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The Healthy Fight

The Government's decision in September to fund immune therapy drugs to treat melanoma was good news for many people. Not least the scientists at the Malaghan Institute of Medical Research, who are researching similar cancer therapies here in New Zealand.

Keytruda and new Opdivo are drugs that work on the immune system and use the body’s own defence mechanisms to fight cancer. This idea has been around for more than a century, but only in the past 10 years has it been converted into successful therapies. Immune therapy promises a gentler and more effective treatment than the current ‘cut, poison and burn’ approaches.

It’s no surprise to Professor Graham Le Gros, Director of the Malaghan Institute of Medical Research, who became fascinated with the emerging science of immunology early on in his career. “When I looked at all the different things I could do with my life, I saw that although cellular immunology was a very difficult subject, it would have the biggest impact if it could be made to work appropriately,” he says.

The human immune system, of which we have a very imperfect knowledge, is a delicately balanced marvel that keeps most of us healthy most of the time. It learns to spot harmful viruses and bacteria, then sends armies of cells on search and destroy missions until they are all gone. It is also proving to be a deep well of new approaches to treating disease.

Raised in Blenheim, Graham was trained at Massey, Otago and Auckland universities before embarking on a career in immunology research overseas. He and his wife Professor Franca Ronchese (a cancer researcher) were recruited back to the Malaghan Institute in 1994, and they have since built it into the country’s largest independent biomedical research institute. It now has close to 90 staff and students.

“OUR SUPPORT COMES IN MANY FORMS. PHILANTHROPIC SUPPORT IS ABSOLUTELY ESSENTIAL; IT GIVES US THE OPPORTUNITY FOR INDEPENDENCE OF THOUGHT.”

“WE HAVE ASSEMBLED A MOTIVATED GROUP OF PEOPLE, SO EVERYTHING SEEMS TO BE IN PLACE. I SENSE SOMETHING VERY SPECIAL IS HAPPENING HERE.”

“I returned to New Zealand to find an incredibly supportive community that really wanted to help people and make something happen here. It’s taken a long time to recruit and train a group of people into this new scientific art of immunology – there’s been a global shortage of researchers with sufficient skills to do the work. But it has been fantastic. I now work with the best of the best.”

Probing the workings of the immune system doesn’t come cheap. Immune cells are small, rare and complicated. The sophisticated machines and technology needed to study them are very expensive, but for 50 years the Malaghan Institute has enjoyed the support of a raft of dedicated New Zealanders, as well as funding from government and businesses.

“Our support comes in many forms. Philanthropic support is absolutely essential; it gives us the opportunity for independence of thought. Other people advocate for their talented children to come and work here. Our supporters are not afraid to tell me how I should do things either. Leadership is about a willingness to listen and realise that we represent a range of values that should be given space, while staying true to our core mission and goals.”

Bringing the new cancer therapy – in the form of a vaccine – all the way through early clinical trials has been a long-term team effort at Malaghan. A cellular vaccinewas initiated by Ronchese in the early 1990s, then in a “brilliant and bold” move Associate Professor Ian Hermans and chemist collaborator Professor Gavin Painter figured out a different, simpler approach.

“They thought of a way to bring together the most powerful elements of the immune response and make a completely new technology to stimulate the immune system to fight cancer, using a natural chemical discovered in sea sponges. No one else in the world has done it this way. We’re seeing it through now – we have to find the version that works in humans and changes people’s lives by changing the outcomes of their cancer.”

Unlike other New Zealand discoveries, the inventors are determined that this one will not be sold overseas too quickly. Only that way will the potentially large rewards be retained to benefit those on these shores. Negotiating the complexities of the clinical trial process to prove the therapy is safe and effective has still to be completed, but Le Gros believes all the elements are there.

“We have a good drug that works well in our tests so far. It’s something different from everyone else’s and it targets an unmet medical need. We have assembled a motivated group of people so everything seems to be in place. I sense something very special is happening here.”

The institute’s basic research to understand the workings of the immune system is now paying off in other areas, with a patented asthma vaccine and a trial comparing responses to the flu vaccine with the collection of microbes in a person’s gut.

“Things are moving very fast. I believe Opdivo and Keytruda have found the principle that the immune system can be used and manipulated safely to change disease outcomes. Now we’re working like crazy to see where else this pathway can work and find the equivalents for switching off autoimmune disease and type 1 diabetes,” says Le Gros. “It’s really just the beginning.”

TRAINING THE NEXT GENERATION

“It’s such a privilege to be a member of the cancer research group. I’m passionate about improving the quality of anti-cancer treatments and believe my PhD will enhance our ability to design these successfully here in Wellington. The progress I’ve made so far would not have been possible withoutthe supportive environment that Malaghan fosters!” (Olivia Burn, PhD student, University of Otago)

“People like Olivia are coming in behind us and pushing us to go faster. They are the future leaders in medical research. Young people have a naivety and a missionary zeal to have a big impact – they are unafraid. As we train students we are identifying people who have the drive, the skill and the interest in more than their own careers. They will shape society for good.”