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Simple cancer tests potential lifeline for Pacific patients

A simpler means of cancer diagnosis and monitoring, using small fragments of tumour DNA circulating in the bloodstream, could be a lifeline for Pacific patients in particular.

Dr Dianne Sika-Paotonu, Associate Dean (Pacific) at the University of Otago, Wellington, has just been awarded a Pacific Health Research Career Development Award by the Health Research Council of New Zealand (HRC).

With her $195,162 Sir Thomas Davis Te Patu Kite Rangi Ariki Fellowship, she will investigate the potential use of a simple blood test to identify circulating tumour DNA (ctDNA) for the purpose of detecting cancer at an earlier stage.

Circulating tumour DNA (ctDNA) refers to small fragments of tumour DNA found in the blood circulation, recognised by the presence of mutations in cancer genes.

Work in New Zealand led by Professor Parry Guilford, and supported by the Healthier Lives National Science Challenge, has demonstrated that these DNA fragments can be isolated and quantified to obtain information about a cancer's size and progression – so they can tell us how a tumour is behaving.

Dr Sika-Paotonu says there are also indications that ctDNA technology could be extended to develop a simple blood test to detect cancer, which does not require a hospital visit. This will enhance the precision of cancer diagnostics and surveillance, and lead to improved health outcomes for Pacific people by allowing earlier diagnosis and treatment.

Tumours are usually picked up using biopsies, but Dr Sika-Paotonu says this can be a significant barrier to care in Pacific countries where access to healthcare is limited and the cancer burden is growing.

"Sometimes it’s not that easy to get to a tumour and take a biopsy. Most biopsies will require some level of surgical intervention, so that compared to a blood test is a very striking difference,” she says.

"Instead of using ctDNA technology to only monitor treatment progress, we're trying to target the beginning stages and detect cancer at a much earlier time-point when it is more likely to be treated successfully."

While development work in this area is still required, Dr Sika-Paotonu will explore the applicability of this potential technology in resource-constrained environments.

Diagnostic methods are difficult to access in the Pacific region and treatment options are limited and expensive, she says. Often cancer is picked up late and palliative care becomes the only remaining option for many people.

Dr Sika-Paotonu will engage with Pacific health professionals, practitioners and Pacific participants within New Zealand, Tonga, Samoa and the Cook Islands. “In addition to this research work being Pacific-led, it is absolutely essential that Pacific voices and perspectives are represented and included in a way that will help guide the direction of this work moving forward.”

She adds that the career development award is part of fulfilling a promise she made as a child. "When I was little I promised my mother I was going to cure cancer – and of course she keeps reminding me of my promise, so I’ve always gravitated towards cancer research.”

The HRC has supported Dr Sika-Paotonu on a number of research projects to date, where she’s developed her strengths and commitment to reducing health inequities.

The HRC’s manager of Pacific Research Investment, Tolotea Lanumata, says it’s important to support biomedical researchers who explore problems and solutions in partnership with those they’re trying to help.

“Dianne’s approach on this project is to understand the perspectives and experiences of Pacific people with cancer, in order to ensure that any new diagnostic method will not only be clinically relevant but also address barriers to care that Pacific people currently face.”

The HRC today announced 22 Pacific Career Development Awards worth $1,548,043. See below for the full list of recipients – lay summaries will be available on the HRC website on Tuesday 20 November. Visit www.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Pacific Health Research’ and ‘2019’.
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2019 HRC Pacific Health Research Career Development Awards
Sir Thomas Davis Te Patu Kite Rangi Ariki Fellowship

Dr Apo Aporosa, University of Waikato
Improving road safety and health: understanding kava’s impact on driver fitness
30 months, $278,018

Dr Dianne Sika-Paotonu, University of Otago
The applicability of ctDNA as a diagnostic tool for early cancer detection
24 months, $195,162

Pacific Clinical Research Training Fellowship

Ms Soana Muimuiheata, Auckland University of Technology
Food and diabetes: the underlying factors that determine food practices of Tongan people
24 months, $222,433

Dr Malama Tafunai, University of Otago
Prevalence of Chronic Kidney Disease in Samoan residents in New Zealand and Samoa
36 months, $320,000

Pacific Health Research PhD Scholarship

Ms Heimata Herman, The University of Auckland
Health-related policies in schools in the Cook Islands
36 months, $129,200

Mrs Amio Ikihele, The University of Auckland
An mHealth approach: Reducing CVD risk among Pacific people living in NZ
36 months, $128,600

Miss Alvina Pauuvale, The University of Auckland
Mobilising adolescents to drive health improvements in the Glen Innes community
36 months, $129,201

Mr Chris Puliuvea, The University of Auckland
Enhancement of T cells for use in adoptive immunotherapy protocols
36 months, $21,650

Pacific Health Research Masters Scholarship

Ms Tumanu Futi, University of Otago
Is elevated cardiac fibrosis in Pacific patients associated with reduced klotho?
12 months, $32,535

Mrs Amy Henry, University of Otago
Staying at home: A qualitative descriptive study on Pacific palliative care
12 months, $31,244

Pacific Knowledge Translation Grant

Mrs Amio Ikihele, Moana Research
Sexting and NZ-born Niuean adolescent females
6 months, $5,000

Pacific Health Research Summer Studentship

Miss Toni Anitelea, University of Otago
The immunogenetics of Rheumatic Fever and rheumatic heart disease
3 months, $5,000

Mr Adam Faatoese, University of Otago
The applicability of ctDNA as a tool for early cancer detection
3 months, $5,000

Ms Bridie Laing, University of Otago
What are the reformulation preferences of children and young people receiving regular BPG injections?
3 months, $5,000

Miss Meleseini Manukia, The University of Auckland
Vitamin and mineral supplements among Pacific People
3 months, $5,000

Miss Leueta Mulipola, The University of Auckland
Redefining the social construct of depression through Samoan views
3 months, $5,000

Miss Oprah Pupi, University of Otago
The anti-cancer properties of traditional remedies
3 months, $5,000

Mrs Miriam Sundborn, Auckland University of Technology
Can health promotion programmes in schools reduce dental caries
3 months, $5,000

Miss Fuakava Tanginoa, University of Otago
Kids’Cam
3 months, $5,000

Mr Fati Tapu, Massey University
Compilation of Pacific Social Work Resource
3 months, $5,000

Mr Jordan Taylor, University of Otago
Longitudinal quantification of unique Escherichia coli strains
3 months, $5,000

Miss Machaela Tepai, The University of Auckland
Systematic review and clinical audit on non-communicable diseases in Rarotonga
3 months, $5,000

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