Surgeon develops liquid biopsyto improve outcomes for paediatric oncology patients

Associate Professor Jonathan Karpelowsky, recipient of a John Loewenthal Project Grant, has developed a multi-modal liquid biopsy approach for the molecular monitoring of sarcomas. The method is less invasive than traditional tissue biopsies and offers the opportunity for the oncology team to monitor treatments and their impact on cancer cells in the bloodstream more closely.

A paediatric surgeon and Associate Professor at the University of Sydney, Associate Professor Karpelowsky is dedicated to improving the outcomes of children and adolescents with solid tumours. His main position is at The Children’s Hospital at Westmead, with appointments at Royal Prince Alfred Hospital and Westmead Private Hospital.

He and his team at the Advanced Molecular Diagnostics Laboratory within the Children’s Cancer Research Unit have used the grant to develop the liquid biopsy approach using similar technology to that used in the non-invasive prenatal genetic testing in pregnant women.

While a traditional biopsy would require an incision with the accompanying risks and side effects, Associate Professor Karpelowsky’s process means that the procedure is less invasive for children and testing can occur more often. The opportunity for repeated non-invasive testing offered by the liquid biopsy means that more accurate information is available to clinicians. This has the potential for the use of more adaptive, personalised treatments, and ultimately, a better outcome for patients.

The liquid biopsy allows researchers to study the DNA of cancer cells retrieved from the bloodstream to identify any changes that have occurred and determine the success of cancer treatments, such as chemotherapy and targeted therapy.

Associate Professor Karpelowsky said the grant had made it possible to progress this research, attract additional funding and to form international collaborations.

While further research into liquid biopsies for paediatric oncology patients is needed, the results to date have been extremely promising.

“I’m very grateful to the College for the wonderful opportunity the grant has given me,” Associate Professor Karpelowsky said. “It certainly has borne fruit and enabled me to move forward with this research in a really important way.”

Associate Professor Karpelowsky’s history in medicine spans continents. The beginnings of his interest in the field can be traced to his childhood in South Africa, when he lost an 11-year-old friend to bone cancer.

He originally started training in thoracic surgery before undertaking both his adult and paediatric specialist surgical training, which he completed in 2006. He then achieved his PhD at the University of Cape Town.

He is passionate about educating the surgeons of the future and is the current immediate past chair of the Board of Paediatric Surgery, which supervises paediatric surgical training across Australia and Aotearoa New Zealand. As Associate Professor at the University of Sydney, he regularly tutors undergraduate and postgraduate students towards higher degrees.

Associate Professor Karpelowsky has served and currently serves on a number of committees, including the Sydney Children’s Network Human Research Ethics Committee and the Australasian Association of Paediatric Surgery Executive Committee. He has led working parties for the Section of Academic Surgery into research requirements for the Royal Australasian College of Surgeons. He is currently on the section of Academic Surgery Executive Committee and the convener of the annual Developing a Career in Academic Surgery (DCAS) course.

Alongside his interest in the use of liquid biopsies in the molecular monitoring of sarcomas, Associate Professor Karpelowsky’s areas of research include long term follow-up in thoracic conditions of childhood, augmented intraoperative reality for cancer surgery navigation and randomised trials in childhood surgical conditions.

His paediatric surgical clinical interests focus on paediatric surgical oncology and minimally invasive surgery for thoracic conditions of childhood.

Associate Professor Karpelowsky said that since arriving in Australia, he has been impressed by the care and training available through its health service.

“Australia has an enormous amount to be proud of with its freely available clinical care and training opportunities. I thoroughly enjoying working as a surgeon here.”

However, the ability of surgeons to access protected time to pursue research can be more challenging due to the paucity of paid academic positions. He sees the College as having a crucial role to play in ensuring that surgeons are able to carry out vital, lifesaving research and to collaborate with international researchers by awarding grants like the one he received.