Australian-first cancer treatment successful at Monash Health

An Australian-first treatment for cancer found in the kidney has been successfully administered at Monash Health with fantastic results.

Josie was visiting Monash Health for a regular check-up when a CT scan discovered a shadow on her kidney. This shadow was soon diagnosed as an upper tract urothelial carcinoma (UTUC), a type of cancer that occurs in the lining of the urinary tract, specifically the kidneys or the ureters.

UTUC is a rare form of cancer that is more common in people over the age of 70 years. This type of cancer is also three times more likely to be diagnosed in men than women.

Unfortunately for Josie, she was already familiar with this type of cancer after previously being diagnosed in 2018. During this time, treatment for her cancer was the removal of her left kidney and part of her bladder.

With Josie’s recent cancer diagnosis in her right kidney, this same treatment of kidney removal was discussed. However, removing her only remaining kidney would mean Josie would be on dialysis for the rest of her life or until she could receive a kidney transplant. For a younger person like Josie, she would have to wait at least five years for a kidney transplant knowing that the chance of finding  a suitable transplant are slim.

Josie said this news was “very traumatic to hear, and I was going through a lot of emotions.”

Through Dr Weranja Ranasinghe’s guidance, Josie explored other treatment methods to prevent the removal of her remaining kidney.

Dr Ranasinghe, a Urologist and Uro-Oncologic Surgeon at Monash Health, met with Josie to discuss the options available in Australia to keep her kidney.

“The initial treatment for the type of cancer that Josie had was to use laser to destroy the cancer and then give her chemotherapy with a stent into the bladder, with the hope that the chemotherapy gets pushed into the kidney,” Dr Ranasinghe said.

After receiving laser treatment and six weeks of chemotherapy, the cancer in Josie’s kidney was still present. This prompted Dr Ranasinghe to approach Josie with a new treatment that had never been administered in Australia.

JELMYTO treatment

Dr Ranasinghe had come across JELMYTO during his fellowship in Texas, USA when the treatment was in the trial stage.

Dr Ranasinghe said, “when I picked up Josie’s file in the clinic, I initially thought of this treatment.”

After a successful trial, JELMYTO received approval from the U.S. Food and Drug Administration (FDA) and has become the first and only FDA-approved treatment for low-grade UTUC.

The medication is a combination of chemotherapy and an innovative gel technology that is a liquid when chilled and turns into a gel at body temperature. This treatment can be placed in more precise areas of the body where tumours are, unlike traditional liquid chemotherapy, which is difficult to maintain in the kidney.

JELMYTO was tested in a clinical study that found 58% of patients had their tumours disappear after treatment. At the 12-month mark, the majority of the patients who had their tumours disappear were still tumour free.

Based on these successful results and Josie’s special circumstances, Dr Ranasinghe recognised that this treatment could be an effective solution for Josie.

Josie had no hesitations in saying yes to this new treatment.

“I thought anything to help me prolong my life; I am in for,” she said.

Administering an Australian-first treatment

Josie began her JELMYTO treatment in June and completed the recommended 6-week course of treatment. This was the first time that JELMYTO had been administered outside of the United States through the Named Patient Program and the first time it had been used in Australia.

Since this was a first-time treatment in Australia, pharmacy and nursing employees needed special training. Obaid Fazli, Assistant Deputy Director of Pharmacy, and Jincy Kuriakose, Clinical Nurse Specialist, played a significant role in training to safely prepare and administer Josie’s treatments.

Josie’s overall experience receiving this treatment was positive, and she found the treatment to be less invasive than chemotherapy and experienced no significant side effects after the treatment.

“Treatment took 10 minutes to administer, and I would stay for an hour afterwards to monitor any reactions or side effects, and then I would go back to my desk and continue working,” she said.

Three weeks after Josie’s last treatment, tests confirmed there was no cancer in her kidney, and Josie received the wonderful news that she is now cancer free.

When asked how it felt to administer an Australian-first treatment successfully, Dr Ranasinghe said, ” It was very rewarding to be able to provide Josie with good quality of life.”

Josie said part of her positive experience from this treatment came from the nurses at Moorabbin Hospital.

“They work so hard, and their positive attitude and personalities are fantastic. They take personally the care they give you, and it makes a big difference to know that they care about you,” she said.

As a new innovative treatment, JELMYTO is currently not part of the Pharmaceutical Benefits Scheme (PBS).

Josie said, “I would recommend it to anyone. You’re going through this life-or-death experience as it is, and if you don’t try, you will never know. Yes, it can be painful or uncomfortable, but that’s something that you can live with if you know that the treatment will help you.”