Behind the science: Associate Professor Rishi Kotecha

Behind the science: Associate Professor Rishi Kotecha

While many would consider Associate Professor Rishi Kotecha’s work exhausting and harrowing, he views it as stimulating and rewarding, especially when he checks his inbox.

"I still get emails and letters from patients. Some of the children I’ve treated are now at university or with children of their own,” smiles Associate Professor Rishi Kotecha. “It’s amazing to know I made such a big difference in their lives.”

Professor Kotecha not only changes lives, he is passionate about saving young lives.

“Cancer is such a unique disease,” explains the NHMRC fellow and co-leader of the Leukaemia and Cancer Genetics Team at the Telethon Kids Cancer Centre.

“To be able to do this research, to better understand and discover what cancer is doing in the body, so that we’re able to identify new treatments to combat cancer, is a stimulating and interesting prospect,” he says.

However, he has not chosen the easy road in his battle against childhood cancer. Instead Professor Kotecha has focussed his research on the rarer, more deadly forms of the disease.

“People like to discuss success stories,” the paediatric oncologist explains. “When we read that paediatric leukaemia has an 85 per cent overall survival outcome, this only takes into account standard-risk acute lymphoblastic leukaemia, which has the best outcomes."

Traditionally, childhood cancer research has concentrated on solutions and therapies to help the greatest number of patients. But children suffering from more unusual and rarer cancer subtypes have lower survival rates. One such cancer is infant acute lymphoblastic leukaemia (iALL).

Tragically, infants diagnosed with iALL have only a 40 per cent chance of survival. Their young age combined with the aggressive nature of the disease make it extremely difficult for researchers to discover more effective therapies. Today, Dr Kotecha’s goal is to lift survival rates of iALL patients closer to that of other subtypes of paediatric acute lymphoblastic leukaemia.

“The Kids’ Cancer Project provides funds for my preclinical research in the laboratory. What I’m looking at are those cancers which have really bad outcomes for children. We’re trying to discover new ways of understanding the disease and, in turn, discovering new therapies that we can actually translate directly into the clinic,” he says.

Read more: Combinational therapeutics in high-risk infant acute lymphoblastic leukaemia

Professor Kotecha is a Consultant Paediatric Oncologist and Clinical Haematologist at Perth’s Children’s Hospital, Clinical Lead for Paediatric and Adolescent Leukaemia and Lymphoma for Western Australia, and an Associate Professor in the School of Pharmacy and Biomedical Sciences at Curtin University. While all of this means he has to keep multiple balls in the air, it is his work on the ground and in the laboratory where the vital research happens.

“In terms of the laboratory, what we’re trying to do is generate new, pre-clinical models of iALL,” Kotecha explains. “One of the things we’re doing is drug screening and testing new agents within our models to see if they work. These models are derived directly from patients.”

Chemotherapy drugs in current use can be toxic to babies. Professor Kotecha hopes to develop kinder and more effective therapies for infants.

During his study, novel drugs will follow a detailed road map for pre-clinical testing. The evidence and insights Professor Kotecha and his team glean will provide urgently needed information for a collaborative, international iALL clinical trial to treat infants suffering from the disease around the globe.

Professor Kotecha calls it a “privilege” to be a clinician-scientist, as well as a member of the International iALL Clinical Trials Consortium. Focussed on directly improving the outcomes for patients, he is dedicated to his mission of lifting survival rates for those with iALL.

“I present the data to these groups so that we can integrate it into clinical trials and directly influence patients,” he explains. “If we can find drugs to improve outcomes for infants with cancer in our West Australian lab, it will have an impact all over the world.”

Professor Kotecha hails from a large, extended family and he credits that background for his passion to help children. With a young daughter of his own, the medico who works 80-hour weeks explains that he is inspired by the idea of a “whole patient journey”.

“I guess it’s emotional,” Professor Kotecha explains. “But it’s a gift you’re given. To be part of not just a child, but a whole family’s life, then to be able to cure that child … It’s an amazing reward to see children grow up and do the things that they should be doing.”

Based in Perth for the last 16 years, Professor Kotecha is thrilled to see children he treated now living the life they were meant to live. He is updated regularly by email and photos. “Seeing former patients doing so well in life … I guess that’s what drives me.”
Hero image courtesy of Community Newspaper Group. 

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