When thousands of cancer specialists gather for their biggest meeting of the year, they will not know Dolores House. But if they did, her case would strike a chord.
The western New York woman represents what can happen when a patient is treated at a cancer center that offers “gastrointestinal molecular profiling” for tumors — the cutting-edge therapy that the American Society of Clinical Oncology (ASCO) has designated as its “Advance of the Year” for 2021. The ASCO annual meeting takes place June 4-8.
GI molecular profiling is part of standard care at the Wilmot Cancer Institute, where doctors diagnosed House with pancreatic cancer in 2019. It’s a precision approach for all GI tumors, using sophisticated tests to analyze the DNA of the cancer. In House’s case, doctors discovered that she had a very rare genetic subtype of pancreatic cancer (about one in 100) and instead of standard chemotherapy, she could benefit from a well-known immunotherapy drug, Keytruda.
House receives Keytruda infusions at Wilmot, and “it’s been a miracle ever since,” she said.
“I feel great. I just got back from camping!” said the 78-year-old resident of Newfane, N.Y., north of Buffalo. “I was able to set up my camper and walk with my dog. I’m able to stay very active.”
Her pancreatic cancer had already begun to spread to the liver, which makes her case even more remarkable. But due to the immunotherapy, House said, her tumor markers — a biochemical measure of the level of disease in a person’s body — have dropped to almost nothing.
“God and medicine gave me my life,” she said, “and I’m going to live it while I can.”
Because of Wilmot’s specialized approach to gastrointestinal (GI) cancer, all GI patients automatically receive the advanced testing. About 20 percent derive a treatment benefit from it, said House’s oncologist, Aram Hezel, M.D., chief of Hematology and Oncology at Wilmot and a clinician/researcher. In those cases, the analysis will reveal a tumor biomarker or “signature” — such as PD-1, for example — that can be knocked out by a targeted therapy that’s specific to the tumor.
In younger people, the analysis can also reveal a genetic factor that might warrant a discussion about counseling options at Wilmot’s Hereditary Cancer Screening and Risk Reduction Program.
But Hezel emphasized that while the ASCO-validated advance is a great success for some people like House, “we want to keep learning so that every patient can have this benefit.” A large team of Wilmot researchers, in fact, are focused on finding new ways to treat pancreatic cancer using both immune therapies (for example, David Linehan, M.D., Scott Gerber, Ph.D., and Richard Dunne, M.D.) and non-immune therapies (for example, Darren Carpizo, M.D., Ph.D., Hucky Land, Ph.D., Stephano Mello, Ph.D.).
“It’s nice to see this highlighted by ASCO because it creates awareness about the need for molecular profiling and raises standards,” Hezel said. “We could not do this so successfully at Wilmot without an entire team of clinicians and pathologists who embrace the benefits of this approach.”
He also praised colleagues Jennifer Findeis-Hosey, M.D., director of the GI Molecular Pathology Service at the University of Rochester Medical Center; Christa Whitney-Miller, M.D., director of Surgical Pathology; and Zoltan Oltvai, M.D., professor of Pathology and Laboratory Medicine at URMC.
Wilmot serves people in a 27-county region in upstate New York, and Hezel said his team is the leader in applying molecular test results to treatment plans.