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Dr Alex Flynn leads research to improve chemotherapy dosing

Dr Alex Flynn, Medical Oncologist and Clinical Trials Fellow at the Central Coast Local Health District (CCLHD) is leading research aimed at developing chemotherapy dosing methods. Her project entitled "Validation and feasibility of dry-blood spot testing for infusional 5-fluorouracil dosing," seeks to improve the efficacy of treatment while minimising toxicity for patients.

Traditionally, chemotherapy dosing for 5-fluorouracil (5FU) has been calculated based on a patient's height and weight. However, emerging evidence suggests this may not be the best method to calculate treatment doses, as individuals can respond very differently to this treatment based on numerous factors.

“Your body size is not necessarily a good correlation of how your body will deal with 5FU,” Dr Flynn explains. “What may benefit one patient might be too much or too little for another. By giving patients a dose of 5FU and then taking a blood sample, we can see each patient’s individual metabolism and adjust the dose accordingly for subsequent treatments. The patient might actually be able to have a larger dose without the risk of increased toxicity.”

Dr Flynn’s research highlights the need for personalised dosing to maximise benefits and minimise adverse effects from 5FU. By implementing a finger prick test, her project aims to enable patients to collect blood samples at home themselves, minimising the need for frequent hospital visits. For those in rural and remote areas, this innovation would be particularly impactful, significantly reducing the burden of travel for medical care.

Dr Flynn’s project is supported by a NSW Regional Cancer Research Network (NSWRCRN) 2023 'Shovel Ready' Translational Research Project Grant. This project will serve as the foundation for a larger piece of work aimed at optimising the dose of 5FU in metastatic colorectal cancer, with the goal of significantly improving median overall survival. The validation of the finger prick test, the focus of Dr Flynn’s work, is the critical first step in this process. Researchers hope outcomes will lead to improved treatments and ultimately increased survival rates among regional NSW residents with cancer.

The project, based within the Central Coast Local Health District, will be an important step towards aligning practice with international guidelines that recommend therapeutic drug monitoring for 5FU dosing, which have yet to be widely implemented in Australia.

In addition to enhancing chemotherapy dosing for colorectal cancer, Dr. Flynn's research holds promise for other cancer types requiring infusional 5FU regimens, including pancreatic, gastro-oesophageal, and head and neck cancers.

Dr. Alex Flynn completed her education at the University of Sydney and trained in many of the regional hospitals in the Hunter & New England.. Her passion for providing excellent medical care in regional and rural locations  is inspired by her father, who grew up in Albury-Woodonga & worked as a surgeon in outer western Sydney. Dr Flynn is now forging her own path committed to addressing healthcare disparities, with a particular focus on improving access and care for those in regional and rural communities.

The NSW Regional Cancer Research Network is funded by a Cancer Institute NSW Translational Cancer Research Capacity Building Grant through NSW Regional Health Partners.

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