Spotlight Series – Professor Nick Gottardo

It is hard to see how Nick Gottardo fits everything into his day. He is, first and foremost, a paediatric oncologist caring for children and adolescents diagnosed with cancer, and is the senior neuro-oncologist at Perth Children’s Hospital. He is also the Head of the Department of Paediatric and Adolescent Oncology and Haematology, a highly demanding, administrative role, which could easily fill his week.

“I have a dedicated clinic day where I can focus solely on my patients and families… it is my favourite day of the week.”

Nick is also a world-leading researcher, effectively translating promising results in the laboratory into innovative clinical trials, with the ultimate goal of identifying new and effective treatments for patients with devasting brain cancers. He leads a number of clinical trials across Australia and internationally, with several of the trials based on his own laboratory’s data. While Nick established the paediatric neuro-oncology research laboratory, he quickly realised that it was not feasible to be in the lab himself, as his patients always came first.

“I am a clinician with a PhD, which means I understand the science and the intricacies, but my Co-Head, Raelene Endersby, she is the true scientist and drives this work. I can provide oversight and direction, particularly through identifying the clinical need, but I don’t go into the lab – they wouldn’t want me in there!”

Nick was also recently appointed Chair of ANZCHOG, and has just stepped down from his role as Chair of ANZCHOG’s CNS Tumours Group. ANZCHOG’s role as the peak body for paediatric oncology health care professionals has provided Nick with opportunities to influence national policy development and advocate for change through working with government and philanthropic organisations. In addition, he continues to guide ANZCHOG’s direction and collaboration in the clinical trials space.  Nick acknowledges this does mean a lot of meetings and conferences, many at odd times.

“To stay current and relevant, you need to be visible. Having leadership roles within key consortiums and committees means that you have more influence, and Australia and New Zealand are seen as an integral trial partner and leader, not just an afterthought. Networking and close relationships are vital. Just about every clinical trial idea is born over dinner or a social drink.”

Perth is long way from his original beginnings. Nick was born in England, but raised in a small village in Italy, called Sondalo, near the Swiss border. His lifelong desire to pursue medicine may have come from his medical neighbours, but Nick also notes the nearby presence of a large tuberculosis (sanatorium) hospital built in the 1930’s as a national landmark for treatment at high altitude, may have influenced his path.

“The Villagio, as the sanatorium was named, was a remarkable architectural structure, built into the side of a mountain. It was huge. It also meant a disproportionate number of doctors and medical staff in the area.”

After returning to England (and learning English), Nick completed his medical degree and travelled to Australia, taking locum roles throughout NSW and WA. But it was his time at Princess Margaret Hospital in Perth which cemented his career direction.

“It was an exciting time to be entering into paediatric oncology. Tyrosine kinase inhibitors, such as imatinib, were being hailed as the new “magic bullets”. There was hope that we could stop using highly toxic treatments to cure our patients. Of course, we now know that very few cancers can be cured using these single therapy approaches.”

Nick completed a PhD in leukaemia genomics, but it was his desire to help brain cancer patients which influenced his next step.

“In leukaemia, our cure rates were good, we knew so much about the biology and how to stratify our patients to tailor their treatments. But the brain cancer patients, we knew little about the disease and their outcomes were so poor, even for those who survived. I felt there must be more that we could do for these children.”

Nick moved to St Jude Children’s Research Institute (Memphis) and completed a 3 year research and clinical fellowship with world-leaders in paediatric neuro-oncology. He applied many of the genomic techniques learnt during his PhD, and also developed the first mouse model of ependymoma.However, it has been the enduring relationships established with internationally renowned clinicians and scientists which has continued to shape and influence his career once he returned to Perth.

“They have selflessly supported and mentored me and provided a range of leadership and collaborative opportunities. I don’t hesitate to turn to them for a second opinion.”

When asked about the future of paediatric oncology, Nick’s enthusiasm is contagious.

“We are at the cross roads. Precision medicine was a dream which is now becoming a reality. We understand so much more about the underlying biology of the different tumours and their drivers. Our next step is to match targeted agents to exploit these weaknesses. While it is likely that we will still need to use some of our traditional therapies in combination with these agents, hopefully we can reduce some of the awful toxic treatments that we are currently using. We also need sustainable funding avenues for clinical trials – if we want to be at the forefront of applying new agents and giving our children the best chance to survive, we need adequate and reliable resourcing and funding for centres across Australia and New Zealand.”

Below are the different health professionals and researchers we have shone a light on during September

• Principal Research Fellow (Natalie Bradford)
• Paediatric Oncologist (Dr Tristan Pettit)
• Clinical Research Nurse (Reg Gayaman)
• Clinical Nurse Consultant (Helen Starosta)
• Consumer (Anne Kay)
• Pharmacist (Hayley Vasileff)
• Research Scientist (Dr Raelene Endersby)
• Senior Research Fellow (Dr Jennifer Cohen)
• Psycho-oncology clinician & researcher (Associate Professor Maria McCarthy)
• Social Worker (Tanya Alestalo)
• ANZCHOG Chief Executive Officer (Robyn Strong)

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