Patients resistant to chemotherapy found to respond to immunotherapy; trials to begin in January

The treatment was developed by Professor Dario Campana (standing), an expert in advanced cellular therapy from the National University of Singapore Yong Loo Lin School of Medicine. ST PHOTO: JASON QUAH

SINGAPORE - Ten patients who faced almost certain death from an aggressive form of cancer have a new lease on life after undergoing experimental treatment to boost their immune systems.

The patients, who have acute lymphoblastic leukaemia, had exhausted standard forms of treatment such as chemotherapy and bone marrow transplants without success.

Their last ray of hope came in the form of CAR-T cell immunotherapy. The method involves drawing immune cells from a patient's blood and equipping each of them with a Chimeric Antigen Receptor (CAR) - a receptor which binds itself to a specific protein on the cancer cells. This allows the immune cells to track down cancer cells and kill them.

The treatment was developed by Professor Dario Campana, an expert in advanced cellular therapy from the National University of Singapore (NUS) Yong Loo Lin School of Medicine.

The 10 patients, aged between four and 28, responded well to the treatment at National University Hospital between March last year and April. Eight are in remission, one for close to 16 months.

Six-year-old Bradley Kum was diagnosed with acute lymphoblastic leukaemia in 2017. He did not respond well to chemotherapy, which led to a blood clot in his brain that left him unable to speak and walk for about two weeks.

In March last year, his parents let him undergo the CAR-T cell treatment. He has been in remission ever since.

"It was finally a piece of good news," said mum Kum Hwee Peng, who was visibly emotional when recalling the first bone marrow check after the treatment that tested negative for cancer.

Prof Campana and his team will start therapy trials for 100 patients - children and adults - in January over a period of five to 10 years. Previously, the therapy was only administered to children and young adults.

The expanded trials will be another step in the direction of catering personalised treatment for cancer patients. They are expected to help in training more doctors to administer CAR-T cell therapy.

The team will also examine additional ways to apply the treatment to other forms of leukemia and cancers.

Prof Campana, who has dedicated almost two decades of his life to his research in CAR-T cell therapy, was conferred the Jacob and Louise Gabbay Award in Biotechnology and Medicine

"When we first put the receptors onto the T cells and look at them in a petri dish, the results were fantastic," recalled Prof Campana of the first time he and his team experimented with the receptors they had developed about 15 years ago.

"Within minutes, all leukaemic cells were gone. We've never seen a drug doing that."

Prof Campana and his team also came up with the technology to harvest a large number of CAR-T cells in the laboratory that are then infused into patients during the treatment process.

Dr Allen Yeoh, associate professor at the school's department of paediatrics, said: "Prof Campana's work brings hope to cancer patients.

"For the first time, without needing to go to the USA, Singaporeans with relapsed or resistant acute lymphoblastic leukaemia that was previously considered incurable can now receive such life-saving treatment in Singapore."

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