The University of Auckland is home to more than 300 cancer researchers in areas ranging from tumour biology to drug discovery to palliative care. Until recently, however, people tended to work in their disciplinary silos with familiar partners. Now a new research centre is bringing together people and organisations to improve cancer care across Aotearoa New Zealand. 

Te Aka Mātauranga Matepukupuku | The Centre for Cancer Research (Te Aka) is the largest cancer research centre in the country in terms of the number of researchers involved. It aims to support and enhance cancer research by encouraging researchers to collaborate across disciplines and with patients and clinicians. It also aims to foster and deepen relationships with district health boards (DHBs) as well as with clinical, philanthropic, community and industry organisations.

Though cancer doesn’t discriminate, inequities woven into the fabric of society result in inquitable cancer outcomes. Recent research has shown that Māori are twice as likely to die from cancer as non-Māori. In fact, life expectancy is seven years shorter for Māori than for non-Māori.

“Māori don’t live seven years less than non-Māori because of some fluke of genetics. It’s because of how our society is set up,” says George Laking (Te Whakatōhea), who is Manutaki Haumanu Māori (Clinical Director Māori) of Te Aka. Laking also has a similar role in Māori health with the Auckland District Health Board as well as being a medical oncologist and honourary University of Auckland academic.

“Equity is about remedying uneven outcomes in health and wellbeing that are avoidable and unjust.”

Inequities exist along every step of the cancer journey, says Leesa Russell, project manager for Te Aka.

“The Waitangi Tribunal Health Services and Outcomes Inquiry found that the health system as a whole is inequitable for Māori. When it comes to cancer, Māori access services less, feel less comfortable in the environment, and tend to be diagnosed later, when the cancer is worse.”

These inequities extend to research. At Te Aka, only four percent of members are Māori, though Māori make up nearly 17 percent of the population. That’s why one of the centre’s goals is to develop Māori cancer clinicians and researchers in particular as part of a broader mandate to train future leaders in cancer research and treatment.

In addition to improving equity, Crown entities, including universities and district health boards (DHBs), must honour their obligations to Te Tiriti o Waitangi, the Treaty of Waitangi, says Laking.

“A large part of what Te Tiriti is about is maximising the wellbeing and success of Māori in the context of living in a land that’s shared with the Crown. Historically, the Crown has failed to live up to its obligations, and that applies in the field of cancer, so it’s about time that our institutions of higher learning applied an equity lens and a Te Tiriti lens to all their work.”

Pacific peoples also face health inequities and have a higher cancer death rate than the general population. Te Aka is starting to engage with Māori and Pacific organisations to build positive relationships with the communities they serve.

She helped launch the entities that form some of the building blocks of Te Aka – Grafton Clinical Genomics, a genomics lab largely focused on cancer research; the Auckland Cancer Trials Centre, an early-phase clinical research facility dedicated to providing patients access to novel anticancer therapies; and Te Ira Kāwai | Auckland Regional Biobank, which collects tissue samples and relevant clinical information donated by patients to support ethically approved medical research.

Headquartered at New Zealand’s largest university, in its largest and most diverse city, Te Aka has the critical mass of researchers and patients to set the pace for cancer research nationally and to make an impact internationally. Its researchers have strong links with researchers and clinicians across the country and the world. This helps link research and practice.

“Researchers are often aware of the ways to answer research questions but may not be aware what the clinical question is. Clinicians are aware of the question but may not know how to answer it,” says Browett. “By working together, we can make research relevant and immediately applicable.”

Cutting-edge Te Aka research is already helping patients through cancer genomics and personalised medicine. In addition to his mahi as a Te Aka director, Browett co-leads a group sequencing individual patients’ blood cancer genes to work out how best to treat them given the specific mutations that led to their cancers. Other researchers are applying genomics to solid tumours. Te Aka members are also internationally recognised in areas including population health, epidemiology and drug discovery.