Chemotherapy dosing currently is very crude. It's based on body surface area rather than body makeup. You can have two people of the same body surface area. One is a sumo wrestler, one is a gym enthusiast. Clearly they have different body makeup and body composition. Their body composition is a major determinant of how drugs are metabolised and that's why they're frequently overdosed or potentially underdosed if they continue to be dosed based on body surface area. There is no clinical methodology or toolkit that we can currently use that will allow us to predict overdosing or toxicities. And our innovation is being able to use body composition and patient characteristics to be able to predict this.
Colorectal cancer is the second largest cause of cancer death internationally - there are about 2 million new diagnoses of colorectal cancers worldwide, of which over 50% will require chemotherapy treatment. So, if you look at the numbers, 1 million internationally will require chemotherapy, and unfortunately up to 60% to 80% will develop overdosing or toxicities, which either lead to chemotherapy reduction or even cessation, therefore impacting on them being able to complete their cancer treatment. And also, some of them will develop these significant long term complications, such as the terrible hand foot neuropathies. So, if you're someone who relies on your hands or feet to do your normal day to day job, and with colorectal cancer affecting more and more young people, that's a significant impact.
The reason why I'm so keen to solve this problem is because I can see our idea, our innovation, being applied to all forms of cancer. And it's not just cancer. If you look at treatments like hormonal therapy and antibiotic therapy, I suspect that we can use this methodology to dose other types of medication. Furthermore, in paediatrics where precise dosing is vital, we still base medication prescription on weight and body surface area. Isn’t this a very crude way of managing these patients?
When I first started being a doctor, the people that inspired me were those who actually made a difference through listening to their patients and actually giving them what they needed. We therefore have moulded what our product is based on what consumers have voiced as being a major problem. I’ve learned a lot from speaking and learning from our patients.
I am a consultant colorectal surgeon at Western Health Melbourne, and I deal with lots of complex cases trying to help the most needy within the west side of Melbourne. Most of my work is centred around colorectal cancer, and the challenge has always been trying to tailor treatment for our patients. We have patients from different backgrounds, different socioeconomic groups, and it’s really important that we don’t give one-size-fits-all treatment to our patients. And my other role is being an academic surgeon, leading the department of surgery at Western Precinct at the University of Melbourne.
It's the patients that come to see us to talk about their colorectal cancer surgery. Many of my patients have preoperative chemotherapy treatment and we have noticed that many have developed significant problems associated with chemotherapy overdosing. For example, they tell me about their neuropathies or their diarrhoea which has then caused them to be deconditioned. They worry about whether they can make it through the next step of their treatment journey. Unfortunately, there's no accurate way of predicting these side effects. Ultimately these complications affect the patient, including their wellbeing.
So that's really when it became really obvious to me that we needed an innovative solution for this.
We've reached a stage where we have the technology that's been patented, we know the group of people that it's meant to help, we've identified who's meant to be paying for the product, and we actually have a roadmap towards regulation. We are just about to start a clinical trial which incorporates health economics just to show the impact of this product. But what will be so helpful is learning from the experience of others who've gone down this same journey. It is so great to have a supportive environment and fantastic mentorship provided by this program.
One of the biggest challenges is obviously funding and with this, how we can better utilise our resources. The AUSCEP program has taught me to think about things as a bigger picture and has allowed me to utilise resources and connections in a more effective way in order to make a real difference.
Very different to what it is now. I can see that digital health is going to be even more of a major player. Guiding clinicians with what is best practice, aiding with diagnosis, and connecting them with experts in the field. In addition, although AI will be further embedded within clinical workflow, we still need the human touch to be able to connect with our patients.
Prior innovation programs I've been involved with haven't really been focused on clinicians, and they’ve been more focused on the product. It's really nice that we are in a group of collaborators who are actually from similar medical backgrounds. They understand the clinical challenges. Many of our mentors are from the medical space or have been engaged with health, and that's also been really useful. You don't need to explain to them what cancer is all about. They understand.
Go for it! You're going to network and meet so many different people that can help you solve problems and who will become your lifelong colleagues and friends.
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