Hope despite aggressive skin cancer diagnosis

Hope because of scientists who never gave up; who were determined to turn the tables on cancer and to create a better chance of survival, for patients like Dan Collins.

Hope despite aggressive skin cancer diagnosis

Diagnosed with a stage 4 melanoma at the age of 62, Dan Collins feared for his life when he learned about the aggressive form of cancer. However, immunotherapy treatment gave him a reason to hold out hope. Dan had hope because of scientists who never gave up; who were determined to turn the tables on cancer and to create a better chance of survival, for patients like him. Hope that a cure is coming.

Discovery of a mass

Four years ago, Dan had been travelling for work, when he started noticing some pain when he’d lean his head back to rest on the plane. He recalls turning to his family doctor to get answers. An ultrasound revealed there was something inside the back of his head that looked like a cyst.

After an initial biopsy, Dan was referred to a surgeon at The Ottawa Hospital Cancer Centre. Another biopsy revealed the cyst was actually a mass. It was melanoma. “I was scared. Cancer had stripped my family of so much. I lost both of my two older brothers and my father to cancer. I feared for my life,” recalls Dan.

Unfortunately, the mass starting growing – and it was growing fast. By the end of July, just two months later, the mass went from being not visible on the back of his head, to the size of a golf ball.

His surgical oncologist, Dr. Stephanie Obaseki-Johnson, initially wanted to shrink the tumour before surgery to remove it. However, the mass was growing too quickly.

Oncologist Dr. Michael Ong of The Ottawa Hospital in a patient room.
Dan Collins with Oncologist Dr. Michael Ong.

Time to act

On August 11, 2015, Dan had surgery that lasted most of the day. When it was over, he had 25 staples and 38 stitches in the back of his head. As he recovered, Dan was reminded of a saying that helped him through recovery, “Never be ashamed of your scars. It just means you were stronger than whatever tried to hurt you.”

He would need that strength with the news that awaited him. Only two weeks later, the mass was back. His doctors also discovered a mass in his right lung and shadows in the lining of his belly. He had stage 4 cancer – it had metastasized. This was an aggressive cancer that left Dan thinking about the family he had already lost and what would happen to him.

The next generation of treatment

Soon, he was introduced to The Ottawa Hospital’s Dr. Michael Ong and was told about immunotherapy – the next generation of treatment, with the hope of one day eliminating traditional and sometimes harsh treatment like chemotherapy. Dr. Ong prescribed four high doses of immunotherapy. At the same time, radiation treatment began for Dan – 22 in all. His immunotherapy treatments were three weeks apart at the Cancer Centre and between each, he would have an x-ray to monitor the tumours.

“Each x-ray showed the tumours were getting smaller. That’s when the fear started shifting to hope.” – Dan Collins, patient

By December 2015, Dan finished immunotherapy treatment and the next step was to wait. “This transformational treatment was designed to train my own immune system to attack the cancer. We would have to be patient to see if my system would do just that,” says Dan.

While the shadows in Dan’s stomach lining had shrunk, the mass in his lung had not. That’s when Dr. Ong prescribed another immunotherapy drug that would require 24 treatments.

Dan learned from his oncologist that melanoma has gone from being an extremely lethal cancer, with few treatment options, to having many different effective therapies available.

“When I started as an oncologist a decade ago, melanoma was essentially untreatable. Only 25 percent would survive a year. Yet now, we can expect over three quarters of patients to be alive at one year. Many patients are cured of their metastatic cancer and come off treatment. We are now able to prevent 50 percent of high-risk melanoma from returning because of advances in immunotherapy,” says Dr. Ong.

Dan completed his last immunotherapy treatments in September 2017.

Oncologist Dr. Michael Ong posing with armed crossed at The Ottawa Hospital.
Oncologist Dr. Michael Ong of The Ottawa Hospital.

Today, there is no sign of cancer

When Dan thinks back to the day of his diagnosis, he remembers wondering if he was going to die. “I believe I’m here today because of research and because of those who have donated to research before me.”

He thinks back to when his older brother Rick died of cancer in 2007. “At the time he was treated, his doctor asked if he would participate in a research study. The doctor told him directly, this would not help him, but it would help somebody in the future.” Dan pauses to reflect and then continues, “I like to think, that maybe, he had a hand in helping me out today. Maybe he helped me survive. One thing I do know is that research was a game changer for me.”

The Ottawa Hospital has been a leader in bringing immunotherapy to patients. Research and life-changing treatments available at The Ottawa Hospital altered Dan’s outcome and he hopes that advancements will continue to have an impact on many more patients, not only here at home but right around the world.

To support life-saving research at The Ottawa Hospital that helps patients like Dan, please donate today.

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A second chance after dire lung cancer diagnosis

At the age of 47 and with no risk factors, Andrea Redway was ‘shocked beyond belief’ when diagnosed with stage 4 lung cancer. The Ottawa Hospital was ready.

Immunotherapy provides a second chance after dire lung cancer diagnosis

As a lawyer, Andrea Redway has worked on international initiatives relating to justice reform. She’s travelled the world tackling big projects and has always been ready to face new challenges head-on—but nothing could have prepared Andrea for a stage 4 lung cancer diagnosis. This diagnosis rocked her world and left her wondering how long she would survive.

The first signs of trouble appeared in January 2015 when Andrea developed a cough that persisted. In March, she left on a work trip abroad. It was an exciting career opportunity with the added bonus of being able to bring her husband and two children, who were 8 and 11 at the time. Three weeks after returning home, the cough continued and she couldn’t shake her jet lag. “Usually I’m over jet lag in a week. I was still so exhausted, and thought maybe I had pneumonia,” recalls Andrea.

“Here I was, 47 years old and I had no risk factors. I would never
have thought that I could get lung cancer.” – Andrea Redway

Grim diagnosis

With no family doctor, she went to a walk-in clinic and was prescribed antibiotics. Within a few days, she started noticing other symptoms. “I had strange pains in my leg and then some cramping in my abdomen. The exhaustion continued.”

Andrea received a referral to a family doctor and an x-ray was ordered. The results showed a large mass on her lung. Within a week, she received the grim diagnosis—stage 4 lung cancer. The cancer had already spread to her bones, adrenal glands, brain and there were early signs of it in her colon. She was shocked beyond belief. “Here I was, 47 years old and I had no risk factors. I would never have thought that I could get lung cancer.”

Andrea Redway and family
Andrea, husband Michael Cayley, with their two children in Tofino, B.C. post diagnosis.

All Andrea and her husband could think about was getting on treatment right away. She had to, for the sake of her children.

She was referred to Dr. Garth Nicholas, an oncologist at The Ottawa Hospital and began chemotherapy treatment along with a small amount of radiation. Six weeks later, a scan revealed the chemotherapy was only partially working.

 

Dr. Garth Nicholas at The Ottawa Hospital
Dr. Garth Nicholas is an oncologist at The Ottawa Hospital

 

Clinging to life

Dr. Nicholas was aware of a new clinical trial, published in the New England Journal of Medicine. It was an immunotherapy treatment specifically used to treat stage 4 lung cancer, but it wasn’t yet available in Canada. He applied for the compassionate care program with the drug company and Andrea was given one dose of the drug, Nivolumab. Today, Nivolumab is now routinely used to treat many people with lung cancer. It is also used to treat other cancers, most notably melanoma.

But Andrea’s cancer continued to progress and she became very sick. Back in hospital, it was discovered that she had a perforated bowel. She recalls the situation being dire, “I needed emergency surgery or that was going to be the end of the line for me.”

Given the progression of Andrea’s cancer, it was uncertain if surgery was a viable option, but her care team at The Ottawa Hospital wanted to give Andrea the chance to have more time with her family. “Dr. Guillaume Martel, who is my saviour, did the surgery. Here I am today as a result,” says Andrea.

Once she recovered from surgery, Andrea was able to resume treatment to take on the cancer, which had ravaged her body. One month later, she received her second dose of immunotherapy. “I continued with immunotherapy for about two years. I completed my treatment in September 2017 and I’ve been great ever since.”

“Everything else is gone. It’s amazing—totally amazing. With little kids, we’ve had so many special moments since then.” – Andrea Redway

Eight months after starting treatment, Andrea’s scan showed the cancer was gone from outside of her lungs and the primary tumour on her lung had shrunk to about half. “When the tumour showed up on the scan originally, it was six centimeters. Now, it’s about 2.5 centimeters. It’s been described as mostly necrotic or dead.”

Transformational results

While Andrea did experience side effects like fatigue, dry eyes and joint pain, she says it was a small price to pay because immunotherapy was a game changer. “Everything else is gone. It’s amazing—totally amazing. With little kids, we’ve had so many special moments since then.”

Dr. Nicholas explains how much cancer treatment has improved in just four years since Andrea’s initial diagnosis. “Immunotherapy has become a standard part of the treatment of lung cancer over the past four years or so. There are rare patients like Andrea for whom it is an extraordinarily effective treatment, much better than any other therapy we’ve had in the past.”

However, Dr. Nicholas adds that not every lung cancer patient has a positive response like Andrea, and more research needs to be done. “There is a lot of ongoing research into why some tumours respond to immunotherapy while others do not, and whether we can do anything to alter non-responding tumours in order to make them respond.”

Today, Andrea continues to embrace those special moments, grateful to be watching her children grow.

 

You can help give all patients like Andrea hope by supporting life-saving research at The Ottawa Hospital today.

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Could biotherapeutics be the next revolution in cancer treatment?

From helping the body’s own immune system better detect and fight cancer, to treating cancer with immune cells, viruses and vaccines, The Ottawa Hospital is conducting cutting-edge research that could transform cancer care right here at home and around the world. 

Could cancer biotherapeutics be the next revolution in cancer treatment?

From helping the body’s own immune system better detect and fight cancer, to treating cancer with genetically-enhanced immune cells, viruses and vaccines, The Ottawa Hospital is conducting cutting-edge research that could transform cancer care right here at home and around the world.

For decades, scientists have tried to stimulate the immune system to attack cancer cells. A breakthrough came through the discovery that cancer cells make key molecules that suppress immune cells and prevent them from attacking the cancer. This discovery opened the door to revolutionary immunotherapy drugs called checkpoint inhibitors, which have shown striking results in recent years.

While promising research on checkpoint inhibitors continues, the race is now on to bring an innovative new kind of immunotherapy to patients – one that uses living cells, viruses and genes to fight cancer.

The Ottawa Hospital is a world leader in developing these innovative therapies, called cancer biotherapeutics.

“Our immune system is constantly trying to recognize and kill cancer cells, but the cancer cells are always trying to hide from it.” – Dr. John Bell

Helping the body recognize and destroy cancer

CAR-T cell therapy is an emerging biotherapeutic treatment that harnesses the power of a patient’s own immune cells, known as T-cells, to treat their cancer. T-cells play a critical role in the immune system by killing abnormal cells, such as cells infected by germs or cancer cells. In some cancers, like acute lymphoblastic leukemia (ALL), cancerous cells become invisible to the T-cells that are meant to kill them. In CAR-T therapy the T-cells are collected and reprogrammed in the lab to recognize and destroy the cancerous cells.

“This type of immunotherapy research is groundbreaking,” said Dr. Natasha Kekre, a hematologist and associate scientist at The Ottawa Hospital, “but it is important to remember that that CAR-T therapy is still very new and there can be serious side effects. We need more research to learn about this therapy and make it work for even more people and more kinds of cancer.”

The Ottawa Hospital is one of the first hospitals in Canada to participate in internationally-led CAR-T trials, and as one of Canada’s top research and treatment centres, the hospital is ideally positioned to play a lead role in bringing an innovative CAR-T research program to Canada, and to Canadian patients.

“Our goal is to build Canadian expertise and capacity for innovation in the promising CAR-T field through both laboratory research and clinical trials,” said Dr. Kekre, who is working with a team across the country. “This could lead to better CAR-T therapies that work for more kinds of cancer, as well as innovative approaches for providing CAR-T therapy in the Canadian system.”

A graphic explaining how CAR-T works

Infecting cancer cells with viruses

Another promising biotherapeutic treatment uses oncolytic viruses that selectively infect and kill cancer cells. “Our immune system is constantly trying to recognize and kill cancer cells, but the cancer cells are always trying to hide from it,” explained Dr. John Bell, senior scientist at The Ottawa Hospital. “When you infect a cancer cell with a virus, it raises a big red flag, which helps the immune system recognize and attack the cancer.”

Recent laboratory research from Dr. Bell’s team suggests that a combination of two immunotherapies, oncolytic viruses and checkpoint inhibitors, could be much more successful in treating breast cancer and possibly other cancers.

“We found that when you add a checkpoint inhibitor after the virus, this releases all the alarms and the immune system sends in the full army against the cancer,” said Dr. Bell.

Though these methods have shown promising results, more research and clinical trials are needed.

Doctor speaking with a patient in her office at a hospital

Cancer-fighting vaccine

In addition to these techniques The Ottawa Hospital’s Dr. Rebecca Auer has found that a cell vaccine, developed in the lab using an individual’s cancer cells combined with a cancer-fighting virus, could be effective in battling cancer. Once injected, this vaccine uses a triple-threat to attack the cancer.

First, the virus only infects and kills cancer cells, leaving healthy cells unscathed. Second, the virus produces a protein called interleukin-12, which boosts the immune system’s natural ability to fight the tumour. Third, as a result, the vaccine trains the immune system to recognize and fight off the same kind of tumour if it ever comes back.

Dr. Auer and her colleagues are developing the processes required to manufacture this personalized cell vaccine and plan to initiate a “first in human” clinical trial in 2020.

Lifesaving therapies: from idea to bedside

Today, cancer care is changing at an unprecedented pace. Many patients who, only a few years ago, had few to no treatment options are now being offered hope with treatments that are more targeted and personalized. We are seeing approvals for new cancer drugs grow at an almost exponential rate, while world-class research and clinical trials are being integrated into cutting-edge cancer care.

Over the next 15 years, Canadians will see a 40 percent increase in cancer diagnoses with almost one in two developing cancer in their lifetime. Our ability to translate research into patient therapies coupled with one of the best-equipped cancer centres in the country means we are well-positioned to face this challenge head-on.

We need your support today to fund
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Immunotherapy eradicates cop’s melanoma

Despite years of treatment to prevent recurrence of skin cancer, Ian McDonell’s melanoma –a disease that killed his brother– spread to his brain and body. In 2017, he started an innovative immunotherapy treatment. A year later, all scans showed his cancer was gone.

A melanoma diagnosis

The Ottawa Hospital, The Ottawa Hospital Foundation, Ian McDonell
Ian McDonell received immunotherapy in 2017, which erased any trace of his melanoma.

Several years ago, Ian McDonell, a Staff Sergeant with the Ottawa Police and father of three had just lost his father to cancer and his brother was dying of melanoma. Ian’s wife insisted he see his physician to check out a mole on his back. It turned out to be an ulcerated nodular malignant melanoma – an aggressive form of skin cancer.

Ian had surgery to remove it along with a lymph node from his left groin. Several weeks later, he had a lymph node removed from his armpit. Following these surgeries, he had no signs of cancer, but due to his family’s history, Ian was at high risk for relapse.

Sobering news

Ian was feeling well, but during a standard monitoring visit in June 2017, his CT and MRI scans showed sobering news. He had half a dozen tumours in his groin and abdomen, and three more tumours metastasized to his brain. Ian’s cancer was stage 4.

Given the severity of the findings, Dr. Michel Ong at The Ottawa Hospital suggested an aggressive approach – a recently approved immunotherapy treatment.

Unmasking cancer

Scientists have tried for decades to stimulate the immune system to attack cancer cells. But the game-changer was the discovery that cancer cells make key molecules, called immune checkpoint proteins, that suppress immune cells and prevent them from attacking the cancer. These immune checkpoint proteins cloak the cancer from the immune system. New drugs called immune checkpoint inhibitors remove this cloak and allow immune cells called T-cells to naturally attack and destroy the cancer.

“The idea of chemotherapy is to kill off cancer directly,” said Dr. Ong. “There are potential side effects, because chemotherapy tries to poison the cancer.

“Immunotherapy does not directly affect the cancer itself. Instead, immunotherapy unmasks the cancer to your immune system by flipping some switches on T-cells, and the body’s own immune system does the rest.” – Dr. Michael Ong

Ian McDonell with his wife Michelle (left), and their daughters Kendra, Macy, and Ainsley, hiking in the Adirondack Mountains in 2019.
Ian McDonell with his wife Michelle (left), and their daughters, hiking in the Adirondack Mountains in 2019.

CyberKnife treatment

Ian started on a combination of two immunotherapies given intravenously in the chemotherapy unit at The Ottawa Hospital’s Cancer Centre. He also underwent CyberKnife radiotherapy treatment where high doses of radiation were directed at his brain tumours. He bravely continued with the second round of immunotherapy, but was so sick, he had to be taken off the treatment and started on steroid medications to slow down the immune system. Ian felt better, but his immunotherapy was on hold.

Shrinking tumours

When Ian began to develop weakness in his face, he worried his cancer was getting worse. It wasn’t. Scans showed one tumour had shrunk from 25 to 10 mm, and another had shrunk from eight to four mm.

Dr. Ong recommended trying a single immunotherapy rather than two, and while the treatment made Ian very sick, it did the trick.

Two months later, the results of a PET scan, MRI, and a CT scan showed that he was tumour-free. All trace of his cancer was gone.

Oncologist Dr. Michael Ong said recent immunotherapies are hugely successful for treating melanoma.
Oncologist Dr. Michael Ong said recent immunotherapies are hugely successful for treating melanoma.

Advances in immunotherapy

When Dr. Ong first met Ian in 2013, options for immunotherapy or targeted chemotherapy weren’t available. Thanks to incredible advances in immunotherapy, there is now hope.

“In the last few years, we’ve gone from having very poor options to having many effective options for melanoma. That’s because cancer therapy continues to develop at a very rapid pace,” said Dr. Ong. “We, at The Ottawa Hospital, are constantly participating in practice-changing clinical trials. The standard of care is constantly changing, as it should. We are continually trying to push the limits of cancer treatment.”

The Ottawa Hospital is a leader in cancer immunotherapy research, both in terms of developing new therapies and in offering experimental treatments to patients. Currently, there are approximately 70 active cancer immunotherapy clinical trials being conducted at the hospital involving nearly 700 patients. The hospital also hosts a national network for immunotherapy research and has developed a number of unique immunotherapies made directly of cells and viruses.

Hope for the future

Because of successful immunotherapy treatments, patients like Ian are now planning a future of living cancer-free.

“When the provincial exams for police services came up, I said, ‘I’m gonna write it, because I’ve got a bit of hope now.’” said Ian.

More importantly, in addition to his career plans, immunotherapy has allowed Ian to plan for the future with his family and a chance to watch his daughters grow up.

Hear more about oncologist Dr. Michael Ong’s work with immunotherapy.

To support life-saving research at The Ottawa Hospital that helps patients like Ian, please donate.

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Natural killer cells could be immunotherapy game-changer

Scientists have known that key molecules on cancer cells suppress the immune T-cells and prevent them from attacking the cancer. Dr. Ardolino discovers other immune cells, called killer cells, that could offer more immunotherapy treatment options.

Although the connection between the immune system and cancer has been recognized for over a century, understanding how the immune system works against cancer has been the biggest challenge for scientists like Dr. Michele Ardolino.

Initially, efforts were made to stimulate the immune system to make it attack the cancer. But the game-changer was the discovery that there are key molecules, called immune checkpoints, on cancer cells that suppress the immune cells and prevent them from attacking the cancer. There are many types of immune cells. T-cells have been recognized as key immune cells and the ones that immunotherapy drugs have been designed to target.

Dr. Michele Ardolino in his lab
Dr. Michele Ardolino’s discovery focused on ‘natural killer’ immune cells.

“What we didn’t know before is that some of these receptors are present in other immune cells,” said Dr. Michele Ardolino, scientist at The Ottawa Hospital and assistant professor at the University of Ottawa. “What we discovered is that these receptors are present on another type of immune cell called natural killer cells.”

He said that even though most of the immunotherapy drugs target the T-cells to make them work better, not all cancer tumours are responsive to T-cells.

“But,” said Dr. Ardolino, “These tumours might be very effectively killed by natural killer cells. So, if we know what kind of tumour the patient has, we can design therapies to elicit the most effective immune response. Which in some cases could be a T-cell response and in other cases could be a natural killer response.”

“We now have a better idea of how the immune system suppresses cancer. This means that we can now target the mechanism that suppresses the immune system in a more specific way.”

“This is cool for a number of reasons,” said Dr. Ardolino. “We now have a better idea of how the immune system suppresses cancer. This means that we can now target the mechanism that suppresses the immune system in a more specific way. And we can elicit a stronger natural killer cell response against cancer.”

It is becoming widely recognized that not only is cancer unique to each patient, but the immune system is also unique to each person. Researchers and clinicians are realizing the importance of tailoring the immunotherapy not only to each person’s cancer but to their own unique immune system. It is a complex problem to give a drug that would have maximum therapeutic effect with the least side effects, to be as targeted as possible.

Dr. Ardolino recently published a breakthrough discovery that has potential to make immunotherapy treatments to work for more people, and more types of cancers.

In October 2018, immunologists James Allison and Tasuku Honjo were awarded the Nobel Prize in Medicine for their discoveries of immune checkpoint inhibitors, considered a landmark in the fight against cancer.


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CAR-T cell therapy—new hope when standard cancer treatments fail

When Stefany Dupont’s leukemia returned after her bone marrow transplant, the prognosis was dire. However, she was eligible for a novel immunotherapy clinical trial using CAR-T cells, which ultimately saved her life. The Ottawa Hospital is developing a made-in-Canada CAR-T cell clinical trial to help other patients with blood cancers have a better chance of survival.

A game-changing cancer treatment

Stefany Dupont’s leukemia symptoms have disappeared. Her cancer was put into complete remission by a revolutionary new treatment called CAR-T cell therapy. This emerging form of immunotherapy has the potential to transform how cancer patients are treated in Canada and around the world.

Daunting odds

Stefany was first diagnosed with acute lymphoblastic leukemia (ALL) when she was just 13 years old. Children with leukemia are given a strict chemotherapy protocol that effectively cures more than 90 percent of patients. Unfortunately, this was not the case with Stefany.

She was in remission for five years but, in 2010, her leukemia came back. By then she was 18, an adult, and began receiving treatment at The Ottawa Hospital. In 2015, she received chemotherapy followed by a hematopoietic bone marrow stem cell transplant. She was on the mend until a year and a half later when she had another relapse. Adults with leukemia who relapse after a transplant have less than a 10 percent chance of survival.

“Stefany was unlucky enough to relapse within two years of her transplant,” said Dr. Jill Fulcher, Stefany’s doctor, who specializes in malignant hematology and is a clinician-investigator at The Ottawa Hospital. “But her leukemia came back with a blast and she was very sick. Palliative management was all we had to offer patients with ALL who relapsed so soon post-transplant.”

Dr. Jill Fulcher stands behind Stefany listening with stethoscope
Hematologist Dr. Jill Fulcher confirms that Stefany Dupont is in remission over one year after her CAR-T cell therapy. Previously, Stefany was given a 10 to 20 percent chance of survival, pre-CAR-T cell treatment.

New hope

Dr. Fulcher and her colleague Dr. Natasha Kekre, a hematologist and associate scientist at The Ottawa Hospital, knew that clinical trials in the United States, using CAR-T cell immunotherapy, showed promising results in children and adolescents with leukemia and blood cancers, putting many into long-lasting remission.

For patients like Stefany who are extremely sick and out of options, CAR-T cell therapy offers new hope. That’s why Dr. Kekre is leading the charge to bring CAR-T cell immunotherapy to The Ottawa Hospital.

Giving Canadians access to leading-edge treatments

As one of Canada’s leading research and treatment centres, equipped with world-leading expertise, The Ottawa Hospital is ideally positioned to help bring this innovative treatment to Canada, and to Canadian patients. The Ottawa Hospital is one of the first hospitals in Canada to participate in internationally-led CAR-T trials, and the Hospital is now playing a lead role in a made-in-Canada CAR-T research program.

Hematologist Natasha Kekre
Dr. Natasha Kekre is working with other hospitals across Canada to develop a “made-in-Canada” approach for CAR-T cancer therapy.

“Our goal is to build Canadian expertise and capacity for innovation in the promising CAR-T field through both laboratory research and clinical trials,” said Dr. Kekre, who is working with a team across the country. “This could lead to better CAR-T therapies that work for more kinds of cancer, as well as innovative approaches for providing CAR-T therapy in the Canadian system.”

A key component of the program is a clinical trial using the first made-in-Canada CAR-T cell therapy. This trial is expected to open at The Ottawa Hospital and BC Cancer in 2019.

From translational research to trial design to manufacturing, The Ottawa Hospital, alongside BC Cancer, is ideally positioned to shepherd this complex trial of an experimental therapy to our patients.

“It’s well recognized that Ottawa is a world leader in clinical trials and innovative trial designs,” said Dr. Manoj Lalu, associate scientist and anesthesiologist at The Ottawa Hospital who is part of the CAR-T team. “Many of the guidelines produced internationally around trial design and reporting originate from The Ottawa Hospital.”

About CAR-T Therapy

CAR-T cell therapy harnesses the power of a patient’s own immune cells, known as T-cells, to treat their cancer. T-cells play a critical role in the immune system by killing abnormal cells, such as cells infected by germs or cancer cells. In some cancers, like acute lymphoblastic leukemia (ALL), cancerous cells become invisible to the T-cells that are meant to kill them. In CAR-T therapy the T-cells are collected and reprogrammed in the lab to recognize and destroy the cancerous cells.

“This type of immunotherapy research is groundbreaking,” said Dr. Kekre, “but it is important to remember that that CAR-T therapy is still very new and there can be serious side effects. We need more research to learn about this therapy and make it work for even more people.”

A well-deserved reprieve

CAR-T treatment was not yet available in Canada when Stefany needed it. So, her only option at the time was to try to join a CAR-T clinical trial at the Children’s Hospital of Philadelphia. Since the hospital’s clinical trial was still accepting patients with ALL up to 25 years of age, Stefany was eligible to participate.

Three months following Stefany’s CAR-T cell infusion in Philadelphia, she had a bone marrow biopsy that showed she was in remission —her treatment was working.

Three months after that, Stefany went on a well-deserved trip.

“After the sixth month waiting time, I went to Australia,” said Stefany. She visited Sydney, Brisbane, Melbourne, went scuba diving at the Great Barrier Reef, and hang-gliding over the shores of Byron Bay. It was a wonderful break after the intensive treatment.

“It is a really good sign that Stefany has remained in remission for over 2 years after having CAR-T cell therapy,” said Dr. Fulcher. “Without this therapy, she definitely would not be with us today.”

A graphic explaining how CAR-T works

Unique biotherapeutics facility

CAR-T therapy needs to be individually manufactured for each patient, using a patient’s own cells combined with large amounts of highly pure virus to deliver the CAR gene. The Ottawa Hospital’s Biotherapeutics Manufacturing Centre is ideally positioned to manufacture this kind of therapy because it has the most advanced system to make the clinical grade virus needed to create CAR-T cells for clinical trials. This is the only facility in Canada that has produced this kind of virus for clinical trials.

“With our unique manufacturing facility, our expertise in clinical trials and our world-class cancer and hematology programs, The Ottawa Hospital is ideally positioned to lead the way in developing the next generation of CAR-T therapy,” said Dr. Rebecca Auer, Director of Cancer Research at The Ottawa Hospital.

“The Ottawa Hospital is ideally positioned to lead the way in developing the next generation of CAR-T therapy.” – Dr. Rebecca Auer

“Patients with ALL, lymphoma, and other blood cancers could benefit from this experimental treatment,” said Dr. Kekre. The hope is that one day CAR-T cell therapy may also be a treatment for a variety of cancers, such as breast and colorectal cancer. It is through clinical trials conducted at The Ottawa Hospital that innovative cancer treatments will be discovered and will continue to offer hope to patients like Stephany.

Organizations such as BioCanRx, the Canada Foundation for Innovation, and the Government of Ontario have supported The Ottawa Hospital’s CAR-T research and the Biotherapeutics Manufacturing Centre, but additional funding is essential to make this program a reality.


The Ottawa Hospital Foundation is raising money for research, revolutionizing the care we provide patients.

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Ottawa study is changing the standard of care for breast cancer patients world-wide.
From leukemia patient to multi-marathoner – with a walker
Leukemia patient, Bob Hardy, had a 40% chance of survival. But hope was restored after treatment at The Ottawa Hospital.