Dr. Tinker: ‘This is an exciting time for oncology’

April 10, 2017

Found in General

For those who do not know me, I’m Dr. Anna Tinker, a medical oncologist at the BC Cancer Agency in Vancouver. My area of clinical focus is the treatment of gynecologic cancers. My research focus includes an interest in the development of cancer clinical trials. However, I also enjoy translational research, whereby discoveries and technologies from the laboratory are subsequently applied to improving the clinical care of patients. This is facilitated by my work with British Columbia’s gynecologic research group, called OVCARE. It is my pleasure to be blogging again for the BC Cancer Foundation. It has been four years since my last blog, and there are certainly some interesting developments and updates.

One of the most exciting developments in cancer treatment has to be immunotherapy. This is a broad term that encompasses anything from drugs that stimulate the immune system, vaccine therapy, oncoviruses (the use of viruses to attack cancers) to the use of the patients own T-cells as cancer therapy (a form of adoptive cell therapy).  These last four years, I have worked with researchers at the Trev & Joyce Deeley Research Centre, to design B.C.’s first adoptive cell therapy trial. Generous donations to the BC Cancer Foundation have permitted the construction of the specialized laboratory facility that is required to work with human immunologic cells in a way that allows those cells to be grown, enhanced and subsequently returned to the patient as a form of cancer treatment.  This laboratory is called the Conconi Family Immunotherapy Lab, after the major donors.

For our first trial, we will prove that we have the local expertise and clinical knowledge to safely treat patients with high numbers of T-cells (immune cells). With the completion of this trial, we will open the door to future, increasingly more sophisticated adoptive cell therapy trials.  This first trial is therefore very exciting and important for the growth of the immunotherapy program in B.C. In my next blog, I will tell you a bit more about our first trial, designed for woman with recurrent gynecologic cancers.

I have also been interested in studying the ways in which existing immunotherapy drugs (those that activate the immune system to recognize and fight cancer) may be further enhanced by studying how they interact with radiation therapy. To achieve this, we will soon open a clinical trial which combines an immunotherapy drug with local radiation treatments. It has been an exciting project and I will share more about it with you in the coming weeks.

In addition to cancer treatment, I have been keenly interested in cancer prevention. The cancers I treat cannot be screened for, meaning we cannot detect them before a patient has cancer symptoms. Because some cancers are hereditary, the BC Cancer Agency Hereditary Cancer Program has worked hard to identify those patients who may have an inherited predisposition to cancer. On the whole, approximately 10 per cent of cancer patients have inherited a faulty gene that made them susceptible to cancer. It is very important to find those patients and test their DNA for mutations. If they have living family members, testing those individuals for the same cancer mutations can identify strategies to reduce the risk of becoming affected with cancer. The old adage that “an ounce of prevention is worth a pound of cure” couldn’t be truer for cancer. By preventing cancers all together we can save lives, alleviate tremendous suffering for patients and families, and reduce costs to  our health care system. The increased efforts of the Hereditary Cancer Program, to screen patients at risk of having an inherited cancer syndrome gene, have been a major improvement in the care we can provide to our patients and to B.C. families.

Prevention is the key, but early cancer detection can also save lives.  Working with my colleagues at the Ovarian Cancer Research Program (OVCARE), we have piloted a new tool for ovarian and endometrial cancer detection. The pilot study uses sophisticated molecular technologies to detect low levels of cancer cell DNA that is shed from the uterus in women already diagnosed with ovarian and endometrial cancers. We hope this new method may prove to be sensitive (meaning it finds cancer cells reliably in our study subjects), in which case our tool could be further studied and developed as a new screening method.

This is an exciting time for oncology. The growing armamentarium of cancer treatments has given us new options for treatment. The increasing sophistication in genetics and biology, where knowledge and technologies have been exploding, is creating new opportunities and spawning innovative approaches like never before. This, combined with the new leadership at the BC Cancer Agency, leadership that has emphasized the importance of  research being done right here in B.C., makes this one of the most opportune times to be working here. I feel hopeful that we will continue to move the dial and improve the prevention, treatment and care of cancer patients in B.C.

Please check in again next week!