Identifying tailored treatments for advanced blood cancer patients

After 45 years of working on ships, which he did from the age of 17, Philip Khan was looking forward to his retirement. More quality time with his wife, more time to do a list of things.

Sadly for Philip, retirement was cut short when he was diagnosed with a blood cancer three years ago.

Blood cancers are cancers derived from blood, bone marrow and immune cells and include leukaemias and lymphomas. Often aggressive, they are a major cause of cancer mortality in Australia and globally.

Some patients may be cured with chemotherapy and bone marrow transplantation, however patients with relapsed or resistant lymphomas or leukaemias have an extremely poor prognosis.

Over the last three years, Philip’s lymphoma was treated in Townsville, Brisbane and Sydney.

During this time there were many moments Philip and his wife Naoko felt the strain of his prognosis and what the future held.

“We have returned home to Mackay feeling very dejected and pondering what was to come” Philip shared.

It seemed like he had come to the end of his treatment options.

Then, a phone call inviting him to meet with Professor Steven Lane, Head of the Cancer Program at QIMR Berghofer, offered hope which had almost gone.

Professor Lane, a clinical haematologist at the Royal Brisbane and Women’s Hospital (RBWH), has been driving research so people living with advanced blood cancer, can access genomic screening which could lead to targeted treatment for these patients.

Invited to develop a haematology cancer arm of the MoST program, this research led by Professor Lane, currently offers hope to patients who have run out of treatment options.

The Blood Cancer Genomics Trial (MoST-LLy) is using the experience and platform of the Molecular Screening and Therapeutics (MoST) Program. The MoST program has pioneered the way for patients with solid cancers to be screened and treated with targeted treatment.

Professor Lane explained; “Chemotherapy is really a one-size fits all therapy approach to blood cancer that does not look at the genetic mutations and is no longer justifiable or cost efficient”.

“Moreover, genetic testing, once prohibitively expensive, is now accessible and deliverable in a timely manner,” he said.

The MoST-LLy pilot study links molecular screening of more than 500 genes of the patient with a series of clinical sub-studies or trials, testing new treatments.

Patients with relapsed or resistant lymphomas or leukaemias are offered the screening which provides a genomic profile to potentially match a patient to medicine precisely tailored to treat their individual disease (precision medicine).

For Philip, the meeting with Professor Lane and the opportunity to participate in the study, helped, “It shone a light at the end of the long tunnel.”

Philip, flew down from Mackay to Brisbane and was the first patient to take part in the MoST-LLy study after receiving a recommendation for treatment from the MoST Molecular Tumour Board.

Throughout treatment, researchers look for biomarkers of response as well as biomarkers of resistance, with considerations such as why patients didn’t respond or the markers for patients that did respond.

Biomarker-driven studies have the potential to fast-track the identification of patient groups most likely to benefit from precision medicine.

“MoST-LLy will provide a new model of rapid clinical translation and access to novel treatments for high-risk blood cancers in Australia, with findings that may change the management of advanced haematological malignancy and improve patient outcome,” Professor Lane said.

The pilot study was co-funded by the Leukaemia Foundation and Tour de Cure. Further funding by the Australian Government’s Medical Research Future Fund (MRFF) will enable the program to be further expanded.

From the pilot sites at RBWH and Royal Adelaide Hospital, MoST-LLy will expand to three new sites in 2022 in Western Australia, New South Wales and Tasmania.

MoST-LLy is a collaboration between RBWH, Royal Adelaide Hospital, QIMR Berghofer, SA Pathology, Garvan Institute of Medical Research, Omico (the Australian Genomic Cancer Medicine Centre) and the NHMRC Clinical Trials Centre at the University of Sydney. The research has ethics approval from St Vincent’s Hospital Human Research Ethics Committee and the University of Sydney is the regulatory sponsor of clinical trials undertaken through MoST-LLy.

To enquire about eligibility for this study, patients should ask their treating doctor to contact the clinical trials doctors at RBWH.

Click here for Digital Version Click here to Subscribe