Research Profiles

Clinical Associate Professor Sandra O'Toole has been working at Royal Prince Alfred Hospital for two and a half years, but has spent the last decade engaged in breast cancer research.

Associate Professor O'Toole is studying how genes that influence development in embryos may play an important role in breast cancer and how blocking these genes may provide a promising new approach to treating the most aggressive types of breast cancer. 

The Hedgehog pathway is most active in the earliest stages of life where it directs the formation of organs and limbs. It typically lies dormant in adult years, but may be reactivated in some types of cancers. Associate Professor O’Toole has recently shown the Hedgehog pathway is associated with a particularly aggressive and difficult to treat type of cancer called ‘triple negative’ breast cancer. This type of breast cancer accounts for around 10 to 15 per cent of cases and tends to occur in younger women. With a multidisciplinary team of scientists and cancer specialists, Associate Professor O’Toole also showed that blocking this pathway significantly decreased the growth and spread of cancer cells and could be a new approach in treating this aggressive type of breast cancer.

She is working with Associate Professor Jane Beith and Dr Alexander Swarbrick towards developing and testing treatments to block the Hedgehog pathway in breast cancer. It is hoped a clinical trial will start at Royal Prince Alfred soon. A grant from the Sydney Breast Cancer Foundation has allowed the establishment of a tissue bank of breast cancers which are studied to understand the gene changes that occur and how they may be used to better diagnose and treat this disease.

Associate Professor O'Toole was inspired to start her career in breast cancer research after seeing the terrible impact breast cancer had on her mother. One of the most enjoyable aspects of research for her is working with a team of scientists, medical and surgical cancer specialists, to tackle challenges from all angles using basic and clinical science to find the right answers.

The year was 1978, the location Nepal. Professor Warwick Britton began his research affair with with leprosy and tuberculosis.

An immunologist by profession, Professor Britton has discovered much about the immune system by studying infectious diseases such as tuberculosis.

Tuberculosis is a highly contagious disease with devastating effects. It has had a long history, but is plagued by new challenges - drug-resistant strains, the threat of HIV and undetected cases.

It is still rife in some of Australia’s closest neighbours including Indonesia, Papa New Guinea and Vietnam.

Over the decade, Professor Britton has collaborated with a team, including Professor Guy Marks, to discover much about the disease including its genetic make-up, its interaction with the immune system and how best to diagnose it early to control its spread.

The team’s findings have been possible thanks to a containment lab at the Centenary Institute allowing researchers to investigate the disease in a controlled environment without fear of infection.

The aim is to now put this in-depth research into practice. The recent award of a National Health and Medical Research Council Centre for Research Excellence in tuberculosis control will allow them to do just that. The five-year funding will enable a team of Australian researchers with colleagues in Asia to create a hub for tuberculosis research and training in Australia. The focus is on developing new vaccines, diagnostic tools and strategies for the early detection and control of this highly infectious disease.

Professor Britton’s legacy lives on in Nepal with a research laboratory he created in 1986 still operating.

As a specialist in maternal and foetal medicine, Professor Jon Hyett looks after pregnancies that have a high risk of complication - either for the mother, or for the foetus.

Professor Hyett has worked at RPA for five years, having trained in obstetrics, maternal and foetal medicine in the UK before working in Australia. At Royal Prince Alfred, he leads a research group which has a strong clinical focus and a continual dedication to research to maintain the highest standards of obstetric care.

The group’s main research interest is to predict risk of pregnancy complication, either at an early stage (12 weeks), or immediately before delivery (at 36 weeks).

The group is currently working on a way to predict the risk of pre-eclampsia, a disease harmful to both the mother and foetus. If a risk is found at 12 weeks’ pregnancy, simple treatments like aspirin may prevent the onset of this disease.

Professor Hyett’s team is also leading the way in Australia with non-intrusive ways to screen pregnant women. A simple blood test can be used to define the foetus’ blood group by testing minute amounts of foetal DNA found in the mother. The group is on the cusp of a breakthrough by testing how this method may be used to screen for Down Syndrome, and other complications, at as early as 10 weeks into a pregnancy.

Through a National Health and Medical Research Council grant, the group is also studying the effect of rotating babies that are badly positioned during labour to reduce the rate of caesarean sections.

High risk obstetrics is a rewarding and diverse speciality for Professor Hyett who is constantly kept busy with the range of research needs this field demands.

Among his many positions, Professor Paul Bannon is dedicated to a life of surgery and research – taking discoveries from the laboratory bench to the patient’s bedside. Professor Bannon completed his surgical training at Royal Prince Alfred and, under the guidance of the late Professor Douglas Baird, was encouraged to take up research and has never looked back.

Professor Bannon’s interests are extensive and have the potential to result in major breakthroughs for the early detection, prevention and treatment of heart and lung disease.

The aorta is the main supplier of blood to the body. If weakened or enlarged, it can cause a rupture, or aneurysm, which is life threatening. Professor Bannon is investigating how the aorta works and whether the conditions that cause aneurysms are inherited. The aim is to predict ruptures before it is too late, and allow surgery to be performed at the best time so that it is low risk.

Professor Bannon is also overseeing exciting developments in the creation of ‘off the shelf’ blood vessels made of biocompatible materials. The materials used are compatible with the human body so that the vessel is not rejected when inserted. If successful, these devices can be used to replace damaged vessels and improve heart function with very few complications.

Together with the Bernie Banton Centre, Professor Bannon is working towards a breakthrough in the management of one of the most devastating forms of lung cancer - mesothelioma. The team has made great surgical progress to improve survival rates, but there is much more to do.

He is also working on innovative heart surgery to determine the best course of action for high risk patients and to reduce the risk of stroke during surgery.

Underpinning these areas is a dedicated research group at Royal Prince Alfred, which reviews leading evidence from around the world to get better outcomes for research and surgery.

Professor Bannon is also committed to developing young surgeons into thinkers and leading researchers.
Success in these areas may allow him to reach his ultimate goal - to be out of a job.

In a fantastic example of collaboration between the University of Sydney, Royal Prince Alfred Hospital and the Centenary Institute, Professor Chris Semsarian is leading a team that is embarking on breakthrough and internationally leading research.

The team has been awarded two National Health and Medical Research Council grants. With a national success rate of 17 per cent, gaining two grants is testament of the calibre of the team and importance of their work.

One of the grants will look at the link between genetically-based sudden cardiac death and epilepsy; the other continues work on the genetic basis in families with hypertrophic cardiomyopathy. The overarching goal with both research pieces is to discover new gene faults in cases of hypertrophic cardiomyopathy and sudden death in epilepsy.

Using the latest technology the team will look into all 23,000 genes, in the hope of making life changing discoveries for patients and families living with these conditions.

Hypertrophic Cardiomyopathy is the most common genetic heart disorder. In about 50 per cent of cases the gene abnormality is unknown, and tragically in some cases the first sign of disease is sudden death.

Through the research, the team aims to identify gene faults and translate this into strategies to identify risk, treat patients accordingly, and most importantly prevent sudden death.

The cause of sudden death in epilepsy remains a mystery, and yet is the most common cause of epilepsy-related death.

The research is based on the notion that there is a gene which controls both electrical rhythms of the brain and heart, to find a link between heart disease and epilepsy. By delving deeper he hopes to learn much more about the condition.

Professor Semsarian is hopeful that a life changing discovery will be made to help patients and their families cope with these conditions, and to make a lasting impact both at home and for the global community.

Professor Semsarian was the recipient of the Royal Prince Alfred Foundation Medal for Excellence in Medical Research in 2009, and received the 2012 RT Hall Prize for Research, the highest award given by the Cardiac Society of Australia and New Zealand each year. Both awards recognised his outstanding research into the clinical and genetic basis of heart disease in the young.