A new cancer treatment clinic that treats patients with malignant tumours by using their own immune cells in a vaccine has opened in the Cayman Islands.
Two cancer patients, both of whom came to Cayman from the United States specifically for the treatment, have already started the therapy, which involves a series of four simple injections over four months.
Dr. Thomas Wagner, co-founder of Perseus PCI (Personalised Cancer Immunotherapeutics) based in the Smith Road Plaza, said his immunotherapy treatment is a painless alternative to chemotherapy and radiation therapy. He also has a clinic in Greenville, South Carolina, where he is doing trials on the therapy and awaiting US Food and Drug Administration approval for the treatments.
The Cayman Islands Health Practice Commission in February licensed Dr. Wagner’s company to offer the treatment in Cayman, where Dr. Sook Yin is the treating physician. The centre became operational in April.
Dr. Wagner insisted that he had not set up the clinic in Cayman to “get around the FDA”.
“We are working constantly with the FDA; we have been for 13 years and we continue to work with the FDA. We have been given Orphan Drug Designation [which the FDA bestows for products that demonstrate promise for the diagnosis and/or treatment of rare diseases or conditions], which is not an easy thing to be given.
“We continue to work with FDA and to work on this childhood disease. With the FDA, you work on one disease at a time, but the therapy is the same with all tumours,” Dr. Wagner said.
Dr. Wagner’s immunotherapy underwent phase one and phase two FDA-regulated clinical trials from 2000 until 2009, after which Dr. Wagner retired and set up Perseus. At that point, his company established a new clinical trial, this time for immunotherapy treatment for neuroblastoma, a cancerous tumour that develops from nerve tissue and that usually afflicts young children.
“We are doing everything in Cayman exactly how we’re doing the FDA trials here … it’s our hope to be able to collect this data and submit this data along with our US data when we go from neuroblastoma to other cancers … You could consider it an extension of our trials here,” added Dr. Wagner, speaking from Greenville.
“We’re trying to utilise the Health Practice Commission[-approved] treatment in Cayman as a connecting trial to that, to make the whole thing go faster. I’m 70 years old, I’m in a hurry to get this approved before I’m gone,” he said.
The therapy is injected under the skin once a month over four months. Dr. Wagner said that by using patient’s own cells to fight the cancer, they do not suffer the types of side effects and complications that come with radiation therapy and chemotherapy.
In the 13 years that he has been carrying out the trials in the US, 44 patients have undergone the treatment. All had stage 4 cancers and had been given between three to five months to live.
Dr. Wagner said all 44 survived at least two years. One patient, Mary Carol Abercrombie, who was one of his earliest patients, has survived 11 and a half years since starting the treatment and has no sign of the melanoma with which she was diagnosed 13 years ago.
Six of the patients, or 14 per cent, are now disease free, he said. In cases where the tumours were too big to surgically remove, the patients eventually died.
“One hundred per cent of our patients where the surgeon could remove all visible sign of tumour are alive,” he said, adding that the immunotherapy efficiently takes out cancer cells on the periphery of a tumour.
While his patients in the US study have all been stage 4 cancer patients, with the approval granted by the Health Practice Commission in Cayman, patients at earlier stages of cancer and with different types of cancers can be treated here.
He describes the Perseus PCI therapy as a vaccine made specifically for each patient from a portion of their solid tumour and their own blood cells.
Mrs. Abercrombie, now 63, was diagnosed with Stage IV melanoma 13 years ago. She started Dr. Wagner’s immunotherapy after a year on the cancer treatment Interferon failed to improve her condition.
By the time she finished the injections, her melanoma had disappeared and has not returned.
Unlike immunotherapies that use other people’s cells, Mrs. Abercrombie said she was attracted to Dr. Wagner’s approach because the therapy was personalised and it made sense to her that her immune cells would be used to combat her cancer cells.
“You’re using your own cells to fight your own cells and you’re using your own immune system. That’s the difference between this and other therapies,” she said.
Mrs. Abercrobie’s doctors had told her she should “enjoy Christmas”, which at the time was three months away, as they did not expect her to see another one. When she had her first injection at the Greenville clinic, her son was preparing to get married in four months. Not only did she see his wedding, and later her daughter’s, she now has four grandchildren whom she believes she would never had known if she had not had the immunotherapy treatment.
The cost of the treatment in Cayman is $93,000, which includes the manufacture of the vaccine, travel to and from the US. For people living in Cayman, the cost will be half that, Dr. Sook said. The treatments are not covered by medical insurance, but his company is in talks with local insurance companies.
For patients trying other treatments first or who are unsure if they want to undergo the immunotherapy, Dr. Wagner said the company will freeze and store cancer tumour tissue at the facility for free.
“The most tragic thing is the patients who have surgery and have chemotherapy and feel awful and call us and say they want to do this, but there’s no tissue left to work with,” Dr. Wagner said. “We don’t need much, a milligram of tumour tissue … Any surgery they’re going to be doing, they can be harvested for that. The hospital is so close, Terry [Hilton, the laboratory manager] can go there and pick the tissue up in a phial, freeze it and store that material. Anyone in Cayman that has cancer and has surgery, this is something we can do, we can store their tissue in case they want to do the therapy.” Dr. Wagner sees immunotherapy as the future of cancer treatment. “In the last 50 years, we’ve learned more about the human body than in all the time before that. From the discovery of DNA to the present is that period where we learned so much about the human body … and yet, we treat cancer the same way we did 50 years ago. That’s ludicrous. Logic tells us this shouldn’t be true,” he said.
“Cancer starts in our body 10 times a day every day, at least. That is something we learned that about 20 to 25 years ago … 99.9999 per cent of cancers that start are automatically stopped by the natural process in the body. I made the decision in the institute I directed at that time that it made a great deal more sense to figure out the mechanisms in the body that stop the cancer and tweak them somehow rather than bomb them with chemotherapy,” he said.
Simply put, a patient’s cancerous tumour cells are inserted into a dendritic immune cell, which triggers a massive response by the immune system against that type of cancer cell, so only those cancer cells and no healthy cells are targeted.
Dr. Yin said she had teamed up with Dr. Wagner because she was anxious to see a cancer treatment choice available to people with cancer because they are running out of time. “It’s a time bomb. We’re losing people all the time. That’s why we have to make this available,” Dr. Yin said.
“This is the future of medicine … Cayman is a world-known site for finance; I think it could become a world centre for personalised cellular medicine,” Dr. Wagner said.
Perseus is the second cellular
medicine company to acquire a licence to operate in Cayman. Last year, the Health Practice Commission authorised Stematix Cayman Lab to perform Regennex stem cell procedures, which use a person’s own adult stem cells on an individual’s own body.