TVNZ Breakfast: Revolutionary approach to fight cancer

we turn now to some quite remarkable
news from the frontiers of developing new cancer treatments now normally when
we do that we have to leave New Zealand but this is very much a key we made a
fear the country’s first-ever clinical trial of a cancer treatment called CAR T-cell therapy is getting underway after receiving final regulatory approval this
is big obviously it’s a trial so the results will determine efficacy and
effectiveness and we don’t want to prejudge that but there’s growing
excitement about the potential for this target for this treatment to target
certain cancers including some types of leukemia lymphoma and myeloma and in
this case patients with a type of non-hodgkin lymphoma who have exhausted
other treatment of options that’s an important detail and we’ll discuss that
shortly the trials being conducted by the Malagan Institute as part of its
potentially breakthrough development of new CAR T-cell technology and to explain
how it all works and what fingers crossed it might do and tell us more
about the clinical trial were delighted to welcome to the program the Malaghan
Institute’s clinical director Dr. Robert Weinkove Robert it’s it’s lovely to
have you with us thank you I was watching a lovely TED talk you gave in
which you described your dad who was also a doctor having a weight loss was
his motto his motto was we hope to see less of you which i think is fantastic
and ultimately that’s our role as as clinicians as doctors we want to try and
make if we can people’s illness is a smaller part of their lives and we don’t
know whether this trial is going to be the right step towards that but I think
it’s it’s progress towards what hopefully in the long run will be better
and perhaps less toxic therapies for some people yes wouldn’t it be wonderful
if we saw less of our cancer patients wouldn’t that be a remarkable
breakthrough so how does CAR T-cell therapy work so it’s a slightly
different treatment to some of the conventional ways we treat cancers
particularly lymphomas which this trial is in and instead of using chemotherapy
or or more conventional immune therapies what this involves is taking patients
immune cells out we take them out by a process called Leukaphresis it’s done
at the New Zealand Blood Service so we take out some cells from the patient we
take them off to our specialized laboratories at the Malaghan Institute and
we process and we basically redirect the immune cells reprogram them to direct
them again targets on the cancer cells on the
lymphoma cells we grow them up in the lab we then have to run a series of
safety tests on the cells and once they’re suitable for release we bring
the patient into hospital give them a small dose of what we call conditioning
chemotherapy so that their body can accept the new cells and then give the
cells back to them through their veins and that’s really what the treatment
involves after that there’s then a close period of monitoring because there can
be toxicities fevers and inflammation and so on but this type of treatment has
shown some real successes in some trials overseas and it’s becoming a standard of
care in some other countries we can’t yet offer that routinely in New Zealand
but we hope to be able to be able to pave the way through clinical trials
like ours it’s really important with cancer treatments to not get carried
away until the trials demonstrate absolutely efficacy because false
hope I guess is a terrible thing right but but there is a very real sense of
excitement about CAR T-cell therapy isn’t there there is and that’s based on
other trials that have been done overseas in the U.S.. in China where our
collaborators Wellington Zhaotai Therapies Limited are based there’s a real
sense in numerous trials we’ve seen some patients having very good responses now
it’s not everybody and and even in the best trials of the best therapies to
date there’s only a fraction of people who enjoy really good long-term
responses but and there are some including prominent New Zealanders
who’ve had some really good responses and yes and so we’ll be really keen to
try and bring that modality of treatment here we called this trial ENABLE and
there’s a reason for that we don’t know what the results of this study will be
but we hope it can do is enable the clinical setup the regulatory setup to
allow us to accelerate the the use of these types of treatments here where
they’re proven to be effective in the future and also I found this absolutely
fascinating this is for patients who have exhausted other treatment options
right why is that this is a phase one trial so
it’s a first phase one study we’re generating the cells here in New Zealand
and we don’t yet know how safe and effective it is so when you first do a
trial like that it’s really important that we need to enroll people who
haven’t got other treatment options because we don’t yet know whether the
treatment will be safe we don’t yet know whether it’ll be
effective we’ve got good reason to think it may well be effective but we have to
do this in people who’ve exhausted other treatment options so this trial won’t be
for everybody and we’ll be encouraging people who think they might be eligible
to speak to their own clinicians so to be blunt and brutal and unsentimental
about it and forgive me and I and and and if I’m wrong please correct me but
in normal circumstances the patient’s you are dealing with would be stage four
or terminal or that’s right I mean if people had other potentially curative
options we wouldn’t be advising them to take part in a study that’s right and so
those people one imagines would be desperate to get into this trial and and
and it’s very important that they’re working with their oncologists rather
than coming direct to you but how will the trial participants be selected so
we’ve got some quite stringent inclusion exclusion criteria these have been
agreed by the management trial management committee we’re also lucky to
have a data safety monitoring committee including some overseas clinicians with
experience of these types of treatment and we’ve really designed those criteria
to select people who we think are not going to be put at undue risk from
toxicities of the treatments those criteria are not dissimilar to the kind
of criteria we might use to decide if somebody would go ahead with a
bone-marrow transplant for instance one final question we’re just going to do
the seven o’clock news and I’m naughty for even asking it but I know how much this means
to you and and you have a very real sense of excitement about this don’t you
I do I think it’s a new modality of treatment for us here in New Zealand
there’s good proof of principle this kind of treatment can work very well so
yeah we’re really excited to be able to offer this here and it’s a major
milestone for us it really is Dr.. Robert Weinkove from the Malaghan Institute we look
forward to talking to you about how the trials going and once you have those
results thanks so much for joining us this morning we really do wish you will
thank you

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