Are We Closer to a Cancer Cure?
By Sonya Collins
WebMD Magazine – Feature
Reviewed by Michael W. Smith, MD
Last year, 20-year-old Milton Wright III seemed to finally have his life on track.
After seemingly endless interruptions to his education, his football career, and his plans to join the Marines, he found his way. He launched a modeling career and appeared in ads for brands including Zumiez and Adidas. He all but forgot he’d ever had cancer.
“I finally felt like things were going in the direction I wanted them to,” Wright says.
But then, 5 years and 2 months into his second remission from acute lymphoblastic leukemia (ALL), Wright slipped on a sidewalk and heard his ribs crack. He walked the few blocks to Seattle Children’s Hospital. He had lived nearby since shortly after he was diagnosed with leukemiaat age 8. He’d spent several years there in treatment for two bouts of leukemia — the second when he was 15.
After examining his ribs and drawing blood, the emergency nurse told Wright to follow up with blood cancer doctors. “That’s when I added everything up,” he recalls. “The broken ribs, the blood samples. They think I have it again.”
Wright knew kids who’d gotten leukemia a third time. “None of them survived. That’s when they give you your 6 months. I realized that I was going to die soon.”
Wright’s doctor, Rebecca A. Gardner, MD, an assistant professor in pediatrics at the University of Washington, did confirm his leukemia was back, but she didn’t give him 6 months. As the lead researcher in a new clinical trial, she suggested Wright be the second person to take part. The first person had no remaining signs of leukemia just 9 days after treatment began.
The trial tests a type of immunotherapy, a new wave of experimental and newly approved treatments that spur the immune system to fight off cancer like it does other illnesses.
Some doctors and scientists call it the pathway to a cure. Among them is Lynn M. Schuchter, MD, chief of hematology/oncology at the University of Pennsylvania. “We are supercharging the immune system,” she says. “This brings a totally new dimension to attacking a cancer cell.”
Some cancer cells share traits with healthy cells, making them unrecognizable as abnormal to the immune system. Wright’s immune system learned to spot them. Through Gardner’s clinical trial, researchers genetically modified Wright’s own T cells — white blood cells that survey the body for infections and other abnormalities — to recognize and attack his leukemia. After researchers reengineered Wright’s cells in the lab, he got his cells back through an IV, and everyone waited for him to get a fever. Fever is a sign the T cells are working, but if doctors can’t manage the fever, they might have to kill off the T cells with a different drug and end the cancer treatment.
Two weeks after he got the cells, Wright’s fever landed him in intensive care and doctors considered killing the cells. “I wasn’t ready for them to do that. I asked if we could give it another day or two.” Two days later, Wright’s fever dropped. A few days after that, when he was well enough for a spinal tap to test for leukemia, the cancer was gone.
A year later, it’s still hard for Wright to believe. “When I say I’m cured, I don’t feel 100% sure. But according to my blood work, they can’t find a single cancer cell in my body.”
Wright has since had a bone marrow transplant — another safeguard against relapse. His recovery seems like a miracle to him, but scores of people with this type of leukemia have now gone into remission after similar treatments.
“It’s not just a handful of patients. It’s an expanding number at multiple centers,” says Renier J. Brentjens, MD, PhD, an oncologist at Memorial Sloan Kettering Cancer Center in New York. He has spent 20 years researching ways to manipulate immune cells to fight cancer. “That’s often an indication that you’re not looking at a one-patient thing or a fluke.”
Since 2009, researchers at Sloan Kettering, University of Pennsylvania, and the National Cancer Institute have tried this treatment on about 100 people with ALL. More than 70 have gone into complete remission. Some form of this experimental treatment is in trials at dozens of institutes around the world.