“I left a very upset surgeon all scrubbed up in his greens [scrubs] and ready to operate,” Mr Biddle said. “It turns out it was the only thing they could offer for someone like me other than going home and getting my affairs in order.” The knowledge that this cancer, synonymous with exposure to asbestos, could return at any time is a constant companion. “When you’re diagnosed with a cancer like this, you’re in a state of shock. You don’t know what to do or where to turn. It’s a dreadful situation,” he said. Now, a world-first immunotherapy trial is giving hope to patients with mesothelioma and advanced pancreatic cancer by reprogramming immune cells to hunt down and destroy deadly tumours.

The experimental therapy has the potential to treat dozens of cancers - including lung, ovarian, and some breast cancers - by targeting a specific protein on the surface of tumour cells. The project is spearheaded by gene therapy expert and clinical haematologist Professor John Rasko at the University of Sydney’s newly established Li Ka Shing Cell and Gene Therapy Initiative. Hong Kong's richest man Li Ka-shing. Credit:Reuters The Li Ka Shing Foundation - the philanthropic organisation of Hong-Kong’s richest man Li Ka-shing - has donated $4.5 million to the university to expand the trial beyond pancreatic cancer to include patients with other cancers that have the mesothelin marker, predominantly mesothelioma. Mr Li is the former head of Hong Kong's largest infrastructure company Cheung Kong Industries (CKI) - now led by his son. Earlier this month the Morrison government blocked CKI's $13 billion takeover bid for Australian gas pipeline operator APA Group.

Loading The foundation’s donation will also enable the creation of a gene therapy workforce and the infrastructure to propel the development and manufacturing of immunotherapies in Australia. “There’s only one word for it,” Mr Biddle said. “Hope.” “If there is hope for a treatment that will possibly cure these kinds of cancers it would be an unbelievable result,” he said. Pancreatic cancer has the lowest survival rate of all major cancers, with 8.7 per cent of patients surviving five years after they are diagnosed. Almost 3000 Australians die of pancreatic cancer every year. It is notoriously hard to detect and is usually only diagnosed once it has spread.

In 2016, 672 Australians died of mesothelioma. Early immunotherapy drugs aim to “take the brakes off” the body’s immune response to cancers by re-energising white blood cells called T-cells. But many patients don’t respond to the treatments. The new trial takes a different tack, focusing on patients with advanced pancreatic cancer and mesothelioma that have a specific marker - a protein on the surface of their cancer cells called mesothelin. The researchers will extract the T-cells from these patients and genetically reprogram these immune cells to create chimeric antigen receptors on their surface (CAR T-cells) that are attracted to mesothelin. Professor John Rasko will lead the project at the newly established Li Ka Shing Cell and Gene Therapy Initiative. Credit:James Brickwood

These reprogrammed immune cells will be injected back into the patients where they multiply, hunt down and destroy the cancer cells, the researchers hypothesise. “We only have to inject a small amount of [CAR-T] cells; the size of the tip of a ballpoint pen - but those cells are capable of proliferating and growing in the body - like normal immune cells - and are capable of killing tens of thousands of cancer cells sequentially,” Professor Rasko said. “It’s terribly, terribly exciting,” Professor Rasko said. “It’s cutting edge, make no mistake.” CAR-T immunotherapy has been approved as a treatment in Europe for specific types of leukaemia and lymphoma, but this is the first in Australia to target solid tumours. Mesothelin is found on the surface of up to 85 per cent of pancreatic cancers and up to 90 per cent of mesothelioma.

Loading Replay Replay video Play video Play video The protein is also detectable in roughly a dozen other cancers, including lung, ovarian and connective tissue cancers as well as an estimated 10-15 per cent of breast cancers, Professor Rasko said. “This technique is cancer agnostic,” Professor Rasko said. “The thing that links all these cancers together is they express a particular protein on the tumour surface that we can target with the reprogrammed immune cells.” The Australian researchers will collaborate with investigators in the US, Canada and Sweden.