Grace Gawler - Helping You Navigate the Cancer Maze

Genomic Test for Drug Based Immunotherapy

Not all genomic tests are the same.

It is therefore vitally important to contact us FIRST if you are considering genomic testing:The Grace Gawler Institute

There is significant variation in the types of tests and their purpose. Some genomic tests are purposed towards suitability for a clinical trial, others are research focused, some are only offered to patients that have been heavily pre-treated. The more sophisticated tests (our recommendation) offer personalised and targeted treatments. Some tests are performed in Australia, others are performed overseas. Some tests are computer automated whilst others are interpreted by skilled genomic pathologists. The later is our preference for patients considering joining our Survivorship Action Plans. It is cost effective from the outset when you choose the most applicable test for your unique cancer situation.

It is important to understand the difference between conventional drug based immunotherapy and immune enhancement cell based immune therapy.

Drug based immune therapy is a type of drug treatment that hijacks the body’s own immune system to fight cancer.

It is different to chemotherapy which works by killing cancer cells. Different types of immunotherapy work in different ways for various cancers. So far it has been of benefit in only a few types of cancer and it is not without risk of short and long-term adverse side-effects

Cell based immune therapy is made from your own immune system. The cells are harvested from your blood, transported to a high-tech laboratory where your cells are multiplied creating a series of personalised cancer vaccines. The vaccines significantly increase activity numbers and function of your natural killer cells and dendritic cells.

As well, the cells are now retrained to seek and destroy cancer cells like a heatseeking missile. The process restores your immune system, has no side effects and a high safety margin – no adverse side-effects.

A new Genomic Test –  before considering treatment with drug based immunotherapy we believe it is essential to have a TML (tumour mutational load) test. TML is emerging as an important indicator of sensitivity to immune checkpoint inhibitors and may indicate your likely response to immunotherapy providing you with informed consent before considering this treatment.

What is Tumour Mutational Load? Cancer is a complex disease, caused by a wide range of genetic mutations that can be present in many combinations.
Tumour mutational load (TML), or tumour mutational burden (TMB), is a measure of the number of mutations within a tumour genome. TML can vary greatly between tumour types, ranging from just a few mutations to thousands of mutations within a tumour.

How could this benefit me?

The Tumour Mutational Load assay has been designed in response to the need to determine if treatment utilising immune checkpoint inhibitors is likely to be of benefit in your particular clinical circumstances.

For some cancer types, immunotherapy drugs are not listed on the Australian Pharmaceutical Benefits Scheme, and they would incur a large out-of-pocket expense.

We consider this test an important step in gaining as much information as possible prior to deciding on whether to progress with these particular group of drugs.

The Grace Gawler Institute believes patients should be well informed regarding immunotherapies...
Our ethics is that patients should be thoroughly informed regarding risk versus benefit of any cancer treatment. This applies even more so when it comes to drug based immunotherapy. We aim to provide information based not only on science but patients’ real-time experience. Choose wisely.

Few patients or even doctors know of the significant difference between cell-based & conventional drug-based immune therapies (now heavily promoted in Australia & NZ). 
This knowledge alone may help you avoid debilitating side-effects.

Side effects associated with Drug-Based Immunotherapies including
Keytruda (Pembrolizumab) and Car T Cell Therapies

KEYTRUDA can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. 

These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen any time during treatment or even after your treatment has ended.
See-  https://www.keytruda.com/

On Jan 22, 2024, the US Food and Drug Administration (FDA) asked the manufacturers of all six commercial chimeric antigen receptor (CAR) T-cell therapies to add a black box warning to the label to include the risk of the development of T-cell malignancies following therapy. This decision follows reports on Nov 28, 2023, of 22 cases of T-cell malignancies from around 8000 recipients of CAR T-cell therapy included in the FDA Adverse Events Reporting System (FAERS) database. Data from 14 of these patients show that the malignancies occurred 1 to 19 months following CAR T-cell therapy, with around half occurring within a year.
See – https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00037-1/fulltext

 

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