Malaghan’s ‘window of hope’ for people with blood cancer
Friday, 3 November 2023
Kirsty Horgan is pulling into her mum’s house for a cup of tea as she picks up this call. She’s a “box of birds” today. Fifty, and fitter than she’s ever been.
Without science this scene would never have happened. After a cancer diagnosis in July 2019, her non Hodgkin’s lymphoma stopped responding to chemotherapy in 2020.
“At that point my haematologist said, you’ve probably got till Christmas. I think it was September. He said … y’know, that’s it. We’re done.
“I had a bit of a tantrum, I would call it.”
Her son Sam was nine when she was diagnosed. He had just lost his father Mick to cancer. “I just couldn’t leave him alone.”
Then the Christchurch woman got a call saying she might be eligible for a trial. “It opened a window of hope.”
Horgan was one of 21 people with blood cancer who were part of a safety trial of a ground breaking immunotherapy treatment run at Wellington’s Malaghan Institute of Medical Research.
The treatment, known as CAR T-cell therapy, works by taking a patient’s own immune cells (T-cells), modifying them in the laboratory, then giving them back to the patient as a sort of living drug which can identify and kill cancer cells.
Horgan received the therapy in February 2021 and was “completely cancer-free” within three months. She has just seen Sam turn 13, works as a cook, and feels the best she ever has.
About half those on the trial had the same experience.
Malaghan’s clinical director, Dr Rob Weinkove, was not about to use words like “curative” but would say the therapy was well-tolerated without the same level of nasty side effects chemotherapy can bring.
While it was early days, Weinkove said the trial findings suggested there were “no insurmountable obstacles to delivering new cancer treatments like CAR T-cell therapy in our hospitals”.
He confirmed he meant public hospitals, with a key part of the trial being about reducing costs of traditionally expensive immunotherapy.
Malaghan purchased two high-tech ‘’cocoons’’ in late 2021 that took the manual labour out of the therapy and allowed the operation to be scaled up and done at lower cost.
The plan now was to move to a phase two trial in the first half of next year, scaling up to about 60 participants and increasing doses.
The dream is to scale this up, not just into New Zealand hospitals, but to international markets for people whose blood cancer has failed to respond to chemotherapy, Weinkove said.
Several commercial CAR-T cell therapies have been put into practice from phase two trials, Weinkove said.
“Depending what the regulators say it might not be necessary to go to phase three.”
Of course, the number of New Zealanders who get a second chance like Horgan will depend on funding and political will.
“This is quite a unique programme … we can both combine good outcomes for New Zealanders and our health service, with good science and with commercialisation.
“We'll have to see, but I hope they [the new government] will see this is a valuable and exemplar programme.”
Horgan puts it more bluntly, adding there was no way she could have paid the six figures to have immunotherapy overseas if it wasn’t for the trial.
“We’re so lucky we got the opportunity. How many tragic cases and families is it going to tear apart in the meantime?
“It’s there … these are people’s parents and people’s children.”