In a major milestone for Australian cancer patients, the not-for-profit, member-based organisation, Cancer Trials Australia (CTA), has recently marked the recruitment of the 10,000th oncology patient to clinical trials managed on behalf of their strong Member network of hospitals across the country.

These trials offer access to novel, potentially life-saving therapies, and due to the strength of the Network behind them, have been successfully attracted to Australia on the competitive global stage for the benefit of Australian patients.

Professor Mark Rosenthal, former CEO and former Chairperson of CTA, says Australia’s highly competitive cancer research capabilities are thanks to the tenacity and generosity of a small group of researchers that came together in the early 1990s: “We were a small academic group that was, in retrospect, extraordinary,” he says.

Becoming an incorporated entity some 17 years ago has brought with it many changes, but it has not fundamentally changed the intent or culture of CTA as an organisation.

“We were firmly not-for-profit from the outset and we have always been member-based so we’ve grown an incredibly powerful network out of the desire to connect clinicians with similar interests and skills for the common good,” says Professor Rosenthal. “In many ways we were the birthplace of many experimental cancer treatments and we remain a great advocate for patients and cancer treatment. We created this organisation for the love and respect of clinical trials, because we recognised there was a need to collaborate to improve outcomes for patients,” says Professor Rosenthal.

With more than 1,000 commercially sponsored clinical trials under their belt, CTA’s Members have earned an enviable reputation as global leaders in the field. Their clinicians have become highly sought-after advisors for biotechnology and pharmaceutical companies, seeking to design effective trials, ensuring effective treatments are available faster.

“A spectrum of highly trained professionals is really what allows us to do the work that we do. The fact that hospitals now have research fellows embedded within them, and that these people can see first-hand how research is done — that helps to build our local capability and ultimately directly benefits patients,” says Professor Andrew Scott, current Chair of CTA, who has been involved in the organisation since its inception.

“During trials, a lot of time is spent doing things that are not related at all to the research itself, from budgeting, contracts, ethical frameworks and financial management. The CTA team has always taken this incredible administrative burden away from the researchers, allowing them to focus on what they do best,” says Professor Rosenthal.

“From a researcher’s perspective, to know CTA provides a pathway for rapid translation of discoveries to the market is something we can all be proud of. Through its professional and driven support of this industry, CTA allows the discoveries of Australian researchers to be studied here and not just disappear overseas,” says Professor Scott.

Professor Rosenthal agrees: “Thirty years ago, no one had the expertise here in Australia that was needed to take molecules from bench to bedside, with all the associated concept and protocol development. Now, in collaboration with biotech companies both in Australia and all over the world, we have 600 trials currently open across CTA Members, and some 40% of these are early phase or first-time-in-human trials; they are the great grandchildren of CTA, that are only possible because of the work that went before them,” says Professor Rosenthal.

One of the greatest strengths of the CTA model has been its ability to consistently make the set-up of Phase 1 oncology trials fast and efficient. The strengthening of this capability, and its application to more than the oncology field of medicine is part of the future direction of the organisation.

“Here in Australia we have many advantages. Of course there are organisations that undertake similar work overseas, but CTA is able to bring new trials rapidly into the clinic thanks to our extensive expertise, highly professional staff, and the strength of the network we’ve built across our hospitals,” says Professor Scott.

“One of the most important outcomes of our work is that it has also created a generation of highly qualified clinical nurses and data managers, who engage directly with patients and underpin the quality of our clinical research,” says Professor Scott.

Associate Professor Jayesh Desai, Chair of CTA’s Phase 1 trial group, agrees, saying the generosity of CTA’s network of researchers and clinical staff has always been a key element of its success. “Our network is really collegiate. We have all benefited from having something that goes beyond us as individuals alone. It’s highly specialised work and it requires immense skill and support.”

“When we work with biotech and pharma, the value they get from working with us instead of going somewhere else is that we are already part of a strong network, so we get along well, we respect each other, and we enjoy working together. There is a lot of value-add that stems from that, because we are in constant communication. The strength of our collaboration helps us compete with massive cancer centres in Boston or New York,” says Desai.

“The fact that we have managed to build this infrastructure has allowed us to benefit in a way that is way beyond what we could have achieved as individuals.  Our people are fantastic and have incredible skills and knowledge, but they are also generous. The culture rewards people that are generous in that way. You’re not on your own as an expert and that ultimately means you’re a better doctor.”

For patients, CTA’s network and the trials themselves have offered enormous benefits.

“When patients join a trial, their care is absolutely first class. Many patients have an altruistic element to their participation in a trial. They figure that even if it may not help them directly, it might help someone else. So, that sense of purpose can be a real positive during treatment,” says Professor Rosenthal.

“However, our approach has always been to genuinely look to improve the outcomes for every trial participant. We recruit patients into trials that we genuinely have reason to believe will help them, so the culture and approach of our work is quite unique,” says Professor Rosenthal.

Desai explains too that the way trials are run is critical to ensuring good patient outcomes: “We are able to initiate trials efficiently and the patient opportunities this has provided are enormous. Navigating the health system is tough, but in a trial, you have a whole medical team around you. It provides an incredible support structure.”

“Trials can be transformative for patients and their families, but they have also helped to build and make my career, so that I can give back. I look after my patients better because of the access to knowledge that I’ve had,” says Desai.

Broadening access to treatments remains a key focus for Cancer Trials Australia.

“One of our key achievements has been to improve access to new treatments for Australian cancer patients. Experimental treatments are now available at any time during the patient’s journey. They don’t have to miss out because they don’t live in Melbourne, or because of financial constraints,” says Professor Rosenthal.

“Designing trials requires a seamless, intimate interaction between scientists, clinicians, companies and many others to plan the best way to deliver the trial. It’s a complex process that we have mentored many people through. We have also ensured inclusion of rural and regional sites in studies now and telehealth has enabled new reach for our work,” says Professor Scott.

The future for CTA’s work looks bright.

“Earlier this year we added our first international member, the Auckland City Hospital in New Zealand, so our work is now making impacts beyond Australia,” says CTA’s Chief Executive Officer, Dr Kurt Lackovic.

“Over recent years we have also expanded our support beyond oncology, ensuring a consistency and quality of approach in other therapeutic areas such as cardiology.”

“With the implementation of a national clinical trial governance framework across Australian hospitals in 2021, CTA is well positioned to ensure hospital executives have the necessary oversight of clinical trials, and that thousands more Australian patients will benefit from access to such trials over coming years.”