By MAAYAN HOFFMANUpdated: JUNE 28, 2018 13:32
Cancer has become the No. 1 cause of death in the world – even more prevalent than heart disease. In Israel, according to data from the Israel National Cancer Registry of the Health Ministry, about 23,500 new cancer cases are diagnosed each year.At Tel-Aviv Sourasky Medical Center’s Oncology Division – the largest oncology division in Israel, treating 5,000 new cancer patients a year – the focus is on the personalized screening and treatment of cancer. The medical center takes a multidisciplinary view of the person being screened or treated and the results show the value of the approach.“We try to treat each patient based on his specific disease and the disease characteristics of his specific tumor,” said Ido Wolf, director of the Oncology Division.Specifically, Sourasky’s Oncology Division focuses on molecular testing of all patients, even beyond what is covered by the National Insurance Institute. Wolf said such testing, which examines tumors for various genetic mutations, helps doctors properly diagnose cancer and determine the best, most personalized treatment plan for each patient.“We know now that all tumors are not the same,” Wolf said. “Even within the same type of cancer, there are many subgroups of the disease, and each subgroup can benefit from different therapies… Molecular testing enables us to better help 10% to 20% more patients.”Wolf told a story about Patient X, who eight years ago was diagnosed with thyroid cancer. Doctors treated X with a certain medication, which quickly proved effective. However, after about three years, the medication ceased to help and the cancer progressed.Doctors then conducted a biopsy, found a mutation, and enrolled X in a clinical trial, which kept her alive for another four years. When that treatment was waning, a second biopsy showed a further mutation and X was put on a different medication.“She is alive eight years later because we used specific molecular testing to guide her therapy plan,” said Wolf. “This patient would have died.”Currently, some 150 different types of cancer have been identified, said Wolf. Cancers are classified by the organ where the cancer originates, the type of cells in which the illness develops and various biological processes involved in the illness’s growth.Relatedly, in Tel Aviv’s Integrated Cancer Prevention Center (ICPC), under the direction of Nadir Arber, doctors help to reduce incidents and severity of cancer by providing personalized risk-reduction strategies, detecting disease at an early stage and promoting overall healthy living. Center professionals are also working to develop and implement innovative technologies and approaches to cancer prevention and early detection.
ICPC integrates all screening and prevention activities in a single facility, so within just a few hours, patients can be tested for the 11 most common cancers, including skin, oral, lung and breast cancer. Doctors do a mapping of personal risk factors for developing cancer, including documenting results for ongoing tracking and providing a strict 7 follow-up plan for each patient. Early disease detection can reduce mortality by up to 90%.When it comes to innovation, Zelig Eshhar, another member of the Sourasky cancer research team, is at the forefront. He recently won the EMET Prize in the life science category for his cancer research – an innovative adaptive immunotherapy treatment technique.Eshhar discovered that patients with advanced blood cancer could go into remission, or even be cured, if they were given T-cells genetically modified with synthetic molecules called chimeric antigen receptors. Such T-cells target and destroy tumor cells.Eshhar has been conducting T-cell research for more than a decade. While his first human studies were done in the United States, in Israel Eshhar first tested his theory on rats and mice. Now, the treatment is being actively used on human patients in Israel and abroad.The way it works is that these T-cells can be trained to reject a tumor as foreign. The cells are extracted from the body, modified and trained in the lab, and then put back into the person’s system to do their work.Eshhar, like Wolf, said each person’s cancer is different.“We do it patient by patient,” Eshhar said.Until now, Eshhar’s T-cell treatment has been largely used to treat blood cancers. Now, he and a team of researchers and physicians at Sourasky are “expanding the treatment via new lab tests on mice to treat different indications,” said Eshhar.Added Wolf, “We are now offering more hope than we ever did in oncology.”