Table 4 Narrative of HCRA

Background and need

People living in rural and remote NSW were identified as having higher rates of cancer and poorer cancer outcomes compared to people living in metropolitan Sydney, NSW. People in regional areas also have higher rates of cancer risk factors such as smoking and are also more likely to be diagnosed with low survival cancers. Improving both research capability and translation of research findings into practice is acknowledged as one of the pathways to improving cancer outcomes.

The Response

The Cancer Institute NSW initiated funding for six TCRCs in NSW which were established during 2010–2012. Funding was granted to one centre based in regional NSW, which became the Hunter Cancer Research Alliance (HCRA) in 2014, serving the HNE region. HCRA aimed to provide capacity building, funding and strategic support to cancer clinicians and researchers working across the translational research continuum in the HNE region. During 2014–2021 the CINSW provided $9.7 M in funding to support the work of HCRA.

Key activities

The HCRA Executive (a multi-disciplinary team of researchers, clinicians and key stakeholders) administered the CINSW funding under a single umbrella supported by three Flagship Committees, The Future Leaders Group, The Consumer Engagement Committee and Consumer Advisory Panel (CAP). The operations team provided critical support, increasing the ability of HCRA members to focus on research activities rather than administration and navigation.

Key outputs

HCRA funded salary and other support for 13 PhD candidates, 10 clinical fellows and 5 career advancement fellows. HCRA funding to members included funding for 85 pilot projects, 118 travel grants, 40 grants for statistical support and 35 infrastructure grants building infrastructure in regional NSW. HCRA supported the establishment of the Hunter Cancer Biobank which collected over 51,000 samples and distributed over 13,600 tissue or blood samples during that time. By 2021 the Hunter Cancer Biobank was largely self-sustaining and it continues to support many projects. See https://www.biobank.org.au/.. HCRA conducted 85 capacity-building events, seven annual Hunter Cancer Symposia. Over time the symposia were increasingly inter-disciplinary, demonstrated growing engagement from consumers and included community-facing public lectures.

Impacts

HCRA members leveraged 445 cancer-related grants, awards, fellowships, and scholarship top ups to a value of $38.9 M (25% attribution). Members produced new knowledge including:

• The identification of stem cells necessary for endometrial cell regeneration, which has major ramifications for developing new approaches to controlling endometrial cancer incidence, with patents granted for these discoveries [22].

• Revealing the relationship between neural innervation in tumours and how this information can be used to significantly slow tumour growth [23]. This provides a new paradigm for the treatment of all tumour types that rely on nerve cell innervation and drugs based on this work are in clinical development.

• Development and implementation of the world’s first real-time patient treatment verification system (Watchdog) [24,25,26]. The Watchdog system uses imaging devices to check in real time that the treatment is being delivered correctly, which translates to improved care for all radiation therapy patients.

• Demonstrating the effectiveness of the ‘EAT’ psychological intervention [27] to improve nutrition and outcomes in people experiencing radiotherapy for head and neck cancer. Improved nutritional status, fewer treatment interruptions, lower depression scores, and higher quality of life were found. The approach has been implemented at multiple Australian sites with significant international interest.

• Developing effective interventions to reduce smoking rates among priority groups such as Indigenous women, drug and alcohol users and rural people. Our researchers collaborated with the Cancer Council NSW to deliver the Tobacco Treatment Program to over 150 Social and Community Services across NSW reaching over 2000 smokers from disadvantaged groups.

• The development of 79 cancer-related policies and guidelines which had input from HCRA-funded members during the period of HCRA funding.

While the HCRA cannot claim full credit for these impacts, the research teams working on these different projects worked closely with HCRA and received various types of support.