Dr John Bashford: Redefining the future for rare cancers

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Medical research advocate, oncologist and haematologist, Dr John Bashford is research director at the Icon Group.

The group, which is Australia‚Äôs largest private sector provider of clinical trials, is currently working with a range of life science companies on 31 clinical trials involving immunotherapy across Australia.

"The vision of Icon in the 1990s was to pioneer the ability to manage people treated with autologous stem cell transplants for acute leukemia out of hospital," said Dr Bashford.

"The Icon group has a highly integrated streamlined mechanism for conducting clinical trials," he said. "It offers our patients a depth of experience, quality of care and leadership. The integrated cancer care program is offered across the country rather than just on a state basis which has made it a successful model, and it will continue to grow internationally.

"Our mission is to provide the best quality cancer care as quickly and as close to home as possible for patients. This is because of the growth of our cancer care network. Clinical research and clinical care go hand in hand. Not just medically, but also at a nursing level, at a pharmacy level and at an operational level," said Dr Bashford.

"Icon was the first group to offer a private integrated cancer care model with a haematology and oncology service. We were the first group to offer a cancer care service that involves radiotherapy, medical oncology, clinical haematology, palliative care and then the technical pharmacy side of that - an essential component of our integrated cancer care.

"This was the foundation of our mission and it continues to hold fast today as we strive to make quality cancer care accessible to people in their own communities without insisting they remain in a hospital for unnecessary periods of time."

Dr Bashford told BiotechDispatch Icon's approach has been driven by the objective of making research part of day-to-day patient care.

"Research has been in the DNA of the organisation since it was established, through testing new treatments, and taking new approaches to care in our clinics as part of our daily work. We believe it improves the quality of care and it provides a quality guarantee for our treated patients. It means they have access to the newest therapies," he said.

Icon is playing a leading role in the development of emerging targeted therapies and immunotherapy, which Dr Bashford said have driven the organisation's growth in the past decade. "They will continue to be the areas of the greatest growth," he said.

"Immunotherapy really aims to tackle one of the great paradoxes of cancer - why doesn't the body reject cancer cells? What stops the body from saying, 'these cells are imposters and we need to get rid of them?"

"What we know is that there is a complicated mechanism that cancer cells use to subvert the normal immune system - immunotherapy is a way of turning that around and switching on the body's own immune system," he continued.

"The checkpoint inhibitors have really revolutionised a whole variety of areas. Most notably melanoma, but also lung cancer where we are starting to see results with long term survival that had never been seen before.

"The next wave of immunotherapy is really the cellular products when cells are programmed to directly kill cancer and then you infuse them back and that is what CAR-T cells are. They are the first generation of that type of therapy.

"It is a very sophisticated and complex technology to create. We know how - the big challenge now is to step that up into a reproducible, consistent way of delivering those cells. The major pharma companies have worked very hard to do that but it is still a work in progress."

According to Dr Bashford, "Targeted therapies are the other important area of research focus and development. The emerging therapies are designed to target the metabolic mechanisms and engine room of cells that have particular abnormalities.  If you can make a therapy to target those abnormalities, then you can switch them off.

"There has been a huge growth of those compounds, the ability to profile cancers individually, try and find which abnormalities fix a particular cancer. This is an area of active research for us and it has seen very significant steps forward."

Dr Amanda Ruth (amanda@dailydispatch.com.au)