THE YEAR IN REVIEW

In 2021 and early 2022, the Breast Cancer Trials Research Department has been a hive of activity, the benefits of which will flow on through the coming years. Both home grown and international trials have been conducted, along with the groundwork for future trials being set up. Collaborations with local and international partners have built a trial portfolio from prevention, to early stage, and metastatic disease. Local therapy, systemic therapy and supportive care have all been represented. The team has been working hard on the activation, trial conduct and ongoing follow up to make sure these trials continue to improve outcomes for people with breast cancer.

Collaborations expanded despite the reduction in face-to-face meetings at conferences due to COVID restrictions. In some ways it felt the world got bigger with COVID as a result of greater difficulties travelling, and on the contrary, our ability to meet via videoconferencing improved (sometimes at the expense of sleep!). Neo-N opened at Italian sites, forging the way for future systemic therapy trials. EXPERT’s international reach expanded to include European and South American sites. A link with JCOG, a Japanese multidisciplinary trials group, is evolving into a productive bilateral exchange. The activation of the FINER trial will see us working with the Canadian Cancer Trials Group.

We were able to recruit strong participant numbers to our trials during this last year despite continued impact of COVID related restrictions in the healthcare settings impacting recruitment and trial conduct activities. Research clinics and central coordination teams were flexible in the approach to trial conduct, while maintaining high quality patient care. Remote monitoring, telehealth, and virtual meetings have overcome many of these challenges, and have potential efficiencies when travel time can be significant throughout Australian and New Zealand sites. Innovative solutions are needed to meet these challenges. The FINER trial will test one such solution. An e-consent module will be introduced and trialled at a limited number of sites aiming to improve on participant understanding of the trial, along with a reduction in the need to travel.

The Breast Cancer trials (BCT) trial portfolio remains diverse and multidisciplinary. Local therapy trials include EXPERT, POSNOC and the MRI evaluation study. BRCA-P is a ground-breaking prevention trial which BCT sites have contributed a significant proportion of participants to despite recruitment has been lower than anticipated due to the pandemic and delayed activation of major countries. Systemic therapy trials include FINER, DIAmOND, CAPTURE, Neo-N and PATINA. Many of these trials capture patient reported outcomes, and some include health economic assessments. There is potential for greater activity in the supportive care and local therapy space.

Primary results of the OLYMPIA trial indicate an overall survival benefit to the addition of 1 year of Olaparib to standard of care in patients with BRCA-related early-stage breast cancer. This has started to change routine clinical practice already. The final primary analysis of the PALLAS trial was presented and published, and follow up will continue, along with correlative analyses with tissue and patient reported outcomes. Publications and presentations of BCT-related research were made throughout the year, including SOFT/TEXT, SOLE and APHINITY.

People are of course the heart of what we do. From the trial participants, to donors and supporters, clinicians, research nurses and central operations staff, we are grateful for the role that they play in bringing practice-changing research to the clinic. The trials department has recruited several new staff members who are rapidly learning new skills and have become highly valued team members.

The BCT research department has been humming along nicely and looks forward to rolling out new trials and to completing recruitment and reporting of existing trials.