A B.C. Cancer Agency researcher is looking at a way to combat cancer that holds similarities to an approach that led to a former Prince George physician's suspension and resignation.
Dr. Brad Nelson, who works at the BCCA's Deeley Research Centre in Victoria, was in Prince George on Friday to talk about his work on creating therapeutic vaccines and T-cell infusions based on the mutations found in a patient's tumour.
In June 2012, Dr. Suresh Katakkar resigned from his post as chief oncologist at the B.C. Cancer Agency for the North. The BCCA had suspended Katakkar with pay and began looking into the care of his other patients after learning he had tried an experimental vaccine on a patient dying from stomach cancer.
Along with administering the chemotherapy drug Oxaliplatin, more often used to fight colorectal cancers, Katakkar later boosted with his own experimental vaccine created from the patient's cancer cells.
Although the BCCA has a special emergency committee that can approve a treatment outside practice guidelines within 48 hours, Katakkar said he did not seek approval because it would have taken too long for him to prepare his submission.
Katakkar said in an email to his patients that the patient, Holy Hill, the daughter of former area MP Jay Hill, responded well to the treatment but succumbed to an infection.
Friends and family of Hill and other patients of Katakkar rallied around him, but to no avail.
Nelson said he was not familiar with Katakkar and the controversy that erupted but he said the clinical trials he hopes to have up and running in about two years will have approval from Health Canada and full review by a research ethics board.
"It's all completely above board, legitimate clinical trials research," Nelson said.
Nelson said his lab has been looking at how the immune system responds to cancer for the last 10 years
"We've had a number of studies where we'd invite patients to submit blood samples and tumour samples and we've been literally opening up the tumours and looking at what sort of immune response is going on naturally in patients," Nelson said.
"And we and others around the world have shown that some patients have a really strong immune response against their tumour, meaning that literally the tumour is packed full of white blood cells, T-cells in particular, that are recognizing and attacking the tumour."
Often it's those patients with the strong immune response who have beat the odds and lived significantly longer than their doctors had predicted.
"It's kind of a no brainer to then think, 'if these T-cells are helping some patients have such a strong effect, why don't we try and give every patient a strong T-cell response?'" Nelson said.
He found it can be a numbers game.
"In some patients, there is just a weak response going on, they might have a million T-cells fighting their tumour," Nelson said. "We can literally give them a hundred billion T-cells properly activated and trained to fight tumours."
Studies in mice have shown results strong enough to replace radiation and chemotherapy although Nelson said he does not think it will deliver the same level of impact to people.
"Our trials would be to have patients go through their standard treatments and in addition, giving the T-cells to make [sure] the cancer doesn't come back," Nelson said.
Nelson hopes to have clinical trials that would initially involve patients who have ovarian cancer, up and running in about two years.
"We're ready to go on the science side today but we need to build infrastructure where we can grow these T-cells in a certified clean room so they can be safely given back to patients," Nelson said.
Growing the T-cells take about two months and the process of transferring them into the patient would take about three weeks. The patient would be given a drug to reduce the T-cells already in their body to make room for the "activated, ramped up" ones developed in the lab which means their immune systems would be suppressed for a period.
Initially, the treatments would be delivered in Vancouver, although Nelson said there is no reason it could not eventually be spread to other hospitals around the province once the therapy is established as a standard of care.
"They would be coming home with a completely revamped immune system which is educated to recognize their cancer," Nelson said. "Those T-cells live with you for the rest of your life, so if your cancer ever comes back down the road, the idea is that those T-cells would nip it in the bud."
