As a medical oncologist, active member of the breast multidisciplinary team at Chris O’Brien Lifehouse and a laboratory researcher with a PhD in cancer molecular biology, Dr Mun Hui demonstrates the pivotal role played by clinician-scientists in cancer research.
Dr Hui’s research focuses on the tumour micro-environment. In an Australian first, she and her lab members, headed by A/Prof Alex Swarbrick at the Garvan Institute of Medical Research developed a technique to collect and sequence individual cancer cells in order to study the genetic makeup of breast cancers.
A common treatment approach for breast cancer is neoadjuvant therapy, such as chemotherapy or immunotherapy, before surgery. These therapies are increasingly common and in some cases considered best practice. But their outcomes and effectiveness vary between patients.
“Why do some women respond to adjuvant therapies and others do not?,” Dr Hui asks. “Why are some cancers more sensitive to treatment and others resistant? If we can understand that, we can find ways to overcome resistance and improve cure rates.”
It starts with improving our understanding of the mechanisms of cancer, Dr Hui says.
In 2017, she established a biobank of breast cancer patients with residual disease and metastatic recurrence undergoing neoadjuvant treatment. Residual disease means a portion of their cancer responded while another portion remained resistant.
“What makes it powerful is that we have paired samples from the same patient,” Dr Hui says. That is, tissue samples collected from women throughout the course of their treatment, allowing the research team to study the behaviour of single cells in different environments.
“Right now we are able to sequence the entire genome and transcriptome of that cell and really go in depth to study it. What is it about these cells that makes them interact with treatment and with each other?”
“It’s important to note it is a group effort with clinicians, pathologists, scientists and bioinformaticians. It’s a symbiotic relationship. They need samples and we need the sequencing and data. It’s very important to be multidisciplinary,” says Dr Hui.
Clinicians not only collect the samples, they give perspective to the scientists about the natural history of the disease, the design of the study protocol and interpretation of data.
“You can have a bunch of letters in code, but what does it mean? What story does it tell? Science needs to be clinically relevant. We need more clinician-scientists,” says Dr Hui.
In an example of cancer research that covers the whole process from ‘bench to bedside’, Dr Hui’s laboratory findings will be translated into clinical trials, with the ultimate goal of identifying new potential drug treatments.
“I’m privileged to be in a position where I can potentially run a clinical trial using the pre-clinical data I’ve gathered.”