Nova Scotia Health first in Atlantic Canada to offer cutting-edge cancer treatment, CAR-T cell therapy

The Queen Elizabeth II Health Sciences Centre in Halifax became the first facility in Atlantic Canada to offer CAR -T cell therapy locally as of March 2022. Prior to this, Nova Scotia patients who were recommended for this highly personalized cancer medicine had to travel outside the country to receive it.

The program was made possible with a government investment of $6.7-million annually, which was announced in July 2021.

“Our ability to provide this innovative treatment in Nova Scotia is a significant step forward for our Cancer Care program and patients,” said Michelle Thompson, Minister of Health and Wellness. “Nova Scotians will now be able to receive this treatment here at home, where they will have the support of friends, family and their care teams before, during and after treatment.”

CAR (Chimeric Antigen Receptor) -T cell therapy is a highly personalized type of cancer treatment called immunotherapy. This involves collecting and genetically modifying a patient’s own immune cells (T-cells) to be able to fight their cancer.

“CAR-T cell therapy is a revolutionary new treatment that presents a paradigm shift in how we treat cancer,” said Dr. Mahmoud Elsawy, a hematologist and medical director, Nova Scotia Health CAR-T cell therapy. “It’s considered a living drug because once infused in the patient, the genetically engineered T-cells continue multiplying and fighting cancer and may even persist inside the body for long periods. It is a lifeline for patients with certain kinds of blood cancer when traditional treatments stop working.”

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“This cutting-edge cancer treatment will also open many avenues for patients with other types of cancer in the near future,” said Dr. Darrell White, a hematologist and Director of the NS Health Cell Therapy and Transplant Program (CTTP).

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“The field of treating patients with hematologic cancers is moving rapidly and we are pleased to work closely with government to increase our ability to offer novel therapies to our growing population,” said Dr. Sudeep Shivakumar, interim Head of the Division of Hematology and Hematologic Oncology.

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Dr. Helmut Hollenhorst, medical director, Nova Scotia Health Cancer Care Program said the multidisciplinary team who worked over the past year to establish this program are to be commended.

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“Establishing the CAR-T cell therapy program in Nova Scotia during the pandemic speaks volumes about the dedication and commitment of teams in hematology and hematologic oncology, intensive care and neurology to ensuring Nova Scotia patients with cancer have access to transformative personalized cancer treatments in their home province. It required extensive training of many teams to be certified as a site to deliver CAR-T cell therapy.”

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Charles Jesso was the first patient to benefit from this therapy in Nova Scotia.

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“I am grateful for this treatment because I was out of options,” said Jesso. “I am also grateful that I didn’t have to travel out of the country to receive it. Even with having the treatment in Nova Scotia, it has been a struggle. My wife was able to be at my side and we both had the support of family and friends. You cannot do this treatment alone. You need a caring partner and you need a good care team. I am so lucky to have both.

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“The treatment is working, but it’s a long road to recovery. I’m looking forward to 10 months from now when I plan to be well enough to go back to work.”

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CAR-T cell therapy is currently approved for some types of blood cancers once traditional chemo or immunotherapy stop working. The process begins with collection of the patient’s T-cells from their own blood, which are then sent to a manufacturing facility in the US to be genetically engineered to attack cancer cells by inserting a ​ chimeric antigen receptor (CAR) on their surface which makes them able to recognize a marker on the surface of cancer cells and destroy them. The cells are grown in large numbers and sent back to the hospital to be infused in the patient.

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Patients receiving this therapy are generally in hospital for about three weeks following infusion of the genetically engineered T-cells, as the potential for serious side effects generally occur within this timeframe. After discharge from hospital, patients are then closely monitored for a period of time as outpatients. Patients are also given clear direction on when symptoms are serious, and they need to go to their local emergency department. Routine check ins with their CAR-T team are scheduled to ensure necessary support and follow-up is in place.

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