When Gerry, a man in his early 40s, stopped responding to blood-cancer therapy, Prof Peter O’Gorman knew that his patient had reached the end of the line. He also knew that drugs licensed in the US might help, but they would not be available here in time to help this patient.
O’Gorman is a consultant haematologist at the Mater Misericordiae University Hospital, in Dublin. He became increasingly frustrated that people in Irish hospitals were dying while patients in the US experienced better outcomes using drugs yet to be licensed here.
“If a cancer patient in Ireland is relapsing and the conventional options have been exhausted, we need the best available options available in real time,” says O’Gorman.
He looked beyond the Irish health system to the Dana Farber Cancer Institute at Harvard University in Boston, and worked out a collaboration whereby Irish patients could participate in new drug trials in the US. O'Gorman established MIRT Ireland (the Mater Institute for Research and Therapy in Blood Health Innovation) to secure the latest drugs for Irish patients.
Access to new drugs
Now, seven years on, Irish blood cancer patients have real-time access to new drugs developed in the US, at no cost to the health service. The outcomes tell the story. Irish blood cancer patients are doing better than most of their European counterparts. Survival and response rates here have doubled.
“In 2010 I took over as chair of the blood cancer trials committee of the Irish Clinical Oncology Research Group [ICORG]. Since the programme started, 170 patients have been enrolled in 32 new blood cancer trials,” says O’Gorman. “As well as providing desperately needed treatment options, the trials save millions of euro on treatment that would have been used in the absence of a trial.”
The most recent round of trials, due to start this week, will involve 42 patients, at a saving of €174,592 each. That’s a total saving of more than €7 million to the HSE.
“A new trial for multiple myeloma patients is about to proceed simultaneously in the Dana Farber Institute in Boston and in eight centres in Ireland,” says O’Gorman.
“The RVDsq trial consists of the best available therapies in myeloma combined in an innovative and highly effective way. I am delighted that Irish patients will have the opportunity to benefit from this.”
The drug trials are only part of the story, as O’Gorman wants Irish consultants to be involved in international blood cancer research. “In the US, it is routine for consultants to spend up to two days a week researching their field. There is no such ‘protected time’ system here.”
MIRT is training doctors to become “clinician-scientists” with both clinical qualifications and a background in blood cancer research, through a PhD programme in DCU twinned with the Dana Farber Cancer Institute.
There is also an undergraduate MSc and summer studentship programme for medical students and science students at UCD. “So far we have put eight doctors and eight undergraduate students through our summer studentship, MSc and PhD programmes,” he says.
O’Gorman and his team have, in his own words, “scraped the money together” through fundraising. Most of the money has come from friends and families of those who benefited from the trials.
“We established a fellowship programme named for our patients, because without their bravery and commitment, we would not have made the great progress we have made in the past seven years,” says O’Gorman. “People such as Sr Martha Hegarty, who worked so hard for people with intellectual disabilities in her lifetime, also made a huge contribution to our understanding of blood cancer by taking part in these trials when she was diagnosed with leukaemia.”
Sr Martha’s friends and family have raised thousands of euro to support Irish haematologists to conduct blood cancer research through the Sr Martha Hegarty Fellowship.
While the HSE provides support for the running of ICORG, O’Gorman says more support is needed at the sites of the drug trials, particularly in relation to the hiring of drug trial staff. “ICORG is undertaking detailed analysis of the drug trials infrastructure. While the HSE’s central support is welcome, we are experiencing ongoing issues in relation to long-term contracts for staff at the trial sites.”
So what’s next for MIRT? O’Gorman would like to raise awareness of blood cancer among the public. He also hopes Irish health policymakers will think long term when it comes to cancer treatment in Ireland.
“Further investment is required so that we can reach our full potential. Irish patients deserve the best. They deserve the best consultants and they deserve access to the best cutting-edge treatments. That is what our programme has tried to achieve.”
On December 10th, Dublin roots band I Draw Slow will play a gig in aid of blood cancer research and therapy in Whelans of Wexford Street. Tickets, €25, from whelanslive.com. All proceeds go to the Mater Institute for Research and Therapy in Blood Health Innovation. See mirtireland.com/materfoundation.ie
Blood cancer: facts and figures Two new cases of blood cancer are diagnosed every day in Ireland
More than one in 10 people diagnosed with cancer in Ireland every year have cancer of the blood. Yet, compared with other cancers with similar impact, such as lung and colorectal, blood cancer has a low public profile There are several types of blood cancer including multiple myeloma, leukaemia and lymphoma
Blood cancers affect the blood, the bones and the kidneys
Survival rates for blood cancer have doubled in Ireland in the past five years