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It was said to Paul Hazelwood that there was nothing else that doctors could do to treat his rare terminal cancer.
Three and a half years later, the Gerringong man is still suffering from Stage 4 small bowel cancer, a fact that he attributes to a medical trial and an anti-cancer drug called Keytruda.
"I have everything," said Hazelwood, 44.
In a great gain for people with rare cancers, the Therapeutic Goods Administration (TGA) has approved the use of Keytruda for several types of rare cancers.
This is the first time that an anti-cancer drug is approved in Australia based on the genetic profile – or biomarker – of a tumor rather than the localization of the cancer.
Dr. Stephen Kao, medical oncologist and principal investigator of a Keytruda clinical trial at Chris O 'Brien Lifehouse, said that it was the first time that a biomarker (dMMR / MSI- H) "unified oncology".
"If you have this biomarker, regardless of the type of cancer, we think that Keytruda or immunotherapy will be effective," Dr. Kao said.
"Previous research has shown that colorectal cancer patients with biomarkers respond much more to the immunotherapy drug than those who do not have one.
"If colorectal cancer presents these biomarkers and responds better to Keytruda than those who did not, what about other tumors?"
The following and ongoing trials included patients – including M. Hazelwood – with various rare cancers who had exhausted other treatment options, such as chemotherapy.
"The trial showed that in these people, a significant number of people responded to Keytruda and not only did they respond, but they tended to have a fairly durable response," said Dr. Kao.
Clinic Professor Morteza Aghmesheh, Hazelwood's oncologist, said that the former coal miner would probably not be alive today without this treatment.
"I think he's in complete remission," said Professor Aghmesheh – who conducted a separate trial for the Lifehouse trial – adding that Hazelwood would still need long-term supervision.
It has been a little over a year since Hazelwood completed his two year course on Keytruda.
The father of two said he did not know how long he would have lived without immunotherapy.
"If you saw me now, you would never think that I have a terminal cancer," he said.
Keytruda is currently registered on the distribution system for only a few cancers, and without this subsidy, the drug is not a cheap treatment.
At a high price, the drug can vary between 8500 and 16 500 dollars per month depending on the weight of the patient.
The Lifehouse trial had patients on the drug for two years.
Richard Vines, president of Rare Cancers Australia, said that the approval of the TGA was "very exciting" and offered great hope for people with rare cancer, but that the government needed "any urgency "to face the cost of the drug.
"It's a big step forward, it's just not going to put the drugs in the hands of patients," he said.
Mr Hazelwood said the listing of this drug would give people hope for longevity.
"It will mean everything to anyone in the situation I am in," he said.
Mr. Hazlewood added that the drug had allowed him to continue enjoying life with his wife and two teenage children.
"I would say it's been a good five years."
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