Finding vital treatments for multiple myeloma
Background
This year, it’s estimated around 2,000 Australians will be diagnosed with multiple myeloma, a type of blood cancer that develops in bone marrow. Although treatments are available to manage the disease, eventually myeloma becomes resistant to all forms of therapy making it incurable. Myeloma, and its current treatments, cause significant illness including bone damage and fracture, anaemia, kidney disease, infections and damage to nerves. Myeloma cells can also lie dormant in the skeleton and come back at any time, growing another tumour.
Immunotherapy is one of the most exciting developments in cancer treatment in years. Unlike standard drug treatments like chemotherapy which can cause significant and lasting side effects, immunotherapy harnesses the body’s own defences to fight cancer without damaging healthy cells. Dr Micklethwaite and his team have been investigating how a breakthrough immunotherapy for other blood cancers could be used to treat myeloma.
The research
One of the latest and most exciting types of immunotherapy to emerge in recent years is called CAR T-cell immunotherapy, and its proving to be highly successful in treating lymphoma and leukaemia. This type of immunotherapy involves taking a patient’s own immune cells, reprogramming them to respond to the cancer cells, and returning them to the patient where they will attack only the cancer cells. CAR T-cell immunotherapy has shown unprecedented success in patients with advanced acute lymphoblastic leukaemia with around 80% of patients responding to treatment and remaining disease-free.
With funding from Cancer Council NSW, Dr Micklethwaite’s team has been developing myeloma-specific CAR T-cells – immune cells that are designed specifically to recognise and destroy myeloma cells. In the lab, the team created a series of these genetically reprogrammed immune cells. In testing their effectiveness, the team has shown these CAR T-cells have significant anti-myeloma capabilities. Choosing one particularly promising CAR T-cell, they are now designing a clinical trial to test their CAR T-cells in patients with multiple myeloma.
The impact
Dr Micklethwaite and his team hope to commence a clinical trial of their myeloma CAR T-cells in 2020. Since myeloma is currently incurable, immunotherapy could potentially transform treatment options for this cancer.
One of the most exciting things about CAR T-cells is that they remain in the body after killing the tumour – this means dormant cells can’t hide and reappear to develop a new tumour later.
Research team
Dr Kenneth Micklethwaite
The University of Sydney
Co-investigator: Associate Professor Simon Harrison
University of Melbourne