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By writing software to analyse a veritable cosmos of data from genome sequencing, Dr Matthew Field has helped pinpoint the underlying genetic causes of diseases such as melanoma and lupus and enabled doctors to tailor precise treatment for individual patients.

Dr Field was awarded the Frank Fenner Early Career Fellowship by the National Health and Medical Research Council at a ceremony in Canberra. Dr Field, senior research fellow in Bioinformatics at the Australian Institute of Tropical Health and Medicine (AITHM) at James Cook University says: “I am deeply honoured to receive this award given the calibre of other early career Australian medical researchers applying for this fellowship.”

Dr Field is also a principal investigator for the Centre for Personalised Immunology – an NHMRC Centre of Research Excellence – at the Australian National University.

He regards his greatest accomplishment as seeing his research translated into improving health outcomes for everyday Australians. “My primary aim is to ensure that Australia is incorporating the latest technologies into the health system and that these technologies are available to all Australians regardless of geographic location.”

A Canadian, with degrees in biology and computer science, Dr Field moved to Australia about seven years ago because he found it a “beautiful country”. His research involves developing next generation bioinformatic “pipelines” to analyse DNA and also the microbiome, the billions of bacteria that colonise humans and are “implicated in various health issues”.

Dr Field is using funding from a $322,000 NHMRC Early Career Fellowship in Public Health, awarded in 2017, towards developing an expert bioinformatics team that will support numerous research projects at the institute. One of the reasons Dr Field sees tropical health research as vital is because by 2050 half the world’s population will be living in the tropics.

“We are running a pilot project with the Cairns Hospital where a lot of people present with very high fevers, suffering from conditions like dengue fever or other types of diseases that are endemic to the tropics.” Currently clinicians try to make a call on what the disease might be, order specific tests, get results and eventually figure out what the disease is.

Dr Field says the research will involve using sequencing technology in a single test to discover what disease the person has. “We sequence the people‘s blood and then we look for what pathogens are actually in their blood…That way you can find out exactly what is responsible for the disease instead of having to just try to use a best-guess methodology by looking at symptoms that are often common to people who have various bacteria and viruses that are found in the tropics.”

Having a single sequencing test for most known tropical diseases could lead to cost savings, allow for faster diagnoses and treatment that can improve the outcome for patients.

Another current James Cook University research project involves analysing genetic mutations in lung cancer patients at Townsville Hospital. Dr Field says: “We give the information back to the clinicians, who are savvy enough that they know with this mutation this drug will work and this drug won’t work and what treatments they should be giving.” His group has applied for funds to extend this research to ten different types of cancer in the next two years.

It builds on work he did in a recent Melanoma Institute of Australia research project that “analysed the largest number of melanomic genomes ever." He developed a bioinformatics infrastructure to try to figure out the "particular mutations that occur in each of the particular melanomas and different subtypes, because there are melanomas that occur in your eyes, in your feet, in your skin.”

The team, led by clinicians, also analysed the genetic makeup of individual patients with this dangerous cancer, finding new genes not previously known to be involved in melanoma.

Even miniscule genetic differences can be crucial for effective treatment. Dr Field says for example in patients with melanoma, a single genetic mutation determines whether treatment with two of the main drugs for metastatic melanoma will be effective for them. “About 50 percent of people with melanoma have one little mutation in one out of three billion bases in the DNA and this one tiny little location tells you whether this expensive treatment is going to work or not.”

He says this finding cut costs - saving tens or even hundreds of thousands of dollars for each course of treatment - and prevented patients with the mutation from being given a drug that would fail to treat their melanoma and “that could harm them even more. That is why it is so important to be smart about giving people just the right treatment that they need.”

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