Immunotherapy Study Involving Wilmot Makes Headlines at National Meeting

 Wilmot Cancer Institute physicians and patients were part of a groundbreaking study that’s taking center stage this week in the world of cancer research.

The study involves immunotherapy, a decades-old concept that’s experiencing resurgence in new clinical trials that harness a person’s own immune system to fight cancer. Lymphoma patient Ed Foster of Elmira, N.Y., was the first person in upstate New York at Wilmot to receive a new, powerful form of immunotherapy known as CAR T-cell therapy. Foster and his treatment were featured in a Democrat and Chronicle Sunday profile last spring.

The investigational phase II study, which involved a total of 111 lymphoma patients from across the country, is being reported on Dec. 6 as a “late-breaking” abstract of high impact at the American Society of Hematology annual meeting in San Diego. The trial was sponsored by Kite Pharma, Inc., a California-based company that has been working with the National Cancer Institute and 22 academic centers, including the University of Rochester Medical Center, to develop the process and technology to manipulate patients’ immune cells and produce a viable treatment.

Kite’s study divided patients into two groups. Foster was part of cohort 1, with 50 other patients, who all had diffuse large B-cell lymphoma and had exhausted other treatment options. They had an average life expectancy of about six months. But as a result of the CAR T-cell treatment, 76 percent responded in some way, meaning that their cancer receded — and 47 percent went into complete remission, with no evidence of disease after three months of follow-up care. The other 29 percent had a partial response to the treatment. (The analysis of the second group has not been reported.)

A married father of three and a physician, Foster volunteered for the clinical trial after his cancer resisted two courses of chemotherapy. Despite the promising results, however, the treatment often causes patients to experience severe side effects as the immune system goes into overdrive. Foster spent several days in the intensive care unit at Strong Memorial Hospital; up to 15 doctors and nurses were involved in managing his care and were responsible for his recovery. Since then, doctors have been closely following his health.

Foster is being primarily cared for by Jonathan W. Friedberg, M.D., M.M.Sc., director of Wilmot and the Rochester region’s CAR T-cell principal investigator, and Patrick Reagan, M.D., a blood cancer specialist.

In the CAR T-cell study, Kite Pharma was also able to show that in 99 percent of the cases they accurately modified the patient’s immune cells, training them to seek and destroy cancer. This suggests that CAR T-cell treatment might be practical in the future as an option for more patients, Reagan said.

Wilmot, which has one of the best lymphoma programs in the country, sent several scientists to the ASH meeting, where they are presenting studies on new treatments for blood cancers. Friedberg and Reagan are involved in other scientific programs at ASH as well, including an educational session that Friedberg is conducting for young oncologists.

Among the additional Wilmot presenters:

• Paul Barr, M.D., director of the Clinical Trials Office for Wilmot and an expert in lymphoma and leukemia, will present 10 different studies on the best use of the latest treatments, their toxicity to patients, and results of studies that look at combinations of drugs. To see the full studies, go to https://ash.confex.com/ash/2016/webprogram/authorb.html and search “Barr.”
• Richard Burack, M.D., Ph.D., vice chair for Clinical Operations in the URMC Department of Pathology and Laboratory Medicine, discovered in mice several features of low grade B-cell lymphomas that aren’t apparent in other realms of observation. His oral presentation reveals important new roles of CD4+ T cells and neoplastic B cells in lymphoma tumors.
• Carla Casulo, M.D., is speaker at an education session on prognosis for follicular lymphoma, a disease with a course that can be challenging to predict. She is also presenting clinical trial results of various treatments for FL and B-cell lymphoma.
• Jane Liesveld, M.D., is moderating a session on optimizing the treatment for acute leukemia (AML), one of her special interests, and is involved in other abstracts presenting data on AML treatment.
• Clive Zent, M.D., is involved in several abstracts exploring better treatment for chronic lymphocytic leukemia (CLL), one of his special interests.

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The University of Rochester Medical Center is home to approximately 3,000 individuals who conduct research on everything from cancer and heart disease to Parkinson’s, pandemic influenza and autism. Spread across many centers, institutes and labs, our scientists have developed therapies that have improved human health locally, in the region and across the globe. To learn more, visit www.urmc.rochester.edu/research. 

The University of Rochester Medical Center is home to approximately 3,000 individuals who conduct research on everything from cancer and heart disease to Parkinson’s, pandemic influenza and autism. Spread across many centers, institutes and labs, our scientists have developed therapies that have improved human health locally, in the region and across the globe. To learn more, visit www.urmc.rochester.edu/research.