A massive change is happening in cancer medicine in Newcastle.
It involves a series of clinical trials with new drugs that block cancer cells from attacking the immune system.
This trials are using “immune therapy”, which Associate Professor Craig Gedye calls “kung fu”.
The Calvary Mater Newcastle Hospital in Waratah is heavily involved in research and trials for this therapy.
Asked if revolution was the right way to describe the therapy, Dr Gedye said: “I can’t disagree with that word”.
Dr Gedye is a researcher and oncologist at the Mater. He’s also part of the University of Newcastle and Hunter Medical Research Institute.
“The drugs are not actually attacking the cancer cells, they are giving people’s immune system a new trick to help attack the cancer,” he said.
The Mater is one of the busiest cancer research units in the country.
“It’s a great team,” Dr Gedye said.
At least half of the Mater’s clinical trials for cancer are using these immune drugs, which are known as “checkpoint inhibitors”.
For the drugs to work, the patient has to be “fit and well”.
“The immune system has to still be active and ready to recognise the cancer. Most times when a cancer grows, it grows because it’s thrown an invisibility cloak over itself. It’s hiding itself from the immune system.”
The Mater has numerous immune-therapy trials occurring, Dr Gedye said.
Overall, this class of drugs work on 10 per cent to 15 per cent of cancers. The results vary dramatically between different cancers. For melanoma, for example, the drugs work for 40 per cent to 50 per cent of people. But for some types of cancer, it fails most people – working only 3 per cent to 4 per cent of the time.
“The reason why it doesn’t work on most people is a topic of intense scientific research,” he said.
“Boy, it’s good when it works.”
Dr Gedye said the drugs represent a “paradigm-shift that has completely revitalised our interest in the immune system”.
“We’re humbled and grateful it’s working for some people. But the last thing you want to do is raise false hopes,” he said.
“Immune therapy really helps some people but totally fails others. I wish I could say it works for everybody but I can’t. But it’s amazing to say to people ‘we’ve got an opportunity, I don’t know if it’s going to help you, but gee I hope so’.”
When the drugs don’t work, the trials are not in vain.
“We’re learning so much about how to make treatments better and how the cancer is trying to defeat and defend itself against the immune system,” he said.
As well as melanoma, immune therapy is also helping a lot of kidney and lung cancer patients – 30 per and and 20 per cent respectively.
The new drugs are allowing these people to get “longer term control of their cancer”.
“But we need to be humble because there are so many questions we don’t know the answers to. That’s why we’re furiously trying to answer every possible question we can about this therapy.”
Some people have no side effects to the drugs, but others have to stop because of side effects.
“Remarkably in some people, the immune system can keep attacking the cancer even if we’ve had to stop the drugs because of side effects,” he said.
The Calvary Mater was involved in one of the world’s first clinical trials of these immune drugs five years ago. Since then, much progress has been made. A quiet revolution is in full swing.
“But it’s only the end of the beginning,” Dr Gedye said.
“We’re quietly grafting away here at one of the busiest and most active clinical-trial units for cancer in the country. We keep working as hard as we can to get as many trials as we can for our patients.”
The trials started with melanoma, but have extended to “every other kind of cancer”.
For example, clinical trials for immune therapy have been done at the Mater for brain, kidney, prostate, bladder, breast, lung and bowel cancer. Dr Gedye said the trials were experiments.
“They give us the opportunity to understand the drugs and hopefully turn them into standard treatments in future,” he said.