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Chandra is a biochemist whose research has investigated various aspects of colorectal cancer. Her PhD thesis explored the use of biologically active compounds from members of the Zingiberaceae plant family, which includes ginger and turmeric, in the prevention of colorectal cancer.


She has experience in isolating and identifying bio-active compounds from medicinal plants using chromatographic, mass spectrometric techniques and NMR and using small animal models to assess efficacy of the active compounds including AOM-induced colon cancer and DSS-induced inflammatory bowel disease model study. She also has worked with primary tissue and cell culture systems to conduct various assays including proliferation, apoptosis and migration assays. Her research interests focus on biomarkers for bowel cancer and understanding bowel cancer liver metastasis leading to cancer treatment. Her work equipped her with a large number of tissue samples from patients complete with clinical parameters including tumour characteristics and patient’s 5 years follow up. She is an expert in immunohistochemistry and the use of tissue microarrays for immunohistochemistry.


Following the completion of her PhD Chandra undertook a Postdoctoral Fellowship at CSIRO Human Nutrition in Adelaide and Wakefield Biomedical Research Institute in Wellington, New Zealand. Chandra began working at the Basil Hetzel Institute in September 2014.


Chandra’s current project aims to:

  • understand colorectal cancer liver metastasis
  • to find biomarkers for colorectal cancer liver metastasis

These biomarkers will be used to accurately determine colorectal cancer patients into low and high risk group of cancer spread or metastasize so that patients will receive better treatment management therefore increase survival.

For example, patients whose tumours have no potential to spread will not have to receive chemotherapy, while others will receive more targeted therapeutic drugs to treat their particular tumour (“personalised medicine”).

Projects

  • Validation and evaluation protein biomarkers to stratify bowel cancer patients according to their risk of spread
  • Biology of perineural invasion in colorectal cancer
  • Identification of protein biomarkers in the liver of bowel cancer patients to detect metastasis

Chandra is available to co-supervise Honours and/or PhD students.

Summary of Student Projects

Supervisors: Professor Guy Maddern and Dr. Chandra Kirana

Basil Hetzel Institute and The Queen Elizabeth Hospital, Woodville South

Projects: Protein biomarkers for colorectal cancer liver metastasis

Colorectal cancer (CRC) is the leading cause of cancer deaths in the Western and developing countries. The incidence and mortality of CRC also increase in young adults. Metastatic dissemination from primary tumour accounts for over 90% of all colorectal cancer death. Adjuvant chemotherapy has been shown to provide a significant improvement in patient survival, however this advantage is not available for all patients who could benefit from it due to inability of current standard method to accurately predict prognosis. Adjuvant chemotherapy for stage II CRC patients is still regarded as controversial. About 25% of stage II CRC patients will develop metastasis after surgical removal of their primary tumour mainly to liver and 50 – 60% of stage III CRC patients will develop metastasis. The overall survival rate for stage II CRC patients five years after surgery is approximately 70 – 80% and that for stage III patients is 30 – 60 %. Questions remaining to be answered include which patients will benefit from adjuvant chemotherapy and what chemotherapy to use to give most benefit for the patients.

Classic disease staging, which is currently the key prognostic indicator for CRC, includes degree of lymph node involvement. Recovery and evaluation of lymph nodes in the resection specimen are, however, influenced by the method and quality of surgical resection, quality of pathologic evaluation, tumour related factors and patient factors. Variation in the assessment of lymph node status could lead to under-staging and as a result a falsely node-negative patient may not receive the potential benefit of adjuvant therapy. It is well recognised that staging by light microscopy alone is not sufficiently accurate to predict spread as significant variation with respect to clinical outcome exists within currently used stages. Carcinoembryonic Antigen (CEA) has been used to predict CRC recurrence for almost 40 years. However, serum CEA has a poor diagnostic accuracy.

There is therefore urgent need for histological staging to be supported by molecular profiling of tumours to provide additional accuracy in stratifying patients for better disease management and ultimately improved survival.

We have identified protein candidates using proteomic approaches and currently collaboratively working with Callaghan Innovation New Zealand to generate a prototype diagnostic test.

Current projects for Honours degree students include evaluation of protein biomarker candidates on a larger number of clinical samples and to determine the functions of the proteins on cancer progression and development using cell culture techniques.

We have fresh frozen normal colon, colon tumour, normal liver and liver metastasis and blood of more than 500 patients and some of them were from matched patients accompanied by complete clinical parameters. In addition we also have tissue microarray of more than 250 samples. This resource is hardly found elsewhere. New projects can be discussed, designed and established to identify additional biomarkers for colorectal cancer for Higher Degree Research Student Projects.

Collaborations

  • Clinicians at The Queen Elizabeth Hospital and Royal Adelaide Hospital, South Australia
  • Mr John Keating, Wellington Hospital, Wellington, New Zealand
  • Professor Richard Stubbs, P3 Research, Wellington, New Zealand
  • Dr Lifeng Peng, Centre for Biodiscovery, School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
  • Dr Andrea Bubendorfer, Callaghan Innovation, New Zealand’s Innovation Agency, Wellington, New Zealand

At least once a year Chandra presents the results of her research to staff, undergraduate and postgraduate students in some Indonesian universities and to the Indonesian community in Adelaide.

Chandra also work closely with Ms Julie Marker, founder of Cancer Voices SA.

Chandra’s projects involve consenting patients.