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    Smart Drugs
    Reporter: Maryanne Demasi
    Producer: Susan Lambert
    Researcher: Nicki Ruscoe

    Related Info
    26 October 2006
    It has been decades in the making - the revolution of smart drugs called “monoclonal antibodies”. Hundreds of thousands of people suffering from chronic disorders such as rheumatoid arthritis, multiple sclerosis and breast cancer are having their lives transformed. How do they work and how successful are they? Catalyst puts the new wave of wonder drugs under the microscope.



    Narration: Lisa I had a lot of troubles walking I was just dragging my leg along which was real fun when you’re chasing two kids.

    Bernadette (Patient): I’ve had knees replaced and my feet reconstructed and in my hands, I can only use my index finger and my right thumb on this hand

    Cathy (Patient): I’ve been in and out of emergencies and chemo and was wondering what other options there are.

    Narration: All these people are suffering from different chronic diseases but thanks to years of scientific research they are among the first to receive a revolutionary treatment.

    Dr David Champion: It’s immensely clever modern drug development. Really, really clever science.

    Professor John Pollard: This could be likened to a magic bullet.

    Narration: These so called ‘magic bullets’ are monoclonal antibodies and they’re bringing new hope to patients.

    Dr Peter Hudson: Antibodies are special because they are own natural defence mechanisms and so they’re very stable molecules, we know how to handle them, we know who to make them and they exquisitely target certain cell populations. Cancer cells, viruses, um, molecules that you don’t wish to have large amounts of in your body.

    Narration: Bernadette has been suffering from rheumatoid arthritis since she was eight. After a co cktail of drugs that didn’t work, she is now on the monoclonal antibody drug, Humira.

    Bernadette (Patient): It’s been wonderful. To just have a relief from the pain.

    Narration: Another new monoclonal drug Tysabri is helping multiple sclerosis patients like Lisa.

    Lisa (Patient): I haven’t had any side effects at all which is always a good thing and I haven’t had any relapses since I’ve been on it.

    Narration: For breast cancer patient Cathy the monoclonal antibody drug Herceptin has proved life changing.

    Dr Fran Boyle: Cathy’s someone who’s breast cancer had come back in her spine so she was very severely affected terrible pain and at risk of paraplegia of the cancer being in her spine. Herceptin has fixed that problem and now she’s well.

    Cathy (Patient): Well I’m back out working, I can look after the kids, I can function.

    b>Narration: So how do these drugs work?

    Dr Peter Hudson: They’re fully human antibodies so it’s really like injecting an antibody that you would otherwise have made yourself.

    Narration: These injected monoclonal antibodies, coloured yellow, are programmed to home in on a single target like this cancer cells, coloured purple, and neutralise it.

    Dr Fran Boyle: This drug in metastatic disease has meant that patients we thought wouldn’t be alive are still with us 4 or 5 years later and that’s something I never expected to see we’ve seen some amazing results as people with very large cancers have seen them go away..I didn’t think I’d see the day.

    Dr Maryanne Demasi: Monoclonal antibodies fit like a lock and key to their disease target so if we imagine these locks are different cells or disease targets in the body chemical drugs like chemotherapy can wipe out or block the action of all these disease targets but monoclonal antibodies are special they’re specific and they can only unlock or block one cell leaving the other cells unscathed and that means less side effects.

    Dr Fran Boyle: I think that what we’re always looking for as clinicians, are drugs that work but don’t have the same side-effects as chemotherapy such as hair loss and nausea, and I think that’s where the excitement came.

    Narration: But doctors are quick to say these drugs are not a miracle cure.

    Dr Fran Boyle: It increases their life span it increases their disease control and improves the quality of life but we don’t realistically expect it will cure people of this cancer has already come back.

    Dr Maryanne Demasi: There’s no doubt that monoclonal antibodies have revolutionised the way doctors treat diseases. But they have their limitations.
    All monoclonal drugs are extremely expensive.

    Ruth (patient) : My Onocologist said ‘ it’s fabulous cause it means you can have herceptin which is really really good but it’s going to cost a lot of money’ at that point it cost about $70000. My husband said we’ll just mortgage the house and I’m like what would I do..I felt guilty about it.

    Narration: While it’s still a problem for many women like Ruth don’t have to worry anymore.

    News headline: One of the most effective and expensive drugs for breast cancer will soon be a lot cheaper. Federal Health Minister Tony Abbot has today agreed to list Herceptin on the Pharmaceutical Benefit Scheme for early onset breast cancer

    Narration: Herceptin is one of the first monoclonal antibody drugs to be subsidised by the government.
    While cost can be overcome, refining the delivery system of the drug is a greater challenge.

    Monoclonal antibodies have to be injected because they are large molecules and can’t be absorbed by the body in any other way.

    This means for patients to get the drug they are tied to the clinic for hours on a regular basis.

    Dr Fran Boyle: What patients would love to be taking is tablets. So I’m hoping that the monoclonal antibodies are actually a phase that we’re going through rather than something that ultimately, is the way we’ll deliver these targeted therapies.

    Narration: Incredibly the next wave of targeted therapies may come from the bottom of the ocean.

    It’s derived from ancient bacteria-3 billion years old.

    An even newer drug that promises to overcome the limitations of monoclonal antibodies.

    Dr Paul Watt: I had these visions of you going into the deep sea vents.

    Narration: Paul explains how phylomers are made. Phylomers are the brain child of Western Australian scientist Dr Paul Watt.

    Dr Paul Watt: So it turns out that in evolution of ancient bacteria that have been around since the dawn of life are very very diverse in the types of protein they make. So we went to those ancient bacteria to create libraries of shapes or keys that are compatible with disease locks.

    Narration: So Phylomers are not monoclonal antibodies but they act like them with the added benefit of being smaller and faster.

    Dr Paul Watt: I believe this technology has enormous potential because we’re able to create some of the positive benefits of antibody technology in a much smaller format, which is more suitable for delivery by non injectable means and has a much lower cost and so it’s more affordable by the patient.

    Narration: And what’s more phylomers can penetrate right inside cells.

    This means they have the potential to target many untreatable diseases.

    Dr Stewart Washer: They can actually go inside cells and cure diseases which antibodies can’t. And stroke is a classic one, phylomer drugs go inside the brain cell and actually stop the cell death from occurring.

    Dr Paul Watt: So these are phylomers made in Australia and they’ve taken years. It’s amazing that something so small can be so potent have such an effect on biology.

    Dr Maryanne Demasi: So faster smaller, better?

    Dr Paul Watt: Absolutely we think phylomers are the next generation of drugs that will be affordable

    Narration: So if monoclonal antibodies are already helping patients today and phylomers are promising to be the drug treatment of tomorrow then where is science taking us?

    Dr Peter Hudson: We’re now entering the realm of personalised medicine where a therapy, or a product, may be uniquely designed for an individual and that is the new future of medicine.

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