Mark Shackleton: science infrastructure

20 November

Regularly, veski takes you in conversation with our innovation fellows. We talk to them about a range of topics from where they got their start in science to what happens in their lab today.

 


 

This week we chat to Dr Mark Shackleton who was awarded a veski innovation fellowship in 2010.

Mark returned to Victoria from the USA where he was developing expertise in melanoma cell biology.

Mark is a Medical Oncologist and Group Leader of the Melanoma Research Laboratory at the Peter MacCallum Cancer Centre.

 

We ask Mark about the current state of science infrastructure in Victoria and what needs to improve.

What do you think of science infrastructure in Victoria?

Overall, what we have in Victoria is pretty good. However, there’s always room for improvement. In my work, I’m focused on bioscience so I am grading our infrastructure according to what I see are needs in that space. I'm particularly fortunate to be at Peter Mac and working on melanoma because of the exceptional resources that exist here for research in this disease – foremost and unfortunately the many melanoma patients who walk through our doors. Tapping into this resource more broadly throughout the state is a major area of potential improvement in Victorian bioscience infrastructure, in my opinion.

What area of Victoria’s science infrastructure has room for improvement?

A simple one – the ability to easily access, for research purposes, patient medical details and tissue samples that were obtained for patient diagnosis and treatment. The current system – or lack of it – is cumbersome and consequently slows down research. If improved, ready access to such information and samples – with careful protection of private patient information, of course – could be a truly valuable asset to Victorian bioscience and ensure that the biomedical research done here can be readily applied to problems that affect people.

The way such resources are currently collected is pretty unsophisticated and regimented – largely for cost reasons – with the end result being that lots of tissues and clinical information sit on dusty shelves for years without being of further use. We need to think more carefully about the ways we could obtain and store tissue samples and clinical data for future use. For example, having access to fresh tissues is very valuable because there are experiments you can't do with cells once they're fixed and dead in the way that pathologists usually process them. It would be great if more tissues were stored without formalin fixation and even in a manner that kept cells alive – such as frozen in dimethyl sulfoxide.

How could access to patient medical details and tissue samples be improved?

Easier, electronic, and broader access to patient medical records is urgently needed. An opportunity exists for academic hospitals to change how they register and treat patients in ways that could help auditing and research. At the moment, a patient’s consent is required before we can access even their de-identified medical details. We need opt-out consent, as well as the proactive recruitment of patients into research programs that collect more detailed information than is obtained during routine clinical care.

How would these improvements help your research?

A switch to this approach would speed up biomedical research. Infrastructure doesn't actually do research but it makes it possible and should make it happen faster. With regard to the tissue samples, tissue banking is a phenomenal resource for research. Geoff Lindeman did a wonderful job to initiate this in Victoria in the early 2000s. As a result, it’s fairly easy for local researchers to test the relevance to human disease of a particular discovery they made – usually using an artificial model.

How would going from paper to electronic records affect your work?

The development of electronic records will make a huge difference to our productivity. A lot of our records are still paper-based and only available to researchers via multiple approval and review processes. The ability to electronically link researchers directly to that information would save months and months of work.

What is the main barrier to introducing the infrastructure you need to improve access?

Cost is the main barrier. The systems are still really expensive.  I also think that we have gone too far with respect to privacy and considerations over individual rights to tissue and medical information. The amount of extra red tape in research is huge that has resulted from privacy legislation. Institutions are now very cautious in how they handle patient tissues and information. All this slows down research.  Of course, this is great for our privacy and for those individuals who care very deeply about what their information and tissues are used for in research. However, one cost of this is that research progress is slowed – potentially everyone suffers from slow development of and inhibited access to treatments that save lives and improve human health. I can’t help thinking there should be a middle ground here, between concerns for the rights and privacy of individuals and our duty to improve the well-being of the community, including future generations, at large.

What is the highest priority in terms of clinical infrastructure?

E-records in my opinion. Having ready access to good data is critical. There are inefficiencies in patient care that could be improved with good electronic records that fed into clinical audit and research protocols. Everyone would benefit from this in my opinion. But the current costs of development and implementation are pretty high, I’m told.

What is the highest priority in your research?

Our highest priority right now is probably the study the heterogeneity of cancer. The genomics area of cancer research is unexpectedly revealing that cancers can be very different from patient to patient. Even more than this, some studies have shown extensive heterogeneity among cancer cells within the same tumor in the same patient! And cancer cells can change in a patient over time too. This presents huge challenges in the fight against this disease. We tend to think of cancer as being a three-dimensional lump but the fourth dimension of cancer – time – is also important in many cases. Very little we do currently in cancer research or treatment accounts for this.

What is needed to enable this study of heterogeneity of cancer?

First, access to patient information obtained not just at one moment, but throughout the course of malignant illness.

Second, an ability to serially and more extensively sample, on an ongoing basis, a patient’s disease to enable research how their cancer changes over time. For example, we need to think creatively about including things like ‘liquid sampling’ of blood that may give us a more complete picture of a person’s disease. To do this, we need technologies enabling the study of plasma DNA, among others.

Third, more long-term investment in bioinformatics is urgently needed. At the moment our ability to analyse genetic information from a patient’s cancer lags behind our ability to generate that information. We need to be putting more resources and muscle into technology development in the bioinformatics space.

Research requires a long-term view; the average three-year research grant cycle does not facilitate really important breakthroughs. For example, drugs arising from research take 10 years or more to develop. Part of the problem is lack of funds and resources. Most research programs operate on a shoestring. The community needs to ‘get’ the direct links between human well-being, between the medicines that save lives, and community investment in research. Broadly, the more we invest, the better health we and our families will enjoy.

 

Next time, we will be in conversation with Dr Matt Call about the Victorian science infrastructure he uses in his research.

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