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Wednesday, October 7, 2015

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‘TumorGraft’ technology helps oncologists treat cancer

Tags: Health News
Rochelle Schwartz and her husband, Yaron Panov

Rochelle Schwartz is not the kind of woman who takes no for an answer. Particularly when her husband’s life is at stake.

A couple of years ago, Schwartz’s husband, Yaron Panov, was told his cancer was inoperable and there was not much doctors could do to help him. He was given six months to live.

Schwartz, herself a physician, suspected that was not the case. She knew of new treatments available in the United States, and she had the gumption to take the bull by the horns and make things happen.

She contacted doctors south of the border and an American-based company with ties to Israel, Champions Oncology, a leader in innovative cancer treatments.

Champions’ “TumorGraft” offers a model for growing and testing human tumours, providing oncologists with the best course of drug treatments for cancer patients. The procedure involves extracting cancer cells and the surrounding tissue, growing them in lab mice, and then testing various drugs on them to see which is best suited for that particular cancer in that particular patient.

The treatment worked and Panov is now several years past the deadline Toronto physicians had set for him.

Now, Schwartz is hoping a young Russian man can benefit from the same techniques that helped her husband. Andrew Avetikov is suffering from a particularly aggressive cancer. His family is staging a fundraising campaign to raise the money to send him south of the border to Champions, in the hope they can do for him what they did for Panov.

Avetikov was receiving chemotherapy last week and was unavailable for comment. However his cousin, Flora Krasnoshtein, said, “The family hopes that Champions Oncology will be able to give us information about specific mutations in Andrew’s tumours via targeted sequencing analysis that they are going to perform, which in turn will enable the expert panel of oncologists to make a more informative decision about personalized treatment options that would help treat Andrew’s cancer.”

In 2009, Avetikov was diagnosed with cancer. He underwent treatments and his condition improved. But after being in remission for 2-1/2 years, a completely different cancer appeared and, “it’s aggressive.” That means, “it grows very fast and is hard to treat,” said Schwartz.

Avetikov has been receiving treatment – powerful drugs administered intravenously. The result has been a lot of harmful side effects, but “nothing is working,” Schwartz said.

She was alerted about Avetikov’s situation by one of her patients from Toronto’s Russian Jewish community.

Avetikov, like Panov a few years ago, is running out of options in Canada. But as for Panov, there may be treatments available south of the border.

Recounting Panov’s story, Schwartz noted that after he underwent surgery in December 2010, they were told, “There’s nothing [more] to do.” Their only option in Toronto was massive surgery, the removal of organs, chemo with a small chance of success.

“I just couldn’t believe that, so I got in touch with Champions Oncology,” Schwartz said.

The principals behind the company are Americans who spend a lot of time in Israel. One of their implantation sites is in Rehovot; others are in Singapore, London and in the Baltimore area.

Following a teleconference with American doctors – Panov’s Canadian doctors declined to participate – her husband’s pathology reports were sent south.

A program of “personalized chemotherapy” was prescribed by Champions.

Speaking from Israel, Champions’ president Ronnie Morris explained the procedure as one that designs a chemo treatment regimen based on each particular patient’s cancer.

Currently, doctors employ a “first line of treatment” that benefits 50 to 60 per cent of patients. For those who require more, the odds of success go down rapidly, he explained, to only 15 per cent in the second-round line and even lower in the third.

Doctors historically prescribe chemo or cocktails of drugs based on trial and error, but in recent years, researchers have attempted to tailor the chemo drugs to work specifically against a patient’s particular cancer.

Champions developed a technique in which the whole tumour from a patient with all its supporting microenvironment are implanted into mice, thereby creating a very similar personalized model of their disease. Then they are able to take this patient’s “live” growing tumour and test different groups of mice with treatments that the oncologist is considering giving to the patient. Once a drug or a combination of drugs proves efficacious against the tumours in the mice, they are used in treatment of the patient, Morris said.

“In terms of the success rate, once we find an answer, it has a 94 per cent success rate of working in the patient. The results that we empirically see in the mice are very similar to what we clinically see in the patient.

In other words, if the mice tumours shrink, disappear or remain stable, similar results are found in patients. That compares to the 15 per cent success rate for the “basket of drugs” used by doctors after the “first line of treatment.”

The process can take from three to six months from the time the tumours are removed from the patients. In addition, it’s expensive.

It’s $1,500 to implant the tumours into the mice, and each drug test or combination of drugs runs $3,000 a test. Most patients require four or five rounds before the most effective cocktail is found; that’s a total of $12,000 to $15,000.

 The drug that was found for Panov made him sick, weak, and he lost his hair, “but it worked,” Schwartz said.

Her husband, an engineer by profession, continues to take medication “to prevent the sarcoma from coming back,” Schwartz said. One month’s supply runs $10,000.

She said American doctors’ attitude to cancer differs from what she’s noticed in Canada. “They [Americans] turn cancer into a chronic disease and treat it with new drugs that come out all the time.” It becomes something you manage, like diabetes, she said.

As for the costs of treatment, “OHIP did not pay anything for my husband’s treatment… If you’re not a doctor or an engineer, you can’t afford it, so you die,” she said.

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