Biliary cancer is one of the most lethal human cancers and claims the lives of over 700 Australians each year. The prevalence of this disease is highest in parts of Asia, particularly North East Thailand, due to high rates of liver fluke infections.

Currently there are very few treatment options for these patients, which is why a team of researchers from key East Asian sites are investigating novel precision-based treatments for this disease. The team is led by Prof John Mariadason (pictured), Dr Andreas Behren and Dr Oliver Klein at the ONJCRI as the La Trobe University School of Cancer Medicine, and research colleagues Prof Temduang Limpaiboon from Khon Kaen University in Thailand and Prof Yoshimasa Saito from Keio University in Japan. These researchers have shared resources and expertise for many years including publishing a significant paper in 2019 and they have now secured funding through the NHMRC e-ASIA Joint Research Program Scheme.

The team has recently made the exciting discovery that some patients with biliary cancer respond to immunotherapy. They have also found that the biology of biliary tumours can be broken down into two main groups – the first is when the cancer cells still somewhat resemble the normal cells, and the second is when cells have transformed into an almost stem type cell. This new three-year funding will now enable the team to understand why only some patients respond to immunotherapy. The team will also conduct hypothesis-driven drug screening to precisely target the two types of biliary cancers they have identified. These studies will be strongly enhanced by the Japanese and Thai research teams who have access to a large number of patient samples and model systems called ‘organoids’, that they have been able to assemble through their location in hospitals which specialise in the care of patients with biliary cancer.

The project has three key priorities:

  1. Build local and international resources. Because biliary cancer is rare, the team will combine tumour samples from Australia, Japan and Thailand to discover trends that can inform cancer behaviour and response to treatment.
  2. Extend the use of existing cell line models and organoids. The team have already started to characterise cell lines and organoid models of this disease, which will be used to screen for new drugs to treat these cancers.
  3. Leverage findings from a successful world-first clinical trial of rare cancers to refine the use of immunotherapy to treat biliary cancer. The team will use findings from the clinical trial led by ONJCRI’s Dr Oliver Klein, Prof Jonathan Cebon and Dr Andreas Behren to see if there is a common thread that can be used to identify patients likely to benefit from immunotherapy that transcends race and ethnicity.

The NHMRC funding will also allow the collaboration and exchange of personnel and technologies across the three sites once COVID-19 restrictions are lifted.