A new kind of cancer treatment in Washington state appears to be remarkably effective in treating leukemia. Lynsie Conradi’s case is especially poignant: The 23-year-old is fighting leukemia for the third time, and last year she lost her husband, Rodney, to cancer. But the new treatment, which involved adding a man-made gene to isolated T-cells from Conradi’s blood, seems to have knocked the leukemia out in just seven days. After a bone marrow test showed no evidence of the disease, Conradi was able to check out of the hospital for a few days. “Don’t ever give up hope,” her mother says. “There’s some dark days, but … don’t give up five minutes before the miracle.”
23-year-old Lynsie Conradi of Bellingham got the news Tuesday, just seven days after undergoing the treatment.
The treatment, called cellular immunotherapy, involves drawing blood from the patient, reprogramming their infection-fighting T-cells to find and destroy cancer cells, and infusing the blood back into their body, Seattle Children’s announced Wednesday.
“This is really amazing. I mean this is the sort of result that we wait around all of our careers to see, to see this kind of dramatic response that we couldn’t have hoped for even five or ten years ago,” said Dr. Doug Hawkins, a cancer specialist at Seattle Children’s.
While the concepts of using the immune system to attract cancer have been around for many years, the development is considered groundbreaking, according to Hawkins.
“It shows as a proof of principle we can develop a very highly specific treatment that is for someone’s cancer that goes just to the cancer cells and spares some of the usual side effects we usually associate with cancer treatment,” Hawkins said.
The current study is focused solely on the vicious form of cancer known as acute lymphoblastic leukemia. But researchers at Seattle Children’s are hopeful they can ultimately use the revolutionary treatment for other types of cancers as well.
The next step for Lynsie is a stem cell transplant, with the aim of clearing the cancer from her body. The goal of the immunotherapy cancer trial was to get her to this stage.
“T-cell therapy will change the way we treat cancer,” said Lynsie’s mother Donna Rainford. “Watching Lyns suffer from the effects of chemo almost two weeks after it’s all done makes me thankful that it will soon be a thing of the past. Bring on those T-cells as part of the normal protocol for other cancer patients!”
To do this, Dr. Gardner and her team draw some of the patient’s blood to harvest their T cells. “T cells are found floating around in your blood which makes them easy for us to retrieve,” she said.
They then take them back to the lab and insert a new gene into the T cells that allows them to recognize a protein found on the surface of leukemia cells. The gene is called a chimeric antigen receptor, or CAR.
The CAR-modified T cells spend two to three weeks growing and multiplying in the lab. Once the cells are ready, they are sent back into the patient’s body in an infusion — similar to a blood transfusion — to fight off the leukemia.
“When the T cells are given back to you, it takes a few days for them to re-adjust,” Dr. Gardner said. The patient might feel very sick and experience flu-like symptoms during this time.
Lynsie admits she felt fine for the first two days after her T cell infusion, but spiked a fever on the third day and ended up in the Intensive Care Unit. “But after the fourth day, I felt completely fine,” she said.
By then, Lynsie’s reprogrammed T cells were off to work, doing just what they were supposed to: killing leukemia cells.
Remission at last
Lynsie with Dr. Gardner and Dr. Michael Jensen, principal investigator for the Dream Team at Seattle Children’s Hospital.
Just nine days after Lynsie’s T cell infusion, she received the news she’d so fervently hope for. The doctors could detect no cancer cells in her body. She was in remission.
Thirteen months later, Lynsie is still in remission following a successful bone marrow transplant. But life after transplant has hardly been easy.
“The bone marrow transplant has been very difficult for me and continues to beat me down daily,” Lynsie said. “I have lost almost 35 pounds. I’m in pain and my stomach is always nauseated.”
Dr. Gardner hopes that one day a stem cell transplant won’t be necessary after the T cell therapy, but for now, researchers are erring on the side of caution.
“We know that before Lynsie got her transplant, we couldn’t find any leukemia cells, and we looked really hard and used tests that can detect very small amounts of residual leukemia,” Dr. Gardner explained. “What we don’t know is with T cell therapy alone, how long would that remission last?”
But researchers might find out soon. “There are some patients who are receiving T cell therapy and opting to not receive a stem cell transplant,” Dr. Gardner added. “Those kids will be very important in learning the answer to this very question.”
A new childhood cancer treatment
If T cell therapy alone does prove successful in curing patients of their leukemia, it could become part of the standard course of treatment, eliminating the need for toxic chemotherapy regimens that can permanently damage the heart and other organs.
It seems there could be a cure in our lifetime.