I'm curious to see if a blood test will predict the success of cancer treatment
Could a simple blood test determine if a cancer patient will respond to treatment? That is the quest of Auckland medical researcher, Dr Cherie Blenkiron.
Blenkiron was curious to know if analysing blood from a patient diagnosed with malignant melanoma could detect whether they would respond to an immunotherapy treatment prior to it being administered, or if blood tests could help determine whether they're responding to the therapy.
The University of Auckland cancer biologist has been given funding from Auckland Medical Research Foundation (AMRF) to explore her hypothesis, and believes it could be a game-changer for not only melanoma, but also treating other cancers.
“Immunotherapies are expensive. They're expensive to buy the drug, but they're also expensive for the patient in terms of travel, they can also have side effects and there's inconvenience as they have to have repeated three-weekly infusions, in some cases for up to two years,” explains Blenkiron.
“We’re trying to develop a blood test to give people the best treatment and best care. We want it cheap, we want it reliable, and we want it to be quick so you can use it more frequently. I think of them as ‘peace of mind tests’.
“Immunotherapy is the most incredible revolution in treatment. Around the world, there are trials going on proving that it also works for lots of other cancer types too. It’s been shown to work really well for lung cancer.
“We’re measuring an immune protein that’s not specific to the cancer type and we are keeping our fingers crossed its applicable to other cancers.”
Ten per cent of all registered cancers each year are melanoma and it's the third most common cancer type diagnosed in New Zealand – over 2,500 people a year.
Dr Blenkiron’s project focusses on malignant melanoma, where the cancer has spread away from the primary skin site. Malignant melanoma is rare, but still common, with New Zealand having the highest incidence rates in the world due to UV exposure.
Dr Blenkiron and her team, based at the University of Auckland’s Faculty of Medical and Health Sciences, approach patients who are going to receive immunotherapy to treat their diagnosed malignant melanoma.
Malignant melanoma is the only cancer type in New Zealand that has immunotherapies Keytruda and Opdivo funded by Pharmac.
These immunotherapies block proteins that the cancer uses as camouflage from a patient’s own attacking and protective immune system. The treatments re-awaken the body's immune system to then attack the cancer.
If proven to be successful, the test will not only provide a targeted treatment plan more likely to be successful for the patient, it will also mitigate the wasted cost for patients whose cancer is unlikely to respond to immunotherapy.
That money can be diverted to be invested into other treatments, or extended to other cancer types.
AMRF, New Zealand’s largest independent research funder, has awarded her $159,937 for the project. Now into the second year, it has been impacted by COVID lockdowns, forcing her to apply for an extension to complete the work.
“We've really been impacted in two ways. One of them has been limited lab access. And the other has been the fact that for the past couple of years, recruitment of new patients has been really challenging because of the increased rules around access to hospitals, and patients are moving to telehealth follow up so we haven't been able to go to the clinic to take another blood sample. And some of our team converted into helping out with the Covid testing,” Blenkiron adds.
“So an extension is essential. We need another year to be able to really complete the study to a point that we can do more.”
AMRF recognised the need for an emergency Covid-19 Relief Fund, to ensure research projects impacted by the pandemic can recover from months of Auckland’s extended lockdowns.
The 2020 and 2021 lockdowns caused major disruptions for researchers. More than 70 projects funded by AMRF are now significantly stalled and need additional support to pay salaries to complete their work.
Pre-Covid, Blenkiron’s trial was expected to recruit about 50 patients in one year. Immunotherapy is typically given every three weeks for two years – this project involves assessing blood samples taken every three months.
“We are still collecting patients who were recruited pre-Covid, they're the ones who are continuing on the treatment, or they have finished the treatment,” Blenkiron says.
AMRF previously provided a grant to Blenkiron for research into Merkel cell carcinoma (MCC), a more rare and aggressive form of skin cancer. Australasia has the highest incidence of MCC in the world.
“We were able to access a new technology, only available overseas, to analyse some of these new immune proteins. This method, Digital Spatial Profiling, showed us that there are many camouflage proteins present within each patient’s cancer. It also pinpointed possible new targets for trials of up and coming immunotherapies. Together this information could tailor new treatments to improve the lives of people diagnosed with MCC worldwide.”
Blenkiron presented the findings at the first international Merkel Cell Carcinoma Symposium, in Florida, just prior to the first lockdown in 2020.
“It's at the point where it's being used to leverage new funding. AMRF are really good at giving people seed funding to kickstart projects and support them to grow into something bigger,” she says.
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