Colorectal cancer (bowel cancer) is the second most common cancer in Australia, as well as the most common cause of death from cancer in this country. For the past 19 years, Prof Robyn Ward has led this multidisciplinary group of laboratory scientists, oncologists and pathologists, known as the Molecular and Cellular Oncology group (MCO). The goal of the group has been to better understand the genetic and epigenetic mechanisms that drive the development of colorectal cancer, and to translate that new understanding into ways of improving outcomes for people with cancer.
Our work has been facilitated by a systematic collection of tissues, clinical and pathological information from over 2100 individuals who have undergone surgical removal of tumours of their large bowel. To date, we have analysed colorectal cancers from over 1500 people for the presence of novel genetic and epigenetic lesions, including activating mutations of the KRAS and BRAF oncogenes, methylation of the cancer-related genes MLH1, MGMT and P16 and classification according to the CpG island methylator phenotype (CIMP). This analysis has been used to identify “molecular signatures” of subtypes of bowel cancer, and the way that these signatures can predict clinical features and patient outcomes.
Our work has also focussed on the biological basis of familial bowel cancer, in an attempt to better understand the genetic and epigenetic factors that lead to an inherited predisposition to this disease. This work led to the identification of epigenetic changes in the mismatch repair genes leading to bowel cancer development at a young age.
In the past few years, under the leadership of Dr Luke Hesson, the group has focussed much of its efforts on the precursor lesions of bowel cancer, and in particular a distinctive subtype known as laterally spreading tumours (LSTs). Understanding these earliest stages of tumour development will be important in both the early detection of colorectal cancer, and ultimately its prevention.
Dr Michael Bourke –Gastroenterologist, Westmead Endoscopy Centre
Dr Alan Meagher – Colorectal surgeon, St Vincents Hospital
Professor Ian Tomlinson – Cancer Research UK
Dr Oliver Sieber – Ludwig Institute for Cancer Research, Melbourne
Peter Molloy – CSIRO, Sydney