Improving immunotherapy for advanced cancer

For people with cancer, every moment counts. Personalized treatments are most effective when given early – and, for immunotherapies like CAR T-cell therapy, there is a narrow window where they can have the greatest benefits. To make the most of that window, doctors need tests that can spot cancer recurrences early and fast. 

Dr Nathalie Johnson and her team are developing a test to spot signs of returning lymphoma. The test looks for tiny fragments of cancer DNA in the blood, flagging recurrences up to 6 months earlier than traditional methods to help people access CAR T-cell therapy before they get too sick. Because the CAR T cells are made from a person’s own cells, the researchers also hope that using immune cells from people who are less sick will make the therapy more effective. 

“Testing would identify patients at high risk of relapse at an earlier time than usual clinical care,” says Dr Johnson, Associate Professor and Louis Lowenstein Chair of Hematology and Oncology at McGill University. 

People with cancer often deal with long waits for testing, followed by anxiety until they receive their results. Dr Johnson’s new test can be completed within 16 days, letting doctors know fast if a person’s cancer is returning and opening the door to proactive treatment. 

“We validated that the test predicts response to therapy and that it could be done quickly,” she says. “Ultimately, the test will allow us to adapt treatment based on very early response to first-line therapy, intensifying if there is a poor response or decreasing toxicity if there is a great response.” 

The researchers are also testing how well CAR T-cell therapy works based on when it is given – whether during remission or in the early stages of a recurrence. They hope to shed light on the best time to give patients this treatment, increasing its effectiveness to save more lives. 

“The next step is to investigate strategies to intervene sooner to avoid chemotherapy that is not going to cure people and allow them to have earlier access to CAR T when the chance of success is higher,” Dr Johnson adds. 

Eventually, the researchers hope not only to optimize the treatment but also to ensure that it can be made in Canada. CAR T cells must be made in specialized laboratories – but transporting them long distances can increase the cost of treatment. By making CAR T-cell therapies locally, Dr Johnson’s team aims to lower costs and increase effectiveness, giving more people access to life-saving treatment.