NZ cancer ‘breakthrough’
Innovative drug passes first stage of trial, offering new hope to cancer sufferers. Pip Keane and Stacey Kirk report.
New Zealand scientists are developing their own melanoma vaccine to rival ‘‘wonder-drug’’ Keytruda.
It should be available within five years – and with a considerably lower price tag.
Malaghan Institute director Graham Le Gros has tipped the vaccine discovery, led by associate professor Ian Hermans and Gavin Painter, as the equivalent to discovering penicillin.
Pre-clinical trials on mice were promising, he said. The Institute has begun a closed trial of 45 patients, and results are expected this coming year.
‘‘It actually has got a very exciting profile and is meeting many of the things that Keytruda does in a pre-clinical setting,’’ Le Gros said.
‘‘We have huge amount of international interest, and we’re trying to keep all the value here and we want to try and actually make it work here.’’
Kathryn Williams was diagnosed with melanoma and given 12 months to live. But with the help of the researchers at the institute, the 45-year-old mum is still alive seven years later. She hails the 12 scientists’ latest work on a vaccine as ‘‘the medical breakthrough of the 21st century’’, saying it offers hope to cancer sufferers like herself.
In the lab, the synthetic vaccine technology has been shown to delay the growth of an aggressive melanoma tumour.
The vaccine’s researchers, from both the Malaghan Institute and Victoria University’s Ferrier Research Institute, have set up Avalia, a Lower Hutt-based venture, to attract considerable international investment and progress to clinical trials.
Chief executive Melissa Yiannoutsos said trials on the vaccine would help Avalia’s work to develop a synthetic platform of vaccines that could be effective across a number of cancers.
The vaccine is an immunotherapy, which activates the body’s own immune system to kill cancer cells.
‘‘It’s a chemical way of activating the immune system to do the same kind of thing that Keytruda is doing,’’ said Le Gros.
Keytruda, by comparison, takes a biologic approach.
Trials had already found the compounds to be incredibly effective.
Williams was diagnosed with incurable stage 4 metastic melanoma at the end of 2008 after discovering a tiny mole on her shoulder.
After her diagnosis she was granted ‘‘compassionate case’’ access to a vaccine by the Malaghan Institute. Using her own tumour, she gave blood and a vaccine was formulated and administered at Wellington Hospital every 12 weeks for 15 months. The gift was not part of a clinical trial.
‘‘If a melanoma patient is unable to access targeted immunotherapy treatment, and is ineligible for participation in clinical trials, the outcome in 2015 for a New Zealander diagnosed with stage 3 and 4 melanoma remains as dismal as it did for me in 2008,’’ she said.
Williams went into spontaneous remission in 2010.
She said chemotherapy and radiotherapy treatments were not effective in assisting the curative treatment of melanoma. ‘‘What is not being said is that there is nothing on the grocery shelf for melanoma patients. Melanoma patients need access to treatment now and they are not concerned where it comes from.
‘‘Immunotherapy supports our immune system to do the work it is designed to do. Traditional cancer treatment like chemotherapy and radiotherapy are massive assaults to our body systems, destroying even our good cells and functioning body systems. Immunotherapy makes sense.’’
The development of the Malaghan/ Ferrier drug and others like it is one of the many challenges national drug-purchaser Pharmac faces in its funding decisions.
A furore had erupted over Keytruda, made by global drug giant Merck, Sharpe & Dohme, which was deemed by one of Pharmac’s advisory groups to be a low priority option for funding. Pharmac is yet to make a formal decision on it.
But the drug is now at the centre of a political stoush, with Labour vowing to intervene in Pharmac’s processes to fund the drug, and the Government warning against undermining Pharmac in any future negotiations.
Pharmac director of operations Sarah Fitt said a number of similar drugs were in the late stage of development.
It was very difficult to cut funding from one drug, in order to fund another, once a decision had already been made. ‘‘Any commercial negotiations need to consider the pricing offered in light of the potential for competition in this market as well as the clinical evidence.’’
Pharmac understood that ‘‘anyone would find the prospect of developing a melanoma scary, and that the prospect of a new way of treating this disease in the form of immunotherapy provides hope of a better outcome’’, she said.
But data surrounding Keytruda was still inconclusive.
‘‘We are aware that funding a promising new treatment which may not ultimately live up to that promise means that other New Zealanders miss out on access to treatments that are well proven.’’
But Williams fears for Kiwi melanoma sufferers currently contemplating raising cash to seek treatment overseas.
‘‘We are creating an inequitable health service, two health systems, one for those with financial resource and one for those without.’’