A breakthrough era for blood cancer treatment For decades, cancer treatment has generally involved surgery, radiation and chemotherapy. Today, a new approach reshaping the landscape is immunotherapy, which harnesses a patient’s own immune system to attack the cancer.
CAR T-cell therapy and research at RNSH Although CAR T-cell therapy is readily available in the US, it is still a specialised area in Australia, and available in only a handful of public hospitals. Six patients with conditions including lymphoma and myeloma have received the therapy through two clinical trials run with pharmaceutical companies at RNSH’s Haematology Department. Alongside the trials, Cameron is also busy researching in the laboratory, focusing on further engineering CAR T-cells to make them function better. Whereas some tumours are susceptible to a T-cell attack, others have mechanisms that resist it. “The next challenge is to create cells with additional modification so they can function better in the hostile cancer environment,” he says. “We need a new generation or new iteration of CAR T-cells.”
Clinicians use immunotherapy in many ways, but one of the most transformative for certain blood cancers involves engineering a patient’s T-cells – a type of white blood cell – to seek out and destroy cancer cells. Known as CAR T-cell immunotherapy, it was first approved in the United States (US) in 2017 and has expanded rapidly across the world. Northern Sydney Local Health District’s (NSLHD’s) ability to deliver this therapy has taken a major leap forward since 2025, guided by haematologist Professor Cameron Turtle. After nearly two decades at the acclaimed Fred Hutchinson Cancer Centre in the US, where he focused on developing CAR T-cell technologies, Cameron has returned to his old training ground at Royal North Shore Hospital (RNSH), bringing the expertise needed to make this treatment available in the district for the first time. What are CAR T-cells? CAR T-cells are T-cells that have been taken from a patient and genetically modified so they can produce chimeric antigen receptors, or CARs. These receptors act like “guidance systems”, helping the T-cells to recognise a specific protein found on cancer cells. When a CAR T-cell encounters the protein, it latches onto it, becomes activated, and launches an immune attack to destroy the cancer cell.
Cameron says CAR T-cell treatment has brought about a dramatic increase in survival outcomes in patients with some blood cancers. In the past, patients with certain types of lymphomas that did not respond to chemotherapy or transplants unfortunately died. But with CAR T-cells, clinicians are seeing durable remissions for about 40 per cent of patients. “It’s a huge leap from the previous standard of care,” Cameron says. “This therapy has changed the landscape for people who have relapsed, and
12 Tomorrow’s medicine today
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