My lymphoma takes a back seat…

Sorry things have been rather quiet here lately, but I have to confess I’ve been less interested in following CAR-T and Follicular Lymphoma events for the past several months, and the reason is this: Last May, I was diagnosed with Prostate Cancer.

Fortunately, prostate cancer is a slow-growing cancer, allowing time to explore several options, including “active surveillance”, a.k.a. “watch-and-wait” (sound familiar, fellow fNHL survivors?).

Unfortunately, my “watch-and-wait” period proved short-lived, as a February biopsy showed progression to what is known as a Gleason 7, meaning treatment of some sort was now necessary to eradicate the cancer before it could spread outside the prostate.

I opted for a full prostatectomy rather than radiation (I was told they’re equally effective), and I had the surgery on April 4. I’m pleased to report that everything has gone much better than I expected, and my health is almost fully restored just 10 days later.

Two days ago I received the pathology report of the surgery. Four lymph nodes were removed for biopsy along with the prostate, and fortunately they showed no cancer. I suppose it is bonus information that there were no active lymphoma cells in the lymph nodes either. Thus the remission from my July 2015 CAR-T infusion continues!

During my exploration of options last summer, one radiologist mentioned to me that it was her belief that my prostate cancer took hold during the period when I was immunocompromised, as a result of several treatments leading up to my CAR-T infusion. No one else mentioned this, but I believe it has some merit. I think this is another reason fNHL patients should seek the minimum treatment necessary to achieve a reasonable remission — the risk of developing a secondary cancer. I’d be interested to read risk assessments of the various treatments available insofar as secondary cancers. The disease I seem to see most often is Myelodysplastic Syndrome (MDS), which has been described as a “pre-leukemia”.

Of course, prostate cancer is a relatively common cancer anyway for men over 60 (which I’m about to become), so perhaps all my prior treatments did was to speed things up by a few years.

Anyway, I’m happy to report that I’m ready to resume tracking current events regarding CAR-T as I encounter them. This blog’s partner-in-crime William (Bill) has been doing this reliably the entire time. I hope to begin to take a more active role along with him in the months ahead.

Best in Health to all of you!

— Ben

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CAR-T Cell Videos

CAR-T Cell Videos:

ASCO: Advance of the Year (plus 6 additional videos)       https://youtu.be/escPvXbgbwY

 

Dana Farber: CAR-T: How does it work  https://www.youtube.com/watch?v=OadAW99s4Ik&feature=youtu.be

 

Sloan Kettering: CAR-T Cells for Cancer Immunotherapy: https://youtu.be/lM1oTcsB1WY

 

Cellectis: Gene-edited CAR-T Cells – how does it work?      https://youtu.be/TzSurHZjoy0

William

Global CAR T Therapy Trial Shows High Rates of Durable Remission for Non-Hodgkin’s Lymphoma

The New England Journal of Medicine published these data today [December 11, 2017]. Among 28 patients who received the therapy in the single-site pilot trial after their cancers had come back following standard treatments, 43 percent of DLBCL patients achieved complete remission, as did 71 percent of patients with follicular lymphoma, the second most common form of the disease. All patients who were in remission at six months are still in remission, after a median follow-up of 28.6 months.

Source: https://www.pennmedicine.org/news/news-releases/2017/december/global-car-t-trial-shows-durable-remission-for-non-hodgkins-lymphoma

CAR T-Cell Therapy Update From ASH 2017 | Patient Power

A good summary of the current state of CAR-T. This is an interview with Dr. David Maloney of the Fred Hutchinson Cancer Center, conducted by medical journalist and CLL survivor Andrew Schorr, founder of the website “Patient Power”. (As it happens, a friend of ours was one of Dr. Maloney’s earliest fNHL CAR-T patients in summer of 2015.)

https://www.patientpower.info/video/car-t-cell-therapy-update-from-ash

CAR-T and Medicare

The $373k price tag for Gilead/Kite’s FDA-approved CAR-T therapy has been a controversial issue from the outset. Now, Bloomberg reporter Michelle Cortez (whom we’ve mentioned before) has contributed to two stories this week regarding some fatal(!) delays in CAR-T coverage from Medicare. As lymphoma is a disease that often afflicts older people, there are sure to be many individuals who will be over 65 and dependent on Medicare when the time comes to seek a potentially curative treatment:

Months After Approval, Breakthrough Cancer Drug Given to Just Five Patients – Bloomberg

https://www.bloomberg.com/news/articles/2017-12-14/cancer-patients-with-little-time-left-wait-for-gilead-s-new-drug

Novel Cancer Drug Gets Stymied by Medicare Rigid Billing System – Bloomberg

https://www.bloomberg.com/news/articles/2017-12-15/medicare-rigid-billing-system-leaves-gilead-cancer-drug-in-limbo

CAR T cell therapy shows long-lasting remissions in non-Hodgkin’s lymphoma patients

The New England Journal of Medicine published these data today. Among 28 patients who received the therapy in the single-site pilot trial after their cancers had come back following standard treatments, 43 percent of DLBCL patients achieved complete remission, as did 71 percent of patients with follicular lymphoma, the second most common form of the disease. All patients who were in remission at six months are still in remission, after a median follow-up of 28.6 months.

“Taken together, our data from both trials show that most patients who are in remission at three months stay in remission,” said Schuster, who is the Robert and Margarita Louis-Dreyfus Professor in Chronic Lymphocytic Leukemia and Lymphoma Clinical Care and Research in the Perelman School of Medicine and director of the Lymphoma Program at the Abramson Cancer Center.

Source: https://www.news-medical.net/news/20171211/CAR-T-cell-therapy-shows-long-lasting-remissions-in-non-Hodgkins-lymphoma-patients.aspx