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Research Overview

A/Prof Simon Tsao holds a Ph.D. specializing in cancer research. Throughout his career, he has continued his research into the detection of cancer markers in the blood.

This research is essential for progressing our understanding of cancer, especially breast cancer, and will have a range of clinical benefits for patients. The potential clinical benefits may include:

  • Earlier detection of cancer - By detecting cancer markers in the blood, patients will be able to have an additional form of diagnosis in conjunction with the current scans.

  • Diagnosis of cancer type - Not all breast cancers are the same, with some requiring different treatments than others. Detection of blood-based circulating tumor markers may assist in diagnosing the type of cancer detected.

  • Cancer prognostication and progression - The volume and type of cancer markers may aid in understanding the severity or progression of cancer for the patient.

  • Early treatment effect - Early understanding of how effective the prescribed treatment is against the patient's cancer type will aid in early detection of treatment-resistant cancers.

  • Ongoing cancer surveillance - After treatment when the cancer is in remission, it is important to continue surveillance to ensure early detection if the cancer returns. This blood test has the potential to be extremely sensitive to any returning cancers.

Part of A/Prof Tsao’s Ph.D. thesis was accepted for publication in the high-impact journal ‘Nature Communication’, published as Characterising the phenotypic evolution of circulating tumour cells during treatment.

Understanding Cancer Detection

Current diagnosis of breast cancer relies on radiographic scans of the breast. These types of scans are often completed at a breast screen clinic, or by your specialist. 

While these scans are able to detect breast cancer, they are limited in the respect to the size of the cancer they are able to detect. Very small cancers may go unnoticed, no matter how clear the scan, or proficient the doctor. Also, these scanning tools are often bulky and expensive, meaning patients in regional or remote areas have to travel considerable distance to a scanning facility at regular intervals to recieve a scan. This is the current limitation of our cancer detection technology. 

A/Prof Tsao’s research is based on detection of circulating tumor DNA, cells and extra cellular vesicles released from cancers into the bloodstream. Detection of these cancer markers is by a liquid biopsy - also commonly called a blood test. The blood is then placed through a detection device that has been specifically calibrated to detect these cancer markers, and is able to return detailed results about the presence and quantity of these markers. 

These scans allow detection of cancers at much higher sensitivity than radiographic scans like a mammogram, and due to the portability of a blood sample, reduce the requirement of travel for rural and remote patients.

At this stage these technologies are still experimental, and are not a part of current clinical practice.


Refining the Science

An extracellular vesicle is a small, membrane-bound structure released by cells into the blood, containing various molecules such as proteins, nucleic acids, and lipids which plays a role in intercellular communication.

The detection of extracellular vesicles represents one potential application of this research. More advanced applications involve the ability to modify and adapt extracellular vesicles to facilitate the loading of specific cell-targeted treatments, transforming them into precise carriers that seek out cancer cells. This innovation could enhance the delivery of cancer treatments, potentially reducing the necessary treatment dosage for similar or improved efficacy. For patients, this could translate to a decrease in side effects and a lower requirement for chemotherapeutic treatment.

"Effective scientific exploration relies on collaboration among partner institutes, researchers, administration, and patients."

Research Partners and Collaboration

A/Prof Tsao collaborates on this research with various institutes, including Macquarie University and the University of Melbourne.

Conducting cancer research involves thorough planning and collaboration across diverse specialties. Engaging institutes to support research presents operational challenges, requiring several essential processes such as obtaining ethics approvals, establishing operational procedures, implementing biobanking protocols, securing patient consent, and collecting samples to kickstart research.

These steps are fundamental aspects of A/Prof Tsao’s core practice, and each of his practice locations actively participates in cancer research to varying extents.

To support this ongoing work, A/Prof Tsao and his research team have been the recipient of several high-profile research grants, including:

  • 2023: Tour de Cure Pioneering Research Grant, Validating a novel nanotechnology for personalized breast cancer treatment monitoring.

  • 2022: Early Career Researcher Grant, University of Melbourne. Enhancement of tissue-resident T cells for tumor control.

  • 2021: NSW Cancer Council Medical Research Grant, Development of an integrated microfluidic platform for multi-omics analysis of exosomes to improve the treatment of metastatic breast cancer.

  • 2021: James Ramsay Project Grant, Portable circulating tumor cell analysis for personalized breast cancer care.

  • 2021: CASS Medicine/Science Grant, Detecting residual disease in triple-negative breast cancer using a novel cancer array technology.

  • 2021: Earlier Medical Research Grant by, Early detection of breast cancer.

  • 2020: Cancer Council of Victoria Research Grant, Targeting mammary adipose resident regulatory T cells to treat breast cancer.

  • 2020: Research Endowment Fund, Portable circulating tumor cell analysis for personalized breast cancer care.

  • 2020: Research Endowment Fund, Detecting minimal residual disease in breast cancer using a novel cancer array technology.

  • 2020: Research Endowment Fund, Non-invasive diagnosis in thyroid cancer using the novel SERS-MagTag technology.

Research Publications

A/Prof Tsao has authored or co-authored a range of high impact journal publications in the fields of cancer research, liquid biopsy, extracellular vesicle detection and surgical outcomes.

W. Chen, W. Wang, Z. Xie, F. Centurion, D. Paterson, S. Tsao, D. Chu, Zi Gu. Size-dependent penetration of nanoparticles in tumor spheroids: a multidimensional and quantitative study of transcellular and paracellular pathways. Small. 2023 Oct 11:e2304693

W. Zhang, L. Ngo, S. Tsao, D. Lui, Y. Wang. Engineered cancer-derived small extracellular vesicle-liposome hybrid delivery system for targeted treatment of breast cancer. ACS Appl Mater Interfaces. 2023 5;15(13)16420-16433

S. Tsao, W. Zhang, C. Long, J. Jabson, J. Wongtrakul-Kish, K. Inglis, Y. Wang. Monitoring of breast cancer treatment response by analysis of breast cancer-derived extracellular vesicles. The Breast. 2023 Apr 68; 242.

C. McCamley, N. Ruyssers, H. To, S. Tsao. G.B.Mann. Multicentre evaluation of magnetic technology for localisation of non-palpable breast lesions and targeted axillary nodes. ANZ J. Surg. 2021 Nov; 91(11):2411-2417.

R. Chae S. Tsao, C. Baker, J. Lippey. Progressive silicone lymphadenopathy post mastectomy and implant reconstruction for breast cancer. BMJ Case Rep. 2021. 9;14(2):e237711. (FWCI: 0)

A. Mimery, R. Pereira, S. Tsao. Left-sided tubo-ovarian abscess mimicking appendicitis: a diagnostic dilemma. ANZJS, 2020. doi: 10.1111/ans.15770. (FWCI: 0)

S. Tsao, J. Wang, Y. Wang, A. Behren, J. Cebon, M. Trau. Characterising the phenotypic evolution of circulating tumour cells during treatment. Nature Comm. 2018. 9(1): 1482. (FWCI: 2.79)

E. Wee, Y. Wang, S. Tsao, M. Trau. Simple, sensitive and accurate multiplex detection of clinically important melanoma DNA mutations in circulating tumour DNA with SERS Nanotags. Theranostics, 2016. 6(10):1506-13. (FWCI: 5.54)

J. Duarte, J. Peyper, K. Woods, S. Tsao, G. Long, R. Kefford, R. Scolyer, J. Cebon, J. Blackburn. Protein microarrays for the immunological profiling of melanoma. Cancer Immunol Res, 2016;4(1 Suppl):Abstract A024. (FWCI: 0)

J. Duarte, K. Woods, S. Tsao, J. Cebon, J. Blackburn. Seromic profiling of melanoma patients using a custom protein microarray platform. Eur. J. Immunol, 2016; 46:1093-1093. (FWCI: 0)

S. Tsao, R. Vaidyanathan, S. Dey, L. Carrascosa, C. Christophi, J. Cebon, M. Shiddiky, A. Behren, M. Trau. Capture and on-chip analysis of melanoma cells using tunable surface shear forces. Sci Rep, 2016; 6:19709. (FWCI: 0.37)

S. Tsao, S. Weiss, C. Hudson, C. Christophi, J. Cebon, A. Behren and A. Dobrovic. Monitoring response to therapy in melanoma by quantifying circulating tumour DNA with droplet digital PCR for BRAF and NRAS mutations. Sci Rep, 2015. 5: 11198. (FWCI: 5.10)

S. Tsao, A. Behren, J. Cebon, C. Christophi. The role of circulating microRNA in hepatocellular carcinoma. Front Biosci (Landmark Ed), 2015. 1;20:78-104. (FWCI: 0.55)

S. Nair, P. Mishra, S. McLennan, J. Lee, S. Tsao, L. Celi. Alcohol-related injuries requiring surgery. NZ Med J, 2013 10;126(1374):92-5. (FWCI: 0)

An up to date publication history and information on citations and impact rating can be found on ORCiD and Scopus.

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