30 August 2022
Brittany Lavender is a clinical trials manager for a number of the Malaghan Institute’s clinical trials, helping translate discoveries made in the lab to better treatments to fight disease.
The process of taking research in the lab and applying it to people as a treatment is often long and arduous.
“After getting promising lab results indicating that a drug can be applied to treat a condition, we must then do preclinical research. This is usually conducted on animal models. If this is also successful, you can apply to conduct a clinical trial on humans,” says Brittany. “But this requires much planning, consideration, and permissions from a range of organisations which have been established to protect the participants in clinical trials to ensure that the proposed clinical trial is safe and ethical.”
The initial clinical trial – a phase 1 trial – is conducted on only a few dozen participants to determine the safety and dosing of the drug. This then provides data to do further clinical trials with more participants to determine the efficacy of the drug in treating the condition. The whole process can take over a decade in total so much patience and understanding of the scientific and ethical regulations around clinical trials is needed to conduct them.
“Part of my role is assisting design of clinical trials which involves determining details such as the duration of the trial, what questions need to be answered, how we can answer those questions, what samples need to be collected from participants, and what times in the trial we would be need to take these sample,” says Brittany.
Brittany then submits the proposal to relevant ethics boards with details on how informed consent will be provided to participants and how the trial will be conducted safely.
“I love the whole process. I suspect most people would find it boring but for me I really enjoy thinking about every nitty gritty detail related to the trial to make sure everything is covered,” says Brittany. “What keeps me motivated is knowing it has potential to be applied to get better treatments out there, sometimes for conditions that do not currently have a treatment.”
“One of the best things about clinical trials in that it’s a way for everyone to be involved in furthering science and healthcare.”
One of the clinical trials Brittany is involved in is a Phase 1 study testing the therapeutic potential of human hookworms. This could provide an organic, self-regulating method to treat a range of inflammatory and allergic conditions for which there are limited effective treatments.
“Currently, we are testing the safety and functionality of hookworms in healthy participants,” says Brittany. “We are looking at whether our long-term storage technique will preserve functionality of the hookworm. That way, we can also understand the practicalities of using hookworm therapy as a standard of care for treating inflammatory conditions.”
Brittany is also involved in a clinical study, Ka Mātau, Ka Ora (from knowledge comes wellbeing), which started last year at the beginning of New Zealand’s COVID-19 vaccination drive. The ongoing study into the Pfizer-BioNTech vaccine aims to better understand how New Zealanders’ immune systems respond to the Pfizer BioNTech vaccine, particularly in populations likely at higher risk from COVID-19, such as Māori, Pasifika and the elderly. The study involves around 300 participants across Rotorua and Christchurch.
“I've previously only worked on studies that were significantly smaller (20-30 people) and this is 10 times larger! It’s been a great opportunity to challenge myself and get more experience in this space,” says Brittany.
“It’s great to be part of a study that’s so pertinent to society. Rather than something that might be relevant in 10 years’ time, these results are relevant now.”
The initial results from the study have shown that the participants in the trial respond similarly to the vaccine as seen in studies of other populations around the world. This indicates that the efficacy and safety information reported in the international clinical trials can also be applied to our population.
This study is being conducted by Vaccine Alliance Aotearoa New Zealand – Ohu Kaupare Huaketo (VAANZ) a multi-institutional team focused on building New Zealand’s capability and platforms for vaccine development.
“I’ve enjoyed working with so many people from different organisations who’ve been involved in various stages of the clinical trial,” says Brittany “I’ve worked with the clinical trial monitors; with Dr Fran Priddy who was leading VAANZ and is a significant figure in global health; with Maia Brewerton who is the current clinical director with VAANZ; I met people from Moderna; and have met with NZ Ministry officials who helped to fund the study to help inform policy. Even working with the clinical sites in Christchurch and Rotorua to understand how they conducted clinical trials on such a large scale was really interesting!”
“Interacting with patients allows me to see the context at the forefront of the research I'm doing rather than a far-off goal. I can see the people I'm doing this research for, and this keeps me going.”
Brittany encourages everyone to look at what clinical trials are happening and get in touch if anything interests them.
“One of the best things about clinical trials in that it’s a way for everyone to be involved in furthering science and healthcare,” says Brittany. “I want people to know that making that first step and asking for information and deciding it's not for you is completely okay. I enjoy meeting people from different parts of our community and getting people involved in the research and invested in the outcome.”
Brittany started her scientific career working on lab research during her Master’s project. She was working to understand if mitochondria, small organelles in the cell that provide energy, are transferred between cells during bone marrow transplants.
“My experiments mainly took place in the lab. But then I got to go into the hospital and meet the patients whose samples I would be working on. It was my first taste of patient interaction and I loved it,” says Brittany.
From this experience Brittany knew that she wanted to take part in science that involved patient interaction. When her Master’s project finished in 2019, a job opened up at the Malaghan Institute that enabled her to do just that.
“I was in the right place at the right time and I feel incredibly grateful for that. It allowed me to transition from basic science to translational research. From lab bench to patient bed side,” says Brittany.
“Interacting with patients allows me to see the context at the forefront of the research I'm doing rather than a far-off goal. I can see the people I'm doing this research for, and this keeps me going.”