Ovarian cancer patient Linda McClelland and oncologist Jeffrey Goh, with a vial of the CVac ovarian cancer vaccine, at Greenslopes Private Hospital in Brisbane. Picture: Lyndon Mechielsen Source: The Australian
IF cervical cancer vaccine pioneer Ian Frazer is "God's gift" to women, his brother and fellow medical researcher Neil is working to rival that mighty contribution to public health.
The second Frazer sibling to make his mark on medical science - and help save or prolong countless lives - is overseeing pivotal phase-three clinical trials of a world-first vaccine for ovarian cancer, the "silent killer" of women.
Early testing has shown it is capable of adding up to four years to the lives of some women with advanced ovarian cancer, who otherwise would have had only months to live.
US-based Dr Frazer, 56, who is three years younger than his famous brother but a product of the same university, said yesterday that phase-one and phase-two trials of the CVac treatment had been promising.
Like Professor Ian Frazer's cervical cancer vaccine, marketed in Australia under the brand name Gardasil, the experimental ovarian cancer drug switches on the body's immune system to attack cancerous cells and destroy tumours.
For Linda McClelland, 60, it is a lifeline. Her mother died of ovarian cancer and, despite undergoing regular blood test and scans, she was diagnosed with stage 3B of the disease in March 2009.
After initially responding to chemotherapy, she had a relapse 14 months later and underwent further bouts of drug therapy and surgery, before being taken on in a phase-two trial of CVac.
Ms McClelland said her current remission had already been longer than her first.
"In normal circumstances, the second remission is often shorter, so I am very encouraged," Ms McClelland said.
Her quality of life was "brilliant" and she had no side-effects from the vaccine, unlike those of conventional cancer treatments.
Neil Frazer said that if the phase-three trial was successful, CVac would be available in about five years. His brother's break-through cervical cancer vaccine is now being used to immunise children and young people worldwide against the virus that causes genital warts and, ultimately, malignant tumours in women.
The drug Ian Frazer invented was virtually 100 per cent effective in its final trials; his brother will be hoping to emulate that in his stage-three clinical trial, part of an international effort involving 800 women in 14 countries.
Neil Frazer practised medicine as an anaesthetist but made the transition to lab work in the hope of helping more people.
"Personally, I get a thrill any time we get a new medicine to help patients into the hands of physicians," he told The Weekend Australian from North Carolina.
Dr Frazer followed his big brother in studying medicine at Edinburgh University in their native Scotland and had a similar experience of being inspired "by the excellence of the teaching".
"It also did no harm that our parents had very strong scientific backgrounds and acted as role models for us," Dr Frazer said.
Ian Frazer, 59, is more than happy to share the limelight, "if it draws attention to the importance of science".
He is lending his expertise to his brother's project as chairman of the scientific advisory board of the Australian healthcare company, Prima BioMed, that is developing the ovarian cancer vaccine. Neil Frazer is the company's chief medical officer.
Getting to the critical point of a phase-three clinical trial was an achievement in itself, Ian Frazer said. It catapulted CVac into the same category of immunotherapy as the Provenge prostate vaccine recently approved by the US Food and Drug Administration.
To date, CVac has been well tolerated and a few patients in the final stages of the disease, who were expected to live for only a few months, had survived for three or four years on the experimental drug.
Neil Frazer was hopeful of even better outcomes in the phase-three trial, which will involve women recently diagnosed with stage three or four cancer.
About 1300 women are diagnosed with ovarian cancer in Australia each year and, in most cases, the cancer will be at an advanced stage and very difficult to treat. About 800 women a year die from the disease in Australia. There is no general screening test for ovarian cancer.
The number of new cases of cervical cancer in Australia has continued to decline since the start of an organised screening program. There were 715 new cases in Australia in 2006, compared with 1092 detected in 1991, when the program began.
The mortality rate from cervical cancer has more than halved, from 3.9 deaths per 100,000 women in 1991 to 1.9 deaths per 100,000 women in 2007.
Ms McClelland's oncologist, Jeffrey Goh, has been impressed by how well seven of the ovarian cancer patients recruited at Greenslopes Private Hospital have fared on the phase-two trial and will be screening and enrolling more women in the phase-three trial from this month.
"The side-effects have been minimal and it is a real boost psychologically," Dr Goh said. "Patients who enquire about the trial feel very positive about CVac and really want to be part of it. However, I must stress that CVac treatment is still experimental."
In the phase-two trial, Dr Goh and his team have administered up to 10 CVac treatments per patient over a 12-month period, with the aim of prolonging and maintaining patient remission.
Brisbane gynaecological oncologist Russell Land, who has several patients on the trial, said most women responded well to surgery and chemotherapy but relapses after a couple of years were a major problem for those diagnosed at advanced stages.
"CVac is given after chemo with the aim of extending remission for as long as possible," Dr Land said.
"Provided it works, this will be the tried and tested therapy we have needed."
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