Osler Provides Life-Changing Cancer Therapy

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From left to right: Dr. Phil Kuruvilla, Chief of Hematology and Oncologist; Lollita Rahaman, Nurse Educator; Sabiha Delawala, Pharmacy Lead, Oncology; Shannon Farley, Nurse Practitioner; Diana Di Bello, Resource Nurse; Patricia Mosnia, Director, Oncology, Palliative & Benign Hematology; are part of the incredible team at Osler that implemented the Bispecific T-cell engager anti-cancer therapy (BsAbs) therapy for those living with hematological cancer.


With the number of cancer cases in its region expect​ed to double over the next 20 years, William Osler Health System (Osler) is taking decisive action to improve patient outcomes, and is now among the first community hospitals in Canada to provide state-of-the-art anti-cancer therapy for those living with hematological cancer.

Bispecific T-cell engager anti-cancer therapy (BsAbs) harnesses the power of a patient's immune system to enhance anti-tumour activity. Incredibly, it uses synthetic antibodies to bring immune system T-cells into contact with the cancer, which then activate and help destroy it. The BsAbs technology, first administered to a patient at Osler in August 2023, is a new type of cancer treatment leading to improved patient outcomes for people living with hematological cancers (blood cell and vessels, lymph nodes and bone marrow), and is typically only administered in select academic hospitals.

“The day we provided this treatment was one of the happiest for me in 25 years of medical practice," said Dr. Philip Kuruvilla, Chief of Hematology and oncologist at Osler, who was among those instrumental in helping bring BsAbs to Osler. “We have been preparing to bring this specialized treatment to our cancer patients at Osler for more than three years and mobilized our team within less than two months once we had confirmation it was coming."

The BsAbs treatment is currently being provided to inpatients with multiple myeloma (a type of blood cancer that forms in plasma cells in the bone marrow), who have exhausted all other lines of therapy and treatment. This anti-cancer therapy typically improves the survival prognosis from days or weeks to months or years and is already being tested for treatment of other cancers.

The recommended inpatient treatment is three doses of the drug administered over one week with ongoing treatment supported in Osler's Oncology Outpatient Clinic. Following extensive education and research into this treatment, Osler's teams prepared and planned the treatment and monitoring for patients to successfully mitigate and manage potential side effects.

“We typically talk about life expectancy in terms of days, weeks, months or years, but when a patient has a life-limiting illness, being present at a child's graduation or wedding, or celebrating a milestone birthday become the goals," said Shannon Farley, Nurse Practitioner at William Osler Health System. “To me, that is the piece that is so moving about being able to provide these cancer therapies. We are supporting the patient and their loved ones to make more of these precious memories together with the time allowed."

Farley, along with Dr. Kuruvilla and Lollita Rahaman, Nurse Educator, provided guidance to the BsAbs interprofessional team that includes nurses, pharmacists, hospitalists, and ICU and Critical Care Response Teams. All were involved in developing the protocols to be able to safely administer the treatment and monitor patients. Executive support was provided by Dr. Michael Miletin, Executive Medical Director, Quality, Patient Safety & Health System Integration.

Osler supports a workplace culture that promotes, inspires and recognizes ingenuity and innovation, and staff are encouraged to safely learn and support new therapies. Not only was the team successful in bringing this innovative, life-changing treatment to Osler, but also in initiating a unique process supporting equitable health care.

Neurologic exams are usually required for BsAbs treatment, such as daily testing of a patient's ability to write a sentence. Prior to Osler delivering this treatment, these exams had only been applied in clinical trials to individuals proficient in the English language. Given the organization's diverse community, Osler used paediatric neurological assessments as part of its protocols for adults who need the treatment but cannot write in English. This innovative modification has become a learning point for academic hospitals that also provide the treatment.

“To be able to provide this level of care in a community hospital is impressive," said Farley. “For patients to trust us with their wellbeing and let us guide them through the care journey is an honour and such rewarding work."

As one of Canada's busiest community hospitals, Osler serves more than 1.3 million residents across five sites, in one of the fastest-growing and most culturally diverse regions in Ontario. Osler has successfully expanded the breadth of its cancer care services in recent years to include chemotherapy, innovative immunotherapy, rapid genome sequencing, advanced surgical techniques, and access to global clinical trials for new anticancer treatments. Plans are also underway to create a new state-of-the-art cancer care centre that will house more comprehensive oncology services, including radiation therapy.