“One in ten patients undergoing surgery for malignancy removal of the parotid gland will require resection of the facial nerve, resulting in significant morbidity due to facial nerve palsy.”.”

Research project: Optimising outcomes of Facial Nerve Palsy following Parotid Gland Cancer Surgery

Can you explain what your study is about and what you hope to achieve?

Managing facial nerve problems effectively requires a team of different specialists working together. This team includes neurologists (nerve experts), ENT (Ear, nose and throat) surgeons, plastic surgeons, physiotherapists, speech therapists, and psychologists.

The goal is to offer full diagnostic testing, advanced treatments (both surgical and non-surgical), and support while also driving research to improve facial nerve care. Specifically, they aim to:

• Make diagnoses more accurate.
• Improve the care and treatment of patients, focusing on better outcomes related to mouth and facial movement, and ensure patients can easily access these services.

Support research by creating a special implant that can help people with long-term facial nerve problems close their eyes more easily, along with new software to monitor blinking patterns

“Chemotherapy-induced peripheral neuropathy is a common side effect of cancer treatments that affects the nervous system, leading to problems like numbness, tingling, and pain in the hands and feet.”

Research project: Investigating Novel In-vivo Quantification of Chemotherapy-Induced Peripheral Neuropathy

Can you explain what your study is about and what you hope to achieve?

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatments that affects the nervous system, leading to problems like numbness, tingling, and pain in the hands and feet. This condition can be so severe that it forces patients to reduce their chemotherapy doses or stop treatment early, which can lower their chances of successful cancer treatment. The challenge is that we still don’t have a reliable way to predict which patients are most likely to experience severe, long-lasting CIPN.

One reason for this is that doctors currently lack tools to measure nerve damage in cancer patients, which makes it harder to improve outcomes for cancer survivors in both treatment settings and research studies.

A promising technique called in-vivo reflectance confocal microscopy (RCM) is a non-invasive imaging tool that can capture detailed images of nerve endings called Meissner corpuscles, located in the fingertips. These nerve endings are sensitive markers for nerve damage. There has only been one small study testing this method in CIPN patients, and initial results are encouraging. If proven effective, this would offer a new, non-invasive way to measure nerve damage in patients with CIPN.

By combining clinical evaluations, advanced nerve testing, and RCM imaging, the study aims to identify patterns between nerve damage, symptoms, and other patient health information. This could help develop better ways to predict, monitor, and treat CIPN in cancer patients.

“Patients undergoing major oral cavity surgery face many challenges during their recovery, relating to appearance, function and psychological impact of their disease and treatment”

Research project: Pre-operative Laser Hair Removal from Free Flap Donor Sites in Oral Cavity Reconstruction

Can you explain what your study is about and what you hope to achieve?

Patients undergoing major oral cavity surgery face many psychological and physical challenges as well as functional issues.

One challenge is managing the new lining inside their mouth from their reconstruction. This lining is often skin from the arm or leg, which is very different to the normal lining of their mouth.

A consequence of this can be the re-growth of the hair inside the mouth from that leg or arm skin, causing discomfort and distress, as well as affecting speech and swallowing. Previously, this has been addressed after surgery by attempting to remove hair from inside the mouth – this is uncomfortable, time-consuming and can be ineffective.

Our aim is to perform laser hair removal treatment prior to surgery on the planned area of the arm or leg required to be transplanted to the mouth to avoid the need for further treatment post-surgery and improve outcomes for the patient.

“This innovation has the potential to reduce complications and improve recovery for patients after oral cancer treatment”

Research project: Hydrogel Microcapsule Hybrid Implant for steroid delivery to treat granulation tissue after oral cancer surgery

Can you explain what your study is about and what you hope to achieve?

Oral cancer is often treated by removing the cancerous tissue and then rebuilding the jaw. To help with chewing, speaking, and appearance, dental implants are placed to act as artificial tooth roots. Over time, the body forms a healing tissue called granulation tissue around these implants, but sometimes this tissue grows too much. This can make it harder to clean the area, affect long-term success, and lead to complications.

To control this, doctors typically use anti-inflammatory steroids like dexamethasone. These can be applied as creams, but they’re washed away quickly by saliva or contact with food, which means higher doses are often needed. However, this can lead to side effects.

To solve this, researchers are developing a new implantable device made of soft, gel-like materials. This device will sit between the dental implant and the artificial tooth and will slowly release a controlled amount of steroid directly where it’s needed. The device will be durable, safe, and adaptable by adjusting the gel properties to control how much medication is released over time.

“Oral cancer poses a significant global health challenge, with cases expected to increase by 38% from 2018 to 2030”

Research project: Bioengineered cartilaginous grafts for ectopic bone formation in a novel in vivo plasma-treated PEK bioreactor.

Can you explain what your study is about and what you hope to achieve?

­Current treatments for oral cancer can make it hard for patients to eat, speak, and heal, and reconstructing the jawbone is complex. Typically, surgeons use bone from the patient’s leg, but this can lead to complications, infections, and limited availability. Titanium implants can also fail and interfere with imaging used to monitor cancer.

To solve this, researchers have created a 3D-printed artificial bone made from polyetherketone (PEK), a strong, safe material that doesn’t interfere with imaging or radiation. However, getting the bone to regenerate quickly enough before radiotherapy is still a challenge.

The solution being explored combines PEK with a natural material called hypertrophic cartilage extracellular matrix, taken from human bone marrow cells, which has been shown to promote faster bone growth. Researchers will test this combination in sheep (similar to human bone healing) using a specialised bioreactor to evaluate bone growth over 12 weeks with advanced imaging.

The aim is to create a ready-to-use product that allows quicker, safer jawbone reconstruction with fewer risks and lower costs. If successful, this approach could transform treatment options for patients with jawbone damage caused by oral cancer.

“Glioblastoma, a type of brain cancer, is incredibly difficult to treat as no two are the same”

Research project:  A wolf in sheep’s clothing: is IDH-wildtype low-grade glioma the precursor to deadly glioblastoma or an entirely new tumour entity?”

Can you explain what your study is about and what you hope to achieve?

Glioblastoma (GBM) is the most common and most deadly type of brain cancer in adults, with patients surviving just 13 months on average after diagnosis. Recently, a less aggressive type of brain tumour called IDH-wildtype low-grade glioma was discovered. These tumours share genetic changes with GBM but tend to have much better outcomes, with patients surviving longer.

Although scientists have studied the genetics of IDHS extensively, these efforts haven’t yet led to new treatments or better understanding. This research aims to explore RNA—a molecule that translates the instructions in DNA—and how changes to RNA may influence tumour growth. Using advanced techniques like long-read sequencing and spatial transcriptomics (to map molecular patterns in tumour tissues), researchers will examine how IDH cells interact and behave.

The team has tumour samples from 20 IDH patients, and this research will explore whether these tumours represent an early form of GBM or a distinct new tumour type altogether.

Our goals with the SurFebruary funding are to create better diagnostic tests and treatments for IDH patients, learn why patients with IDH live longer compared to GBM patients and discover new treatments to make GBM less aggressive and improve survival rates

“Replacement of teeth is critical in patients' recovery and improving their quality of life after surgery.”

Research project: Computational modelling driven digital surgical planning for jaw reconstruction.

Can you explain what your study is about and what you hope to achieve?

Oral cancer involves the tongue, mouth or jaw and often requires part of the jaw to be removed which leads to loss of teeth, and severely impacting function, aesthetics, and quality of life. The removed jaw is replaced with a bone from the patient’s own anatomy (leg, shoulder, hip bones). The state of art surgery for this reconstruction is guided by computer assisted design and simulation called digital surgical planning, where patient’s CT imaging prior to the surgery is used to ensure the reconstruction occurs accurately. The removed teeth also need to be replaced at the time of surgery or after the surgery. Our previous study showed that the replacement of teeth called dental rehabilitation is critical in patients’ recovery and improving their quality of life after the surgery as it affects their eating, drinking and talking. Patients who do not have the opportunity to have the dental rehabilitation can experience malnutrition, anxiety, impaired socialisation, and loss of employment. However, there are safety concerns for this approach, as immediately placing dental implants and denture at the time of surgery may increase the possibility of remaining jaw and replaced bone from leg/shoulder/hip not healing together.

Our study will use computational modelling to predict how we can safely place dental implants and denture at the time of surgery without compromising jaw and reconstructed bones. We will test this with patients’ available 12 months of CT data after they have the jaw reconstruction surgery to check if bone heals/grows as predicted. Following this we will integrate the computational model into our routine digital planning workflow for patients who will have the jaw reconstruction surgery to check the safety and efficacy of this approach.

“The Integrated Prosthetics & Reconstruction Lab (IPR) at Chris O’Brien Lifehouse focuses on optimising affordable functional and aesthetic rehabilitation of oral cancer patients undergoing reconstructive surgery .”

Research project: Digital 3D printed dental prosthesis to address disparity in dental rehabilitation for oral cancer patients.

Can you explain what your study is about and what you hope to achieve?

Oral cancer involves the tongue, mouth or jaw and often requires the part of jaw to be removed and replaced with a bone from the patient’s own anatomy (leg, shoulder, hip bones). The state of art surgery for this reconstruction is guided by computer and digital design called virtual surgical planning, where patient’s CT imaging prior to the surgery is used to ensure the reconstruction occurs accurately. In the oral cancer reconstructive surgery where the jaw is removed, the patients also loses their teeth. The removed teeth need to be replaced at the time of surgery or after the surgery. Our previous study showed that the replacement of teeth called dental rehabilitation is critical in patients’ recovery and improving their quality of life after the surgery as it affects their eating, drinking and talking. Patients who do not have the opportunity to have the dental rehabilitation can experience malnutrition, anxiety, impaired socialisation, and loss of employment.

The Integrated Prosthetics & Reconstruction Lab (IPR) at Chris O’Brien Lifehouse focuses on optimising affordable functional and aesthetic rehabilitation of oral cancer patients undergoing reconstructive surgery. The IPR can design and print patient-specific dental prostheses from patients’ digital information, with the ability to provide this service anywhere in Australia, enabling specialist surgeons in regional centres to provide prosthetic dental rehabilitation at an affordable cost.

“We propose to utilise the optical scanning of the patients and these printers to develop advanced point of care 3D printed shielding for better personalised patient radiotherapy at Chris O’Brien Lifehouse.”

Research project: 3D printing shielding cutouts for radiotherapy of skin cancer: towards personalized and sustainable healthcare.

Can you explain what your study is about and what you hope to achieve?

For many cancer patients, radiation therapy is used to kill cancer cells and shrink tumours. For those patients that have skin cancer, a key requirement in radiotherapy is to irradiate the region of the tumour while minimising dose to the surrounding healthy tissue. This is achieved by using a patient specific cutout made of lead which collimates the radiation beam to the shape and location required.

This lead cutout bolus should be comfortable for the patient and easy to fit on their skin surface for their radiotherapy treatment session. A cutout is traditionally produced by hand, which is time consuming and, in many cases, relies on a plaster cast of the patient such as the head. This process can also be uncomfortable for the patient and final lead cutout may still not fit the patient accurately, requiring additional work for optimal fitting.

3D printing is increasingly used across many industries including healthcare. 3D printing allows tailored printing of devices from digital information with arbitrary shape and using a variety of materials. The technology, therefore, has the potential to create “next generation” 3D printed shielding cutouts that are personalised to individual patients. The cutouts can be printed as complex shapes, with uniform thicknesses, and using fit-for purpose materials for greater durability and comfort.

Chris O’Brien Lifehouse has developed a 3D printing facility for point-of-care research and manufacturing. Housed within the newly established Biomedical Innovation Hub, the printers are being used for prototyping devices for clinical translational. We propose to utilise the optical scanning of the patients and these printers to develop advanced point of care 3D printed shielding for better personalised patient radiotherapy at Chris O’Brien Lifehouse.

“This map could then help us develop new treatment strategies and also develop tools to predict which way patients are likely to go with treatments.”

Research project: Creating a comprehensive tumour atlas to discover new biomarkers and novel treatment pathways.

Can you explain what your study is about and what you hope to achieve?

Tumours are complex, with many different cell types that could help or hinder the immune system from clearing the tumours. Together, they often form mini ecosystems where individual cells interact with each other, and such ecosystems could be beneficial or detrimental depending on which cells are involved.

Until recently, we were not able to even see all the cells that are usually present within tumours because there were no technologies that enabled a ‘clear view’ of everything present within the tumours. Therefore, what we often saw was probably a small proportion of what was actually present within tumours. This severely hampers not only our understanding of what each and every cell in the tumour does, but also limits our ability to identify biomarkers that can predict how the patients will do.

Recent technological advances have allowed us to see almost everything within tumours. We can now identify every single cell and also go deeper and see what those cells are up to within the tumours. We believe if we can create a comprehensive map of the tumours collected from patients with long term follow up details, we can pinpoint to cells, their interactions and their behaviours that could help or hinder the way our immune system kills tumours. This map could then help us develop new treatment strategies and also develop tools to predict which way patients are likely to go with treatments.

The funding from SurFeb Fund will allow us to do a proof of principle study, where we want to show that a complete atlas from a carefully selected cohort of patients that could provide the necessary platform for developing novel biomarkers and treatment strategies.

“The SurFeb Fund will help support our validation of these exciting findings.”

Research project: Confirming highly sensitive “liquid gold” biomarkers for detecting glioblastoma and monitoring glioblastoma progression.

Can you explain what your study is about and what you hope to achieve?

Glioblastoma is the most common and deadly type of brain cancer in adults that inevitably resists standard therapy and grows back aggressively. Detecting its recurrence is really challenging. Even the most advanced imaging technology and experienced physicians often can’t tell the difference between recurrence and common treatment-effects in the brain. This means that recurrences are often confirmed late, or effective treatments are stopped or changed unnecessarily. In many cases, patients undergo further neurosurgery only to learn that that wasn’t needed. The lack of a reliable tumour monitoring contributes to the very poor quality-of-life and survival outcomes experienced by patients.

To address this critical issue, our research team has conducted extensive studies on extracellular vesicles or ‘EVs’, tiny nanoparticles emitted by glioblastoma tumours. We have innovated methods to measure molecules carried within EVs and have tracked these signals from glioblastoma cells, tissues and surgical fluids into the bloodstream. Remarkably, we found that EV signals in the blood can sensitively detect a glioblastoma tumour with near perfect accuracy.

Building on this discovery, we investigated a new approach of measuring EV signals in the urine, since this is where EVs are disposed from the body. The SurFeb Fund will help support our validation of these exciting findings. This ground-breaking research could revolutionise how glioblastoma is detected and monitored, allowing earlier detection of tumour recurrences, improved treatment strategies, improved endpoints for clinical trials to expedite drug development, and ultimately enhancing the quality-of-life and survival of patients battling this devastating cancer.

“This information will help in reducing the barriers and improving the care of people who most need it.”

Research project: Exploring accessibility to facial nerve services for people with facial nerve paralysis in regional and remote areas.

Can you explain what your study is about and what you hope to achieve?

Facial nerve paralysis causes significant problems with speaking, eating and smiling. It leads to problems at work, maintaining adequate nutrition and socialisation. Facial nerve paralysis can arise and is associated with many conditions including trauma, tumour, infection or congenital, however the greatest dysfunction is experienced on account of a complete sacrifice of the facial nerve after head and neck cancer.

It is our experience at Chris O’Brien Lifehouse that people residing in regional and remote areas of Australia experience more advanced cancers. This means they have bigger tumours, require more treatment – often a combination of surgery, radiation and chemotherapy and have greater changes to their function and quality of life. They also often live further away from local health care centres without access to people who specialise in specific conditions. This means the people with the biggest problems get the least support.

We plan on interviewing people who have accessed the Sydney facial nerve service and exploring what has supported them to get the help they need and what has made it more difficult. We will interview both people from regional and metropolitan areas to understand how the experiences are similar and how they differ.

We will then compare the experiences accessing services to their functional and quality of life outcomes, to understand how access and outcome are linked. This information will help guide us to support and invest in local services for better provision of care, reducing the barriers and improving the care of people who most need it.