By Jose Sandoval-Sus, MD,FACP
A new form of immunotherapy now available in Broward County is helping blood cancer patients battle their disease and, in some cases, do it without some of the most serious side effects associated with chemotherapy. Based on evidence from pivotal, clinical trials in which colleagues at H. Lee Moffitt Cancer Center participated and from what we’ve seen since Chimeric Antigen Receptor (CAR) T Cell Therapy was FDA approved for widespread use, the treatment is a game-changer for patients with B-cell acute lymphoblastic leukemia, aggressive B-cell non-Hodgkin lymphomas, and multiple myeloma patients that have relapsed after multiple lines of conventional treatments.
CAR-T therapy involves harvesting a patient’s T cells from blood and genetically altering them to produce synthetic molecules on the surface of these cells called chimeric antigen receptors (CARs) that better equip them to fight these cancers. The modified cells are introduced to the body through a blood transfusion, with the CARs enabling the T cells to recognize and attach to a specific protein in the membrane of tumor cells and kill them while minimizing damage to healthy cells.
We’ve traditionally treated blood cancers with chemotherapy and antibodies and while those are still important pieces of the puzzle, having this new treatment option is important for several reasons. In addition to being less toxic than some of the aggressive treatments used to cure blood cancer in patients that have relapsed (i.e. stem cell transplantation), it can be effective in cases where the patient’s body no longer responds to classic chemotherapy drug combinations.
In those situations, picture the cancer cells being bulletproof to traditional chemotherapy, enabling them to continue to reproduce. These cancers can also hide from the patient’s immune system (i.e. normal T-cell), which would normally get rid of these abnormal cells. But now we’ve introduced CAR-T and the tumor cells haven’t yet figured out this new opponent, so they’re not able to camouflage from them. In the best-case scenario, the cancer cells are powerless to prevent the attachment, especially since the CAR-T cells bring the rest of the immune system with them to the battle.
Strategic Partnership
Much of what we’re accomplishing locally is the result of an alliance formed in 2017 between the Tampa-based H. Lee Moffitt Cancer Center and South Florida’s Memorial Healthcare System. At that time, the two healthcare organizations created a malignant hematology & cellular therapy program on the campus of Memorial Hospital West in Pembroke Pines. Today, it is the is the only facility in Broward and Palm Beach counties currently offering CAR-T as a treatment for Acute lymphoblastic leukemia, Diffuse large B-cell lymphoma, Mantle cell lymphoma, Follicular lymphoma, Transformed follicular lymphoma, and Primary mediastinal B cell lymphoma with different CAR-T cell products. In 2022, we are looking to expand the CAR-T cell therapy services to patients with multiple myeloma and offer CAR-T clinical trials in partnership with Moffitt.
First Patient in Broward County
The best news is the dramatic effect the immunotherapy has had for our patients. Leticia Lopez, a former Plantation resident now living in Henderson, Nevada, had struggled with Diffuse Large B cell lymphoma since 2007. Multiple rounds of chemotherapy, radiation and even autologous stem cell transplant would keep the disease at bay for periods during the last decade and half, only to have it return each time. Last June, she returned to South Florida for a pet scan to confirm what she already suspected: the unrelenting feeling that something was stuck in her throat was indeed the return of cancer.
It was then, at 74-years-old, Leticia decided she would live out her remaining days as best as could, unwilling to subject herself to the side effects and collateral damage additional, extended rounds of chemotherapy would cause.
Favorable Prognosis
Timing, however, was finally on Leticia’s side. CAR-T cell therapy had recently been approved and she was a candidate we thought would benefit from the approach. In late September Leticia chose to undergo the procedure, having her blood drawn so that the T cells could be reengineered and then reintroduced into her body with the weaponry to successfully attack cancer cells.
I’m excited to report that the tumor near the base of Leticia’s neck is gone and within recent weeks she reported feeling “like nothing had happened.” Two subsequent scans were clean, showing no signs of the disease. Our girl is cancer-free, and with tremendous optimism that this time it’s for good!
CAR-T cell therapy changed the trajectory of Leticia’s life and we’re seeing it have similar results for other patients as well.
If you or someone you know has one of the blood cancers listed above, I urge you to learn more about this new form of immunotherapy by calling (954) 265-4325 or visiting our website at https://moffitt.org/treatments/immunotherapy/cellular-immunotherapy/car-t-therapy/ to begin the process of determining whether CAR-T may be a treatment option.
Dr. Jose Sandoval-Sus is fellowship-trained in oncology and hematology and a specialist at the Moffitt Malignant Hematology and Cellular Therapy program established in partnership with Memorial Healthcare System.
