IVF pioneer Alan Trounson develops world-first therapy to target ovarian cancer, endometriosis
The man who pioneered modern IVF has turned his attention to finding a cure for ovarian cancer and endometriosis, with his world-first cell therapy set to be tested in clinical trials.
The man who pioneered modern IVF to help women become mothers has turned his attention to finding cures for the diseases that can kill or cause them terrible pain.
Renowned IVF and stem cell scientist Alan Trounson is ready to take to clinical trials his world-first immunotherapies to target ovarian cancer and endometriosis.
If successful these panaceas hold the promise of helping the one in seven women with endometriosis and the more than 320,000 diagnosed with ovarian cancer each year.
Ovarian cancer is Australia’s deadliest female cancer; endometriosis a leading cause of infertility.
The trials will involve Australian women testing the cell-based products that were discovered, developed and will be manufactured at Notting Hill in Melbourne’s southeast, home to Cartherics.
This is a small privately-owned, Victorian-based biotech company with big ambitions. Emeritus professor Trounson is its CEO.
Its team of 40 has developed a cell-based therapy that uses natural killer (NK) cells with the working name of CTH-401.
These cells are generated from donated umbilical cord blood that can be turned into not only NK cells, but also other cells of the immune system.
“(But) the NK cells are much safer and if you’re going into a population of patients who are not at risk of death, such as endometriosis patients, you have to go in with something very safe. That’s important,” Trounson said.
“NK cells are safe because their role is to seek out and destroy cells that shouldn’t be there. They’re the first responders in the immune system and very effective at killing.”
This is why Trounson and his team believe they can also be successful targeting endometriosis, an all-too-common condition in which cells similar to the lining of the uterus, or endometrium, grow outside the uterus.
“We think that there’s sound reasoning that women will (respond) to having these NK-based immunotherapies injected directly into their pelvic cavity,” he said. “It’ll probably be a series of three or four injections, I think, for endometriosis.”
Initially it will be trialled in women with advanced endometriosis but down the track Trounson believes it can become a universal treatment.
Lasting legacy
His excitement is palpable, but what’s not so clear is why, when retirement rather than research would be the focus for many his age – Trounson turns 80 in February – does he want to spend his days searching for better ways to fight these difficult diseases?
“I want my legacy to be that I cared about women,” Trounson said. “I think I was so impressed in the days I worked with (the godfather of IVF in Australia) Carl Wood because his view was that we were there to do something significant for women.”
Do “something significant” they did as an integral part of a research program that started between the University of Melbourne and Monash University at the Queen Victoria Hospital and the Royal Women’s Hospital in 1970.
They set up a committee with the working title ‘The Egg Project’, chaired by Wood. The team included John Leeton and Alex Lopata from Monash University and Ian Johnston and James Brown from Melbourne University.
Together the group would go on to achieve the world’s first IVF pregnancy with a Victorian woman, which sadly lasted only nine days, but it helped to prove that IVF in humans worked.
The rest is history. In 1980 the combined team achieved Australia’s first IVF baby, Candice Reed. Today, it is estimated around 13 million babies have been born worldwide thanks to IVF.
Research firsts
Trounson, who had started his career as an animal embryologist, would achieve many IVF firsts including introducing fertility drugs to improve ovulation and embryo freezing techniques that have helped more than 300,000 women become pregnant.
He also discovered that nerve stem cells could be derived from embryonic stem cells which would see him lured to the US in 2007 to head the $9 billion California Institute for Regenerative Medicine.
This was established to accelerate stem cell, regenerative medicine and gene therapy research and has attracted more than $25bn in research investment from biotech, pharmaceuticals and industry.
Trounson returned to Melbourne to set up Cartherics which is funded by “angel investors”, a global group in for the long haul.
“They came on the basis that they thought what we were doing was special and that they wanted to support us,” Trounson said.
“They’re not the sort of normal investment group, they’re angel investors if you like, but they’ve been fantastic for us. They’ve kept us going since 2016, which has been wonderful.”
It has also allowed the company to this month open one of the country’s first cleanroom facilities for clinical-scale manufacturing of cell therapy products.
It is a $4 million investment that will allow them to make hundreds or even thousands of doses of the therapy and store them frozen on site ready to be made available to patients who need them.
Having their own manufacturing facility is key, Trounson says.
“We looked at manufacturing them elsewhere but the costs were really beyond us,” he said.
“So I said to the board why don’t we upgrade our own facilities? That way we have a facility for doing this in the future. It will be much more cost effective and allow us to move quickly from discovery through to the manufacturing phase on site.”
Trounson says it will also allow them to manufacture clinical batches of CTH-401 for the clinical trials that will start towards the end of next year and involve first women with relapsed and drug-resistant refractory ovarian cancer.
Endometriosis
It was the impact in his early years of working with women who really wanted to have children that shaped Trounson’s career and made him interested in conditions that affect them.
It also exposed him to the devastation of endometriosis.
“When I was doing IVF I hadn’t realised how common endo was,” he said. “In nearly every patient who came through, they had endometriosis. It stunned me that it was so wide spread.”
He said research also shows that if endometriosis becomes advanced, it causes not only pain and infertility, but also a 20 per cent increased risk in ovarian cancer in these patients.
“I think it is a danger; endometriosis has some of the same markers as ovarian cancer.”
Retire? Not me
He says retirement for him is a complex question.
“I’ve offered my resignation many times (to the board) and told them they should be able to find someone better and they don’t want to accept it, but there is a point in time when you should move on.”
He says the logical time would be when the company becomes a public business.
And then? Forget gardening, he has already discovered he wasn’t that good at it.
As more of his friends, including the late Wood, fall victim to insidious Alzheimer’s disease, it may become his next “cure” challenge.
“I wish I could make a difference to Alzheimer’s,” Trounson said, as he names loved ones, colleagues and friends who have succumbed to the brain disease.
“It’s too close, too frequent, and I wish we could make a difference.”
He says the company is looking at new immune cell products that could be tailored to disrupt not just ovarian cancer, but potentially triple negative breast cancer, pancreatic and other solid tumours.
He also believes the unique therapy could turn its focus to Alzheimer’s disease and other traumatic brain injury, including Parkinson’s disease.
For now, Trounson says he is content leading the company that has as its mission transforming care in women’s health.
Midwife welcomes potential new treatment
Midwife Olivia Kivlighon says the potential of a treatment for endometriosis that is less invasive offers women like her suffering the debilitating condition much-needed choice.
An ambassador for the Australian Endometriosis Foundation, she said women now had to decide between living in horrific pain versus an invasive surgical treatment or difficult medical management.
“I think that many people have to choose between the two, and you often pick surgery thinking that’s the gold standard and what will be most helpful, but it can come with so many side effects. Less invasive treatments will certainly be wonderful for women.”
Ms Kivlighon, 25, considers herself lucky to have been diagnosed with endometriosis at 21, knowing now that it can take more than five years and many visits to doctors to get confirmation.
She first heard about endometriosis while qualifying as a midwife when a painful, heavy period caused her to faint at work.
A week in hospital and a surgical procedure called a laparoscopy later and Ms Kivlighon was diagnosed with stage 3 endometriosis.
“It was found on the bowel, throughout the uterus and all over my bladder as well. The surgeon said that it looked like it had been there for over five years.”
Her latest surgery in May 2024 required a bowel resection and Ms Kivlighon lost more than 20cm of her lower colon.
She is now trying a more holistic approach to treatment.
“I am doing a more holistic approach; a lot of psychology, healing work, holistic practices, and physiotherapy every week.”
What is endometriosis?
A chronic, inflammatory disease where tissue similar to the lining of the uterus grows outside the uterus, most often in the pelvic cavity. It can also be in areas not connected with the uterus, like the bowel or bladder. Endometriosis has been found in every major organ in the body.
Source: Australian Endometriosis Foundation. Visit: ausendofoundation.org.au
Originally published as IVF pioneer Alan Trounson develops world-first therapy to target ovarian cancer, endometriosis
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