Advancements in Immunology & Immunotherapy

ADVANCEMENTS IN Immunology & Immunotherapy

First,

Made-in-Canada

CAR-T Cell Therapy Shows Promise in Clinical Trial

CAR-T cell therapy offers a fighting chance to patients with cancer in Canada.

More than a dozen people with cancer who had exhausted all treatments are alive and cancer-free thanks to a pioneering Canadian clinical trial of a highly personalized immunotherapy.

Patients in the clinical trial at The Ottawa Hospital and BC Cancer had their T cells removed and genetically engineered to enhance their cancer-killing ability. The supercharged immune cells, called CAR-T cells, were then infused back into the same patient. Health Canada has approved several commercial CAR-T therapies, but access is restricted to

people with just a few kinds of leukemia and lymphoma and in certain age ranges.

Canadian-Led Immunotherapies in Cancer-01 (CLIC-01) is the first trial to manufacture CAR-T therapy in Canada. “Without this trial, I don’t think any of these patients would be alive today, so we’re very encouraged by these results,” says Dr. Natasha Kekre, a scientist and hematologist at The Ottawa Hospital, associate professor at the University of Ottawa, and principal investigator of CLIC-01. “So far, we’re seeing an average progression-free survival of six months, which is very good in this patient population.”

Participant Camille Leahy says, “I feel better than I’ve felt in a very long time. Being able to drive again and take my daughter to her

OICR Fuels Innovative Research on Activating Our Immune System against Cancer

OICR is dedicated to discovering and accelerating innovative cancer treatments for patients.

After 30 years in academia, pharma, and biotech researching the relationship between cancer and the immune system, Dr. Laszlo Radvanyi says oncology is poised to enter a new era of better leveraging our immune system against cancer.

Although decades of research have resulted in a promising new kind of treatment called immunotherapy, these therapies have been aimed mostly at treating late-stage, highly metastatic cancer patients. However, new research shows that harnessing the immune system in earlier stages of cancer could be more effective.

“It has become evident that early cancer lesions that can progress to invasive cancer shape the quality and direction of the immune response much earlier in the disease process than initially thought,” says Dr. Radvanyi. “This can ‘hard wire’ an immune response very early on that can either inhibit or promote tumour progression.”

Dr. Radvanyi is President and Scientific Director of the Ontario Institute for Cancer Research (OICR), which works with partners to accelerate the development of cancer research discoveries and propel them from the lab to the clinic.

OICR specializes in earlier stages of cancer where projects focus on early tumour-immune interactions and develop ways to activate the immune system against cancer. One exciting new OICR clinical program is its

softball games means the world to me. Even if the cancer comes back, this has given me precious time, and I know the research will help many others. It has given me a fighting chance.”

“Canadian patients deserve access to the best cancer treatments in the world, and we need Canadian research to make this happen,” says Dr. Kekre.

The trial is supported by BioCanRx, BC Cancer, the BC Cancer Foundation, The Ottawa Hospital Foundation, the Ontario Institute for Cancer Research, the Ottawa Regional Cancer Foundation, and the Leukemia and Lymphoma Society of Canada.

Visit biocanrx.com for more information.

This article was sponsored by BioCanRx

Window-of-Opportunity (WOO) Network, which recently launched two new clinical trials studying immunotherapies. WOO trials analyze how new agents activate the anti-cancer immune response before surgery after primary diagnosis in a comprehensive way that informs the development of earlier interventions to cure cancer or stop further spread.

These trials can help develop more effective treatment options for future generations of cancer patients, promising to eradicate cancer at an earlier stage before the cancer spreads and becomes resistant to a cure.

“Studying cancers before surgery may provide insights into new ways to identify cancer, measure how cancer cells respond to treatment, and understand how a new therapy works,” says Dr. Radvanyi.

Visit oicr.on.ca to learn more about this and other research programs at OICR.

This article was sponsored by OICR

Publisher: Meredith Burt Business Development Manager: Chelsea Siemon Country Manager: Nina Theodorlis Content & Production Manager: Raymond Fan

Designer: Kylie Armishaw Lead Editor: Karthik Talwar All images are from Getty Images unless otherwise credited. This section was created by Mediaplanet and did not involve Maclean’s Magazine or its editorial departments. Send all inquiries to ca.editorial@mediaplanet.com

Abigail Cukier

McMaster University Develops Promising New Inhaled COVID-19 Vaccines

McMaster University’s nextgeneration COVID-19 vaccines will be delivered by aerosol, directly targeting the respiratory tract, where infections take hold.

The SARS-CoV-2 virus that causes COVID-19 is a coronavirus, as are many viruses responsible for ongoing, seasonal common cold-like infections. Like influenza virus, coronaviruses are notable for their capacity to mutate, which has resulted in the emergence of SARS-CoV-2 variants. Current COVID-19 vaccines are a poor match for the variants that are causing infections now, which has necessitated regular boosting and attempts to update the vaccines.

“This leaves scientists in a situation where we’re always one step behind the virus, and that’s not an enviable position to be in,” says Matthew Miller, Director of the Michael G. DeGroote Institute for Infectious Disease Research (IIDR) at McMaster University, a world-leading centre of transdisciplinary infectious disease research. Miller and his team at the IIDR are taking a fresh approach to virology and vaccinology, building off

decades of research at McMaster to get ahead of the virus and protect people better.

An innovative new approach

“The limitation of the current COVID vaccines authorized in North America is that they only target the spike protein, which is just one of many components of the virus,” says Miller, who is also an investigator with Canada’s Global Nexus for Pandemics and Biological Threats, which is based at McMaster. “And it’s the spike protein that the virus changes most quickly as it’s evolving to escape the immune response.”

diverse set of viruses to the SARS-CoV-2 virus.

Transforming vaccine delivery

Not only do the McMaster vaccines act more broadly against virus variants, but they're delivered in a new, more targeted format: inhaled directly through the mouth and into the lungs via an aerosolized mist.

“All currently-approved COVID vaccines are injected,” says Miller. “When we inject them, we tend to stimulate strong antibodies and T cells that circulate in the blood and are distributed throughout the body. That’s great if you’re trying to protect someone from infections that are spread throughout the body, but it’s not as ideal if you’re trying to protect someone from respiratory infections.”

So while COVID vaccines are now being updated with Omicron-specific spikes to better match the currently-circulating virus, Miller and his team saw a better way. “Our new approach was to develop a vaccine that not only targets the spike but also other components of the virus that don’t change very much as the virus evolves and new variants emerge,” he explains.

Miller and his team applied the field’s recent understanding of immune responses capable of recognizing a broader and more

Building on over a decade of pioneering work on inhalable vaccines for tuberculosis, the McMaster team applied its learnings to the new COVID vaccines. “This elegant system we’ve developed to deliver the vaccine into the lungs is very unique and has really placed McMaster at the forefront of what is now being referred to as mucosal vaccines,” says Miller. “Most other groups who study these types of vaccines are focusing on nasal sprays, which do not deliver the vaccine deep into the lungs where severe infections occur.”

The new vaccine is currently undergoing Phase 1 clinical trials.

Visit globalnexus.mcmaster.ca to learn more.

This article was sponsored by McMaster University

Tania Amardeil

Matthew Miller Director, Michael

G.

DeGroote Institute for Infectious Disease Research (IIDR), McMaster University

The limitation of the current COVID vaccines authorized in North America is that they only target the spike protein, which is just one of many components of the virus.

PHOTO CREDIT: GEORGIA KIRKOS

Researcher Michael D’Agostino demonstrates use of the inhaled vaccine system.

Navigating Your Cancer Journey with Support from Kidney Cancer Canada

tive response is observed, imaging will be extended to every three months or more.

As a biological therapy, immunotherapy is unique as it uses your own immune system to fight cancer cells. The addition of immunotherapy in the treatment of advanced and metastatic renal cancer has led to improved outcome for patients. While the treatment may not work for every patient, the results can be significant for many. In addition, it may work when other treatments have been ineffective or can help other treatments by working together. Immunotherapy may also help a patient stay cancer-free longer by helping the immune system learn to go after recurring cancer cells. This is known as immunomemory.

Kidney Cancer Canada is a patient-centred support organization that advocates for establishing a national guideline for monitoring patients while on immunotherapy. Without guidelines, one challenge is consistent monitoring to detect early progression of the disease. Patients should undergo baseline imaging (CT, MRI, or other) for a clear picture before starting treatment. Once treatment has begun, imaging may be done every six to eight weeks to monitor the response. The objective is to detect early if the patient is not responding while allowing enough time for the therapy to begin working. Once a posi-

Immunotherapy is not without side effects. It can have fewer side effects than some traditional cancer therapies, but if they do occur, they can be quite serious, resulting in the need for medications like steroids to modify the immune response. Side effects should be monitored regularly to ensure the patient can tolerate the treatment and maintain an optimal quality of life. When starting treatment, monitoring may be as often as every three to four weeks.

We encourage patients to keep a simple journal or calendar book to track how they're feeling and any difficulties they’re experiencing while on treatment, and to report any unusual physical symptoms to their oncologist or their health care team immediately. It's important to address any required changes in therapy at scheduled intervals, such as moving from one line of treatment to another or helping manage toxicities early, so staying on treatment is possible. This will hopefully lead to successful outcomes. Immunotherapy is unique to each patient — it doesn't work for everyone, and not everyone may be able to tolerate the treatment. If immunotherapy isn't successful for some patients, there are other types of treatments oncologists can offer, including clinical trials of promising new drugs.

Kidney Cancer Canada is a national community of patients, caregivers, and health professionals who work together to provide every Canadian touched by kidney cancer with support, information, education, and advocacy for treatment options. Programs and services are bilingual. An annual national forum and webinars feature medical and treatment information by Canada’s top kidney cancer doctors, as well as resources on cooking, nutrition, exercise, and stress management. Kidney Cancer Canada’s website, kidneycancercanada.ca, has a wealth of information, like the Video Knowledge Library, which provides informative answers to questions by leading doctors. In addition, Peer Support and Coffee-Chats offer a safe environment for patients and caregivers to meet virtually and discuss all topics. Kidney Cancer Canada also funds innovative research through support from generous donors touched by kidney cancer, including the Warren Y. Soper Charitable Trust, and by teaming up with the Kidney Cancer Research Network of Canada, a nationwide collaboration of doctors and researchers committed to finding a better diagnosis, treatment, and hopefully a cure.

Collins Executive Director, Kidney Cancer Canada

To learn more, visit kidneycancercanada.ca

Immunotherapy as a treatment option for fighting cancer is steadily growing in acceptance.

Christine Collins

Christine

As a biological therapy, immunotherapy is unique as it uses your own immune system to fight cancer cells.

Kidney Cancer Canada is a patient-centred support organization that advocates for establishing a national guideline for monitoring patients while on immunotherapy.

This article was sponsored by one of Canada's leading research-based pharmaceutical companies.

Advanced Skin Cancers Now Have a Broader Range of Treatment Options Available

In recent years, innovations to help the body’s immune system destroy cancer cells have been life-changing for patients.

Melanoma is more than skin deep. It’s a very serious form of skin cancer. In 2021, an estimated 8,700 Canadians learned that they had the disease — an increase of 8.5 per cent over the previous year. More than 1,200 died from melanoma in 2020. It can spread to other areas of the body, making it potentially deadly for anyone regardless of age, gender, or race.

Non-melanoma skin cancers are more common, with over 80,000 cases diagnosed each year. Basal cell carcinoma is the most commonly diagnosed, but it’s less deadly as it’s less likely to metastasize. Melanoma and non-melanoma cancers can have significant health consequences, underscoring the need for prevention (practising sun-safe behaviours, such as wearing broad-spectrum sunscreen), early detection, and effective treatment options. The leading cause for both types of cancers is ultraviolet exposure from the sun or artificial sources, such as tanning beds.

Make early detection a priority

Compared to other types of cancer, signs of skin cancer are visible on a patient’s skin. With that in mind, experts suggest checking your skin and moles monthly. Look for asymmetry, irregular borders, colour, diameter (greater than six millimetres), and evolution (recent changes

in moles). Should you spot anything troubling, talk to your doctor about getting a referral to a dermatologist, who may perform a biopsy of the suspicious skin lesion(s). If skin cancer is found, it can often be addressed through surgery or radiation, according to Mary Zawadzki, Manager of Community Programs and Resources at Melanoma Network of Canada.

For patients whose cancer has metastasized or who didn’t benefit from radiation or surgery, there are other treatments, including immunotherapy.

“For patients whose cancer has metastasized or who didn’t benefit from radiation or surgery, there are other treatments, including immunotherapy,” says Zawadzki. “It’s one of the newer tools available, along with topical chemotherapy (a cream or gel applied directly to the skin, for example) and targeted therapy.” Immunotherapy uses drugs given intravenously to enable the body’s own immune system to destroy cancer cells. Meanwhile, targeted therapy is administered in pill form and focuses on tackling the specific gene mutations of a cancerous tumour.

Advanced tools for metastasized disease

Being diagnosed with melanoma just a decade

ago was devastating to patients, Zawadzki notes. “If the disease couldn't be controlled through surgery or radiation, an oncologist’s toolbox of treatment options was very limited. These new immunotherapies have been ground-breaking. They've allowed people to have a greater sense of hope that they can combat this disease. People can move forward and have a great quality of life.”

New treatments for cancer that has spread can also be used for melanoma and non-melanoma types, which include basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). It’s rare that non-melanomas will spread, but it’s much more common with cSCC if left untreated. For early-stage localized cSCC, a doctor may remove it surgically or through freezing or scraping. These measures may not work if the cSCC is able to grow. For example, an cSCC on the cheek could metastasize to lymph nodes in the neck area. In cases of advanced disease, immunotherapy may be recommended.

As is the case with many cancer types, early detection is key, Zawadzki emphasizes. She suggests Canadians remain diligent about checking for changes in their moles and seeking medical attention without delay if any problems are identified.

For more information about skin cancer, from prevention to current treatment options, speak to your health care provider or visit melanomacanada.ca

This

article was made possible with support from a leading research-based pharmaceutical company.

Michele Sponagle

Mary Zawadzki Manager of Community Programs & Resources, Melanoma Canada

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