Dr. Carman Giacomantonio
Cancer, Molly Appeal
Dr. Carman Giacomantonio sends skin cancers packing with immune therapies
Dalhousie cancer surgeon, Dr. Carman Giacomantonio is putting old-school immune therapies to work with startling new results in skin cancers that would have been deadly just a few years ago. By directly injecting patients' skin tumours with off-the-shelf immune-stimulating agents, he is sending their cancers into remission and granting them years of good-quality life.
Immune therapy has taken off in the past few years, thanks in large part to research and successful clinical trials with melanoma.
"Before the introduction of immune therapy in melanoma, surgery was the only option for cure in the patient population, with little or or no additional benefit from systemic chemotherapy," says Dr. Giacomantonio. "In those days, for the majority of patients a diagnosis of metastatic melanoma would be a death sentence. Today, more than 60 percent of advanced-stage melanoma patients treated with immunotherapy respond to immune therapy and over half of those patients are cured."
Skin cancer responds beautifully to immune therapy, Dr. Giacomantonio explains, because of the skin's primary function as a defense mechanism. "Skin is designed to initiate a powerful immune response, he says. "This is enhanced dramatically when an immune-stimulating agent is injected into a cancerous lesion on the skin."
Dr. Giacomantonio is working with several common agents, including interleukin 2 and BCG (Bacille Calmette-Guerin, used for years as a vaccine against tuberculosis). He is preparing to launch a clinical trial combining these two against melanoma.
Dalhousie Medical Research Foundation's Fall 2019 Molly Appeal is raising funds for sophisticated new mass spectrometry equipment that will accelerate Dr. Giacomantonio's research. He and his colleagues, Dr. Shashi Gujar and Dr. James Fawcett, will use the new equipment to analyze the proteins in patients' tumour samples, to identify "protein signatures" that indicate whether or not their cancer will respond to a particular immune therapy.
"We're moving toward individualized cancer immune therapy," Dr Giacomantonio says. "It's an exciting time... we believe we can harness the power of the skin's immune response to fight other kinds of cancer as well, by taking tumours out of organs and transplanting them into the skin, then injecting them with immune agents to generate a powerful systemic immune response to the cancer."