More doctors treating aching joints with stem cells, even though treatment is costly, unproven and relief is only temporary
It’s expensive, only temporary and lacks gold-standard proof that it actually works, but stem cell therapy for bad knees, hips and shoulders is taking hold in Canada.…
It’s expensive, only temporary and lacks gold-standard proof that it actually works, but stem cell therapy for bad knees, hips and shoulders is taking hold in Canada.
“The future is obviously injections of biologics,” says Dr. Tim Dwyer, an orthopedic surgeon at Women’s College Hospital in Toronto who has treated 20 patients’ faulty joints with stem cell injections at his private clinic. “One day we will look back and think joint replacement was a fabulous solution 30 years ago that now is quite a barbaric approach.”
We have written about these autologous (using a patient’s own stem cells) transplants in this space before. The first type, bone marrow aspirate concentrate (BMAC) therapy, involves extracting stem cells from a patient’s pelvis and spinning them in a centrifuge before re-injecting the refined cells in the damaged joint. The second type, formally known as stromal vascular fractioning, involves removing adipose (fat) cells via liposuction, running them through a centrifuge to collect the stem cells and re-injecting them in the patient’s ailing joint. Both are usually done on a same-day outpatient basis.
Neither treatment has been proven effective in large scale, randomized controlled clinical trials in which one group of patients gets the treatment and another gets a placebo — with neither group (nor the researchers conducting the trial, for that matter) knowing who got what until the data is collected and analyzed.
“That is correct, not at this stage,” says Dr. Dwyer. “We’re basing (the use of the treatment) on cohort studies looking at BMAC in the knee especially.”
Dr. Jas Chahal, a colleague of Dr. Dwyer’s at Women’s College Hospital, believes there is “good basic science,” to support the use of stem cell treatments for knees, hips and joints afflicted by osteoarthritis or damaged by injury. “BMAC has various factors in it that probably help inflammation and pain control. There is emerging clinical evidence in the form of case studies, groups of 10 or 20, who have had it and after 12-month follow-up had good results.”
However, Dr. Duncan Stewart, the President and Scientific Director of the Ontario Institute for Regenerative Medicine, says patients “should be extremely wary of any stem cell therapy that is fee-based and has not been validated through a complete clinical trial process.
“Clinical trials exist to establish not just whether a treatment will work, but to ensure it is safe for the patient,” says Dr. Stewart, CEO of the Ottawa Hospital Research Institute and a leading authority on stem cells who has led or collaborated on more investigator-initiated cell therapy trials than anyone else in Ontario. “There are many promising stem cell therapies out there that are currently in clinical trials, but not all will approved for clinical use – and the only way we can know for sure is by collecting the proper data through a clinical trial that has regulatory and ethical approvals.”
For Dr. Dwyer, who sees the BMAC treatment as more effective but will provide the adipose-derived stem cell treatment for patients for whom BMAC isn’t appropriate, stem cell injections offer an option where none existed before.
“For 10 years of my career I’ve had to say ‘You’re too young to have a knee replacement and a knee scope won’t make you better, so there’s nothing we can do.’ That’s not a fun conversation to have three or four times a day.”
He charges between $3,000 and $3,500 per injection, none of which is covered by the provincial health insurance plan or by private insurance.
Some researchers and clinicians have taken things a significant step further by taking the BMAC cells and, instead of just running them through a centrifuge, culturing them in a lab to vastly increase the number of stem cells they can re-inject into the patient at a later date. But these treatments are significantly more expensive. Dr. Chahal is part of a team conducting a clinical trial extracting the mesenchymal bone marrow stem cells from patients and doing this kind of ex-vivo expansion and then re-injecting them at concentrations of 1 million, 10 million and 50 million cells. Researchers are currently collecting the data.
Of the 20 patients Dr. Dwyer has treated with the same-day therapy, “a couple” saw no improvement in their conditions. Most report feeling better. “Just yesterday I saw three people — two shoulders and a knee — and they were actually ecstatic. Now that’s just a cohort. But it certainly helped those people and they’re at the six-month mark.”
He points out that joint replacements are also not a sure thing.
“It’s not guaranteed that a knee replacement will help. Some 20% of people still have pain afterwards. And there’s always the chance that you get an infection, which can be a disaster. A lot of people, including myself, think that joint replacement is a last resort. So, obviously, having an injection that might take the pain away for a year is a very attractive option.”
Pain relief, if achieved, likely will be only temporary, says Dr. Dwyer. “We’re looking at a year,” says Dr. Dwyer. “For some people it will be more, for some it will be less. It will be something that you will need to have repeated. But if you ignore the financial cost of it, which is a significant factor obviously, and just look at whether you would like to have an injection once a year and not have a knee or a hip replacement, the answer is easy.”
BMAC and adipose stem cell treatments for arthritic and damaged joints have been around for about a decade and are widely available across the United States, with many Canadians travelling there to undergo them, sometimes paying exorbitant fees.
Here at the Canadian Stem Cell Foundation, we get more patient enquiries and blog comments about stem cell treatments for failing joints — be it from either osteoarthritis or injury or overuse — than any other single condition. People are both intrigued and suspicious and are looking for guidance.
What is Health Canada’s position on the use of bone marrow aspirate concentrate injections/transplants to treat knees and hips?
The Office of Policy and International Collaboration at Health Canada’s Biologics and Genetic Therapies Directorate responded by email to say that “in some cases, autologous cell therapy products that are processed for a particular patient by a regulated health professional pursuant to the scope of their practice may not require federal pre-market regulatory authorization under the Food and Drug Regulations. They added that, based on the information we provided, “we do not have enough information to make a determination regarding the regulatory pathway that would apply to BMAC.”
Prof. Leigh Turner, a Canadian who is an Associate Professor at the University of Minnesota’s Centre for Bioethics, has followed the proliferation of clinics offering BMAC and adipose treatments in the United States. He says it’s “premature” for Canadian orthopedic surgeons and other physicians to charge for “so-called stem cell treatments” administered to patients with joint problems.
“Safety and efficacy of such interventions still needs to be evaluated in carefully designed and properly conducted randomized controlled trials,” says Prof. Turner. “Such studies will have to address whether stem cells obtained from BMAC, adipose tissue, or other sources are optimal when treating patients with osteoarthritis. Carefully designed clinical trials should also provide meaningful information about dosing strategies, optimal mode of administering cells, and the frequency with which injections will need to be provided.” And all that, says Prof. Turner, is conditional on stem cell interventions beating placebo during the randomized controlled trial process.
Last fall we told the story of Dan Muscat, an Ontario jeweler whose combination chemo/stem cell transplant treatment helped him recover from scleroderma, an extremely painful, life-threatening autoimmune disease that hardens the skin and attacks internal organs.…
Last fall we told the story of Dan Muscat, an Ontario jeweler whose combination chemo/stem cell transplant treatment helped him recover from scleroderma, an extremely painful, life-threatening autoimmune disease that hardens the skin and attacks internal organs.
We believed then that his transplant, which took place at The Ottawa Hospital over the spring and summer of 2016, was the first time such a therapy had been tried in Canada. It even made news: CTV’s Avis Favaro profiled Dan early this year.
It turns out that other Canadian hospitals are trying — and have been using — the innovative therapy, which involves first extracting bone marrow stem cells from a patient to purify them, then wiping out their diseased immune system with chemotherapy, and finally returning the robust stem cells to the patient. The goal is to have these fortified stem cells rebuild a disease-free immune system.
Calgary’s Dr. Jan Storek has employed the chemo/stem cell treatment on “four or five” patients since 2011 and has contributed to the international Scleroderma: Cyclophosphamide Or Transplantation (SCOT) study, the results of which have yet to be published. He began working with the treatment in the 1990s at the Fred Hutchinson Cancer Center in Seattle.
“I was part of the development of transplants for autoimmune diseases,” says Dr. Storek. “Then the University of Calgary hired me to start a research program in bone marrow transplantation including transplantation for autoimmune diseases.”
He points to the work of Dr. Sharon LeClercq, a Calgary rheumatologist and expert in systemic sclerosis, without whose involvement there would have been no Canadian participation in a randomized study. “Patients participating in studies, particularly in the three randomized studies leading to this success should also be greatly acknowledged,” says Dr. Storek.
One of his transplant recipients is Miaya Killips, pictured above shortly after her 2016 transplant and as she is today. Miaya, who lives in Spruce Grove, Alberta, was diagnosed with scleroderma three years ago. She suffered lung damage, along with hardening of the skin. “I had limited mobility because my joints were tight and I was not able to swallow well — I would choke on food.”
These days, things are much better. “Scleroderma-wise, I’m feeling great. My mobility is much better and I don’t have the pain I had before. I am not choking when I eat and my lungs have stabilized, which is good because before the transplant my doctor had me on a standby list for a lung transplant.”
An electrician by trade, she wants to go back to school as part of a career change. And she and her husband plan to start a family soon, using embryos harvested through in vitro fertilization before she underwent chemotherapy.
We also heard from Shane Knihnitski, a 28-year-old heavy equipment mechanic who underwent a bone marrow stem cell transplant at Saskatoon’s Royal University Hospital in February to treat his scleroderma, which had caused large calcium deposits to form at his joints, resulting in considerable pain and restricted mobility.
“Things are turning around,” Shane says, “and the skin is starting to loosen up. I wasn’t able to see my elbow for two years — it was a big lump like a soft ball — but I can see the bone again.”
Dr. Keltie Anderson, Shane’s rheumatologist, says that while “it’s still very early” Shane has regained “a fairly significant amount of mobility in his hands already.
“When I first started seeing him, he could sort of cup his hands but couldn’t make a fist. Now he can bring the fingers all the way to the palm — almost make a full fist. To have such change already is very impressive.”
That the stem cell transplant procedure is having good results comes as great news to rheumatologists like Dr. Anderson who, until now, had few weapons with which to fight this painful, life-stealing disease. “Basically, you would do cyclophosphamide (a chemotherapy medication to suppress the immune system) and then cross your fingers.
“In Shane’s case he not only has extensive skin involvement, he also had extensive lung involvement. His outlook was quite bleak. And he’s a young guy and (he and his wife) just had their first child.”
Dr. Mohamed Elemary, who directs the hospital’s stem cell transplant program, says Shane was originally referred to Dr. Storek for inclusion in the Calgary study but it had already been completed. “So we started to review the data and see if it was something feasible for him here in Saskatoon. The stem cell transplant unit is run by the cancer centre and by the health region with the University Hospital. We can barely accommodate our patients with malignancies.”
After receiving permission to try the treatment with Shane, making sure he was a good candidate for the procedure, and consulting with Dr. Storek, Dr. Elemary went ahead with the transplant two months ago. “Our concerns vanished because he did tremendously well and was out of the hospital almost two weeks after his transplant. I just saw him a couple of weeks ago and I was amazed at the way that he is responding.”
The treatment does not come without risks. In Shane’s case, he was told there was a 20% chance the treatment could kill him. “But he came through it with flying colours,” says Dr. Anderson. “The last time I saw him he looked great. He didn’t look like someone who’d just gone through ablative chemotherapy with a stem cell transplant. And he was more upbeat than I’d seen him in a long time.”
Dr. Elemary is hoping to get approval to treat another scleroderma patient with stem cells and “with the success of Shane’s story” is optimistic that will happen.
In May, Calgary’s Dr. Storek, with co-authors Drs. LeClercq and Andrew Daly, will publish a report in the Canadian Medical Association Journal, reviewing the challenges of integrating the treatment in Canadian hospitals, given that stem cell transplantation programs are set up to treat patients with malignant cancers. Dr, Storek also
Dan Muscat, whose recovery continues, is delighted that more scleroderma patients are getting the treatment. “I’m trying to get the word out. This should be an option for people when they are diagnosed.”
Dr. Antoine Hakim, one of Canada’s truly inspirational medical leaders, is this year’s winner of the Gairdner Wightman Award.
Dr. Hakim is a long-time friend of the Canadian Stem Cell Foundation.…
Dr. Antoine Hakim, one of Canada’s truly inspirational medical leaders, is this year’s winner of the Gairdner Wightman Award.
Dr. Hakim is a long-time friend of the Canadian Stem Cell Foundation. He founded and led the Canadian Stroke Network that, in its early years, shared resources at The Ottawa Hospital with the Stem Cell Network — from which the Foundation sprang.
“We truly admire Tony Hakim for the amazing job he has done to advance stroke prevention and treatment,” said James Price, Foundation President and CEO. “He has served as a model for us all in working to improve Canadians’ lives.”
In today’s Ottawa Citizen, health writer Elizabeth Payne describes how, after working as a chemical engineer in Alberta, Dr. Hakim switched to medicine because he wanted to do something “more relevant.” On completing his residency in neurology at the Montreal Neurological Institute, he took up stroke as a research interest.
He became North America’s strongest advocate for increased use of the clot-busting drug TPA that, when administered in time, can greatly reduce the effects of a stroke.
“The revolution in stroke treatment,” the Citizen reports, “is seen in the many ‘miraculous’ recoveries he has witnessed in patients who come into the hospital severely handicapped and unable to speak and, within 48 hours, walk out of the hospital talking.”
At 74, Dr. Hakim continues his to enjoy his work, which gives him the opportunity to “keep pushing frontiers the best way I can.”
The other Gairdner 2017 laureates include:
- Japan’s Akira Endo for the first discovery and development of statins that have transformed the prevention and treatment of cardiovascular disease.
- California’s David Julius for determining the molecular basis of somatosensation — how we sense heat, cold and pain.
- Toronto’s Lewis E. Kay for the development of modern NMR spectroscopy.
- Italy’s Rino Rappuoli for pioneering the genomic approach, known as reverse vaccinology, used to develop a vaccine against meningococcus B.
- Texas’s Huda Y. Zoghbi for the discovery of the genetic basis of Rett syndrome and its implications for autism spectrum disorders.
- Brazil’s Cesar Victora, for outstanding contributions to maternal and child health and nutrition in low and middle income countries (John Dirks Canada Gairdner Global Health Award).
Winning a Gairdner, Canada’s top medical price, is often a precursor to even bigger things: 83 Gairdner laureates have gone on to win the Nobel Prize.
The Canadian Stem Cell Foundation commends the federal government for committing to invest in innovation “superclusters” and for identifying the stem cell/regenerative medicine sector as an area where Canada can excel.…
The Canadian Stem Cell Foundation commends the federal government for committing to invest in innovation “superclusters” and for identifying the stem cell/regenerative medicine sector as an area where Canada can excel.
“We consider today’s budget announcement to be a step forward for the stem cell sector in Canada – an industry that is helping to shape our innovation economy,” said James Price, President and CEO of the Canadian Stem Cell Foundation.
The government’s commitment to invest $950 million in business-led innovation superclusters with the greatest potential to accelerate economic growth mirrors the approach taken by the Canadian Stem Cell Foundation in championing the Canadian Stem Cell Strategy. The Strategy is business led and calls for two-thirds of the total investment to be funded by the private sector, with one-third from government.
“The Canadian Stem Cell Strategy will generate more than $1 billion in private and philanthropic investments over its decade-long life, much of which has already been pledged,” Mr. Price said. “It is built to deliver 10 new therapies to the clinic within 10 years, create 12,000 jobs and position Canada as a global leader in the field.”
The supercluster initiative will launch a competition for funds this year with a focus on six “highly innovative industries” including health and bio-sciences. The recommendation comes after the Advisory Council on Economic Development noted that Canada’s “world-class regenerative medicine and stem cell therapy development” could unlock innovation and drive economic growth.
The Canadian Stem Cell Foundation, which has been calling on the federal government to implement the proposed national strategy, looks forward to working with its partners to answer the call for business-led innovation superclusters to advance stem cell therapies to save lives and grow the economy.
“Canada produces some of the best stem cell research in the world,” said Mr. Price. “We must now translate our research into commercial success.”
Last week we wrote about three women whose vision was lost or damaged after they were injected with stem cells derived from their own fat tissue in a Florida clinic.…
Last week we wrote about three women whose vision was lost or damaged after they were injected with stem cells derived from their own fat tissue in a Florida clinic.
This week, a Calgary doctor who uses our website “to educate patients on avoiding the ‘pop up’ shops” offering unproven stem cell treatments, wrote to make us aware of a BBC podcast called Assignment that recently featured an episode titled The Stem Cell Hard Sell.
The UK program focused on another Florida clinic that provides — for a $20,000 fee — eye implants derived from bone marrow stem cells drawn from a patient’s pelvis. Central to the piece is the story of an American man named George Gibson who claims he lost sight in one eye after undergoing the procedure.
The treatment is part of a clinical study that’s listed with the U.S. National Institutes of Health called The Stem Cell Ophthalmology Treatment Study-(SCOTS). However it is unclear if the study is approved by the Food and Drug Administration (FDA). The BBC program points out that researchers usually do not charge patients for the treatments in a clinical trial or study because the outcomes can’t be guaranteed. As we have written in this space before, having patients pay for treatments tends to encourage them to “buy into” seeing favourable results that might not truly be there.
Dr. Paul Knoepfler, an American researcher whose lab conducts stem and cancer cell research at the University of California Davis School of Medicine in Sacramento, writes extensively about unproven stem cell treatments. His blog, The Niche, has dealt with SCOTS, drawing comments from one man who claims his vision was significantly improved and from others — including Mr. Gibson — who warn against the treatment.
A press release about the SCOTS trial, says investigators “hope that the treatment will be shown to improve vision in the vast majority of individuals who are enrolled” and mentions that “previous anecdotal experience with eye disease treated with stem cells has been positive.” However a disclaimer states that “no guarantees of specific improvements or visual results are being made” and that “any medical procedure carries risks as well as potential benefits.” The study, to include 300 patients, has published two case studies of patients whose vision improved.
Our Towards Treatment section explains that we currently know of no Health Canada of FDA approved stem cell treatments for eye disease. Anyone considering such a treatment or participating in a study or trial should consult with their doctors and medical professionals. As well, the International Society for Stem Cell Research has great information for anyone considering any type of stem cell treatment. You can find it here.
Stem cells have the potential to transform Canadian health care by improving patient outcomes and making the system more efficient, according to a new report by the Council of Canadian Academies (CCA).…
Stem cells have the potential to transform Canadian health care by improving patient outcomes and making the system more efficient, according to a new report by the Council of Canadian Academies (CCA).
Titled Building on Canada’s Strengths in Regenerative Medicine, the report was commissioned by the federal government’s Ministries of Innovation, Science and Economic Development (ISED) and Health Canada
“We especially appreciate Science Minister Kirsty Duncan’s efforts at highlighting Canada’s academic research strengths in stem cells,” said James Price, President and CEO of the Canadian Stem Cell Foundation. “This is another good example — this time focusing on academic strengths — of how Canada’s depth in stem cells and regenerative medicine is now being widely recognized.
The CCA document follows last month’s report by the Finance Minister Bill Morneau’s Advisory Council on Economic Growth that singled out the stem cell sector and suggested that building on Canada’s “world-class regenerative medicine and stem cell therapy development“ could unlock innovation and drive economic growth.
The CCA report, the release of which coincides with the beginning of the two-day PanCanadian Strategic Forum on Cell and Gene Therapy in Montreal, hosted by CellCAN — Regenerative Medicine and Cell Therapy Network and BioCanRx. It will feature a panel discussion, moderated by Mr. Price and featuring a talk by Dr. Janet Rossant, chair of the steering committee that produced the CCA report, looking at ways to move the field forward.
Among the report’s key findings:
- There is a need for a long-term funding strategy to encourage research and development across the country.
- There is an opportunity to accelerate translation of research discoveries into clinical applications.
- There needs to be greater co-ordination between the federal regulators who decide about the safety and efficacy of stem cell/regenerative medicine therapies and the provincial reimbursers who decide what therapies will be covered by health care plans.
Last summer we blogged about a team at The Ottawa Hospital that had proved a stem cell/chemo combo treatment could halt the progression of multiple sclerosis (MS) and — in some cases — help patients recover from the autoimmune disease.…
Last summer we blogged about a team at The Ottawa Hospital that had proved a stem cell/chemo combo treatment could halt the progression of multiple sclerosis (MS) and — in some cases — help patients recover from the autoimmune disease.
Now comes news from the United Kingdom that further substantiates the work of Drs. Harry Atkins and Mark Freedman in showing that using bone marrow stem cell transplants to rebuild an MS patient’s immune system can prevent the disease from worsening and dramatically improve mobility and freedom from pain for some.
The Atkins-Freedman study, published in the prestigious Lancet journal, focused on two dozen patients treated over a decade. The UK study, published last week in JAMA Neurology, reviewed 281 patients tracked over five years. Led by Dr. Paolo Muraro of Imperial College London, the study found the treatment prevented symptoms of severe disease from worsening for five years for almost half of the patients treated. Drs. Atkins and Freedman co-authored the UK study and results from their work were included in the review.
Among patients with relapsing MS, nearly three in four saw no worsening of their symptoms five years after treatment, while younger patients with less severe forms of the disease were more likely respond to the therapy. Most of the patients, though, had progressive MS, which is more severe. Among them, one in three experienced no worsening of symptoms, according to a report by Imperial College.
MS occurs when a person’s immune system misfires and begins attacking nerves in the brain and spinal cord. Currently, there is no treatment for sever, progressive MS.
In essence, the new approach, which is called autologous hematopoietic stem cell transplantation, involves extracting the patient’s own bone marrow stem cells and fortifying them, then destroying their immune system through chemotherapy. The stem cells are then transplanted back into the patient to rebuild the immune system — ideally without the disease.
The stem cell/chemo treatment is not for everyone who has MS — young people with more robust stem cells tend to respond better than older patients — and it comes with risks. Eight patients died following the treatment.
Dr. Muraro said the risks must be weighed against the benefits: “We previously knew this treatment reboots or resets the immune system – and that it carried risks – but we didn’t know how long the benefits lasted. In this study, which is the largest long-term follow-up study of this procedure, we’ve shown we can ‘freeze’ a patient’s disease – and stop it from becoming worse, for up to five years.”
What will it take to move regenerative medicine forward so that it can deliver more cures and treatments for age-old diseases?…
What will it take to move regenerative medicine forward so that it can deliver more cures and treatments for age-old diseases?
That’s the subject of the First PanCanadian Strategic Forum on Cell and Gene Therapy to be held March 9 and 10 at the Westin Montreal.
“The cell and gene therapy ecosystem in Canada is coming to a level of maturity where we’re going to be ready to reap the fruit from it,” says Dr. Anne-Marie Alarco, former Chief Scientific Officer of CellCAN — Regenerative Medicine and Cell Therapy Network. “But it’s not going to happen passively. We have to put action in place.”
CellCAN is organizing the Forum in partnership with the Centre for Commercialization of Cancer Immunotherapy (C3i) and BioCanRx.
There is a sense of urgency to begin harvesting the “low hanging fruit,” says Dr. Alarco. Otherwise, she says, Canada could miss out.
Unlike the annual Till & McCulloch Meetings, which focus on the most recent scientific advances in cell therapies and regenerative medicine, the Strategic Forum will concentrate on what’s needed to move therapies into the clinic. Organizers expect to draw a range of academics, scientists, health agency representatives, government regulators, venture capitalists and business leaders from pharma and biotech.
“The idea is to bring together all the major stakeholders,” says Dr. Alarco, “to determine where we are in terms of cell therapies and gene therapies. We have all the elements for what we hope will be an interactive conversation. Hopefully, we will come up with a number action items.”
Lectures and workshops will consider ways to overcome barriers to implementing cell and gene therapies in Canada; build on effective commercialization for the benefit of all Canadians; and identify reimbursement possibilities for developing novel therapies..
Keynote speaker Dr Janet Rossant, President & Scientific Director of the Gairdner Foundation and Chair of the steering committee of the Council of Canadian Academies Workshop on Regenerative Medicine. Their soon-to-be-released report was commissioned by the federal government.
As well, speakers from the United Kingdom, Japan and California will discuss steps taken in their jurisdictions to move the science from the researchers’ laboratories to the patients’ bedsides.
“It is the medicine of the future,” says Dr. Alarco. “We hope to have action items in for this to become a reality for Canadians.”
Think of cancer immunotherapy as an inside job: While chemotherapy and radiation destroy cancer cells from the outside, cancer immunotherapy deploys the patient’s own immune system to attack the disease from within.…
Think of cancer immunotherapy as an inside job: While chemotherapy and radiation destroy cancer cells from the outside, cancer immunotherapy deploys the patient’s own immune system to attack the disease from within.
Cancer immunotherapy’s arsenal of immunotherapies ranges from monoclonal antibodies that can target malignant cells, inhibitors that help the immune system recognize and attack cancer cells, vaccines that trigger an anti-cancer response, and re-engineered and expanded T-cells designed to kill specific cancer cells.
For patients, the life-enhancing prospects of not having to endure the toxic side-effects of chemo and radiation are almost as appealing as the life-saving cures that this revolutionary field of oncological research is poised to deliver.
”The evidence suggests we are at the beginning of a whole new era for cancer treatments,” Prof. Peter Johnson, Director of Medical Oncology at Cancer Research UK, told the Daily Mail in 2015. Things have only accelerated since then for The Next Big Thing in cancer care.
The cancer immunotherapy revolution is moving fast and turning the oncology world upside down, according to Dr. Lambert Busque, Chief Medical Officer of the Centre for Commercialization of Cancer immunotherapy (C3i). Established last year by Canada’s Networks of Centres of Excellence, C3i predicts that immunotherapy could be used in the majority of advanced cancer cases in less than a decade.
Which raises the question: is Canada ready for this revolution in cancer care?
“There is a lot of knowledge and competence in Canada,” says Dr. Busque, whose C3i organization operates out of the Hôpital Maisonneuve-Rosemont’s Integrated University Center of East Montreal. But, he says, Canada needs greater capacity to translate immunotherapies into patient care and to help Canadian companies compete in a rapidly growing global market.
To address those concerns, C3i is partnering with CellCAN Regenerative Medicine and Cell Therapy Network and BioCanRx to host next month’s PanCanadian Strategic Forum on Cell and Gene Therapy in Montreal. Dr. Busque will moderate a panel discussion on what it will take for Canada to become a world leader in commercializing cancer immunotherapy, drawing on the C3i model.
“We designed C3i to be very close to the clinic,” says Dr. Busque. “Because treatment and health care is part of the public sector while development is done in the private sector, the key is to make the link between them, to have a structure to help Canadian inventions mature rapidly and have better access to markets. If we have no instrument to do that, the development will go outside the country.”
Canada, in fact, could become a hub for cancer immunotherapy development if 3Ci can succeed strengthening collaborations with major pharmaceutical firms in driving clinical trial development. Dr. Busque cites C3i’s access to a “state of the art” certified Good Manufacturing Practice (GMP) cell manufacturing unit as critical for conducting trials and developing cell-based and biological therapeutics.
C3i is also making the development of biomarkers a priority. Because not all cancer patients respond in the same way with the same immunotherapy, researchers worldwide have focused their attention on developing biomarkers that can predict therapy outcomes and help doctors tailor treatments to a particular patient or type of patient.
“Biomarkers will be crucial in the development of therapies,” says Dr. Busque. “So we are developing a biomarker unit with next generation computer sequencing to do cutting edge analysis of cellular biomarkers.”
Having already built a network of oncology centres across Quebec, C3i hopes to create linkages across Canada to expand access to patients for larger scale clinical trials.
“We’re not alone. We’re going to be one piece of a large puzzle in Canada. There are so many great contributions being made across Canada. We hope to be a catalyst in respect to Canadian collaborations because Canada can be extremely successful.”
Building on Canada’s “world-class regenerative medicine and stem cell therapy development“ could unlock innovation and drive economic growth, according to an Advisory Council on Economic Growth report released Monday.…
Building on Canada’s “world-class regenerative medicine and stem cell therapy development“ could unlock innovation and drive economic growth, according to an Advisory Council on Economic Growth report released Monday.
The Advisory Council, created by Finance Minister Bill Morneau to find ways to unleash Canada’s economic potential, focused on four sectors in which “Canada has a strong endowment, untapped potential and significant global growth prospects.” The four include: agriculture and food (agfood); advanced manufacturing; energy and renewables; and health care and life sciences.
“It’s a clear victory for the stem cells to be included in this report,” says James Price, President and CEO of the Canadian Stem Cell Foundation. “It shows that our message is getting through and that the Government of Canada recognizes the powerful potential of stem cells and regenerative medicine to not just deliver cures for a number of diseases but significantly boost the economy. “
The Foundation champions the Canadian Stem Cell Strategy, a 10-year private-public partnership that aligns the efforts of Canada’s research scientists, medical professionals, industry partners and philanthropists to move therapies into the clinic, create thousands of high-quality jobs and secure a share of the burgeoning regenerative medicine global market for Canada.
The Advisory Council favours such private-public partnerships, stressing that “government and business should work together to identify and remove the unnecessary obstacles to economic growth” and noting that such partnerships “would help raise our collective ambition and unleash Canada’s real and inclusive growth potential.”
As well, the report, the second of two the Advisory Council has submitted to Minister Morneau as he prepares the federal budget, suggests Canada “seize opportunities (for example by convening private and public actors and setting a sector wide aspiration).”
The Canadian Stem Cell Strategy “creates a roadmap for government and business to work together to do exactly that,” says Mr. Price. “It would clear hurdles for Canada to commercialize more research, bring more clinical trials on stream, develop more therapies and products, and create more jobs.”
Canada stands among the top nations in stem cells and regenerative medicine. The building block cells were discovered by two Canadians — Drs. James Till and Ernest McCulloch — in Toronto in the 1960s and subsequent generations of researchers have made some of the most important discoveries in the field worldwide. Clinical trials are underway in Canada using stem cells to treat type 1 diabetes, heart disease, arthritis and septic shock, while doctors at The Ottawa Hospital have successfully used stem cells to treat autoimmune disease such as multiple sclerosis, Crohn’s disease and scleroderma.
However, Canada is falling behind in terms of funding, with other jurisdictions, particularly California and Japan, investing billions to find new therapies, develop new products and reap the economic benefits.
Minister Morneau established the Advisory Council in March 2016 to develop advice on policy actions “for strong and sustained long-term economic growth.” The first report, released in October, gave recommendations on investing in infrastructure, attracting foreign investment and enhancing economic immigration.