Monash-led team’s ‘game-changer’ for aggressive blood cancer

Australian researchers are leading the world in a cure for a common, but aggressive blood cancer. This is how they are giving hope.

A new treatment for an aggressive blood cancer developed in Australia is proving a lifesaver for patients who had run out of options.

A “significant” number on a world-first clinical trial – that included Victorians – were cured of a resistant non-Hodgkin lymphoma when there had been little hope.

This common cancer starts in the lymphatic system and affects around 550 Victorians a year.

The principal investigator was Monash University Associate Professor Gareth Gregory, who is director of Monash Health’s Haematology Clinical Research.

He said two in five patients were maintaining a long lasting remission which usually leads to cure.

In a world-first, patients from Australia, China and the US, tested an immunotherapy drug used in combination with chemotherapy.

It was designed as a unique treatment for patients with rapidly progressing disease that had relapsed or not responded to initial therapy and could not tolerate stem cell transplants or CAR T-cell therapy.

The treatment is known as a bispecific antibody which is an artificial protein that has “two arms”; one binds to a target on the lymphoma cell and the other to the patient’s immune cell, their T-cell.

It was given as an infusion once every three weeks for 12 treatments. Patients (on the trial) received either a standard treatment or the new antibody treatment with chemotherapy.

“Basically it brings their immune cell right up to the lymphoma cell and says this doesn’t belong here, destroy it. The chemotherapy then boosts the immune system’s activity to do that,” Prof Gregory said.

“To see a large number of patients on this trial maintaining their remission after treatment represents a paradigm shift in how we will approach these patients in the future. It really does look to be a game changer.”

Prof Gregory said six in 10 patients with aggressive non-Hodgkin lymphoma were cured with initial treatment, but in the remaining four who relapsed it could be deadly because of limited treatment options.

“This has given me a second chance,” retired deputy primary school Principal Judith Roach, 79, said.

The Victorian grandmother was one of 274 patients worldwide, 30 from Australia, on the trial.

She said it was a lifesaver because it gave her options when she had exhausted all others.

“I had eight rounds of traditional chemotherapy and I was worse than when I started,” Mrs Roach said.

Prof Gregory described her as a perfect example of the impact of the treatment.

“Judy’s beyond three years now,” he said. “The nature of this sort of lymphoma is that it grows quickly, so usually once we get to two years (in remission) we can take a deep breath.”

He said while the drug was developed by the pharmaceutical industry much of the early work for the new treatment happened in Australia.

“Before this study could be performed a clinical trial needed to be done to show its safety,” Prof Gregory said.

“That clinical trial of 27 patients was done at Monash Health, St Vincent’s Hospital in Melbourne and the Prince of Wales Hospital in Sydney.”

Prof Gregory said without the clinical trial it was unlikely Mrs Roach’s lymphoma would have gone into remission or had a reasonable prospect of cure.

“I was extremely ill and losing weight, and the tumour was bigger than when I started initial treatment,” Mrs Roach said.

She said the new treatment had given her not only a life, but a good life.

“I’m strong, healthy and I’m doing the things I want to do.”

The results of the study have now been published in The Lancet.

The treatment will now be submitted to the Therapeutic Goods Administration (TGA) for use in Australia.