Bertrand Tombal – Chair of the Division of Urology and Professor of Urology at the Université Catholique de Louvain (UCL), Brussels, Belgium Chris Sweeney – Medical Oncologist at the Dana-Farber Cancer Institute, Boston, US Sumanta (Monty) Kumar Pal – Associate Clinical Professor, Department of Medical Oncology & Therapeutics Research, City of Hope, California, US


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ANZUP UPdate Newsletter Autumn 2018  

ANZUP UPdate Newsletter Autumn 2018  

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