New Cancer Treatment, New Hope

How CAR T-Cell therapy helped a patient when chemotherapy could not

Dave Rodney, 62, didn’t have time to be sick. A professional concert and travel promoter, and an avid musician and cook, he had too much living to do.

But in August 2017, while working out, Dave felt a slight discomfort in his lower abdomen. He assumed he’d pulled a muscle. However, at a routine physical shortly afterward, his doctor advised him to go to the Emergency Department at Saint Barnabas Medical Center (SBMC) in Livingston. There, a scan revealed an abdominal mass. Dave was admitted for further tests. The eventual diagnosis: diffuse large B-cell lymphoma (DLBCL).

This aggressive blood cancer, a form of non-Hodgkin lymphoma, usually starts as a fast-growing mass in a lymph node. From September 2017 through January 2018, Dave was treated with chemotherapy under the care of Andrew Brown, MD, a medical oncologist with The Cancer Center at SBMC. Unfortunately, a first round was unsuccessful, as was a second round with a different medication. The next step would typically be to assess whether a stem cell transplant might work. But now, there is also a new treatment called CAR T-cell therapy.

“It was very important that I get him to a specialty center that handles complex cases,” says Dr. Brown. “Because of our health system’s partnership, I sent him down to Rutgers Cancer Institute of New Jersey and Robert Wood Johnson University Hospital in New Brunswick.”

New possibilities

In the fall of 2017, the Food and Drug Administration made a big announcement: It had approved CAR T-cell therapy for adults with DLBCL and for children and young adults with acute lymphoblastic leukemia. In this therapy, T cells (a type of immune system c ell) are taken from a patient’s blood. In a laboratory, a chimeric antigen receptor (CAR), which binds to a certain protein on the patient’s cancer cells, is added to each cell. These CAR T cells are then added back to the patient’s blood to attack cancer cells.

The treatment is given only to patients whose cancer has proven resistant to chemotherapy and who may not be good candidates for stem cell transplants. Further, it can be offered only at centers that have clinicians, nurses and other healthcare professionals who are FACT (Foundation for the Accreditation of Cellular Therapy)-certified.

The teams at Robert Wood Johnson University Hospital (RWJUH) and Rutgers Cancer Institute fit the bill. Dave Rodney would be their first patient for CAR T-cell therapy.

“This is a transformative therapy,” says Dennis Cooper, MD, Chief, Blood and Marrow Transplantation at Rutgers Cancer Institute. “In the past, if a patient with this type of lymphoma wasn’t responsive to chemotherapy, apart from experimental treatments we were essentially out of luck. Now we have a new option that’s potentially curative.”

Moving ahead

Dave met with Dr. Cooper in March of 2018. At that and subsequent visits, he learned more about the procedure and its potential benefits and risks.

“They were very honest and open,” Dave says. “Yes, I’d be the first. But on the plus side, many eyes and ears would be watching me to make sure everything went well. What they said made perfect sense, so I was sold.”

“I can’t think of a time in my career where the staff spent so much time, collectively, preparing to treat a patient,” says Dr. Cooper. “There are strict criteria for care when a patient is getting CAR T cells, encompassing everything from the electronic record to drugs that can cause a reaction, and more. “Everyone in the hospital was very committed. The people who work in the blood and marrow transplant unit, the ICU nurses, the nurse practitioners, the rapid response teams, the neurology attendings and literally every medical resident went through training before we treated our first CAR T-cell patient.”

After thorough preparations, Dave’s T cells were collected and sent to in California to be reengineered, a process that takes several weeks. In November, Dave received a mild pre-treatment chemotherapy to clear his blood of lymphocytes that could compete with CAR T cells. Then he was admitted to RWJUH to receive brand-new CAR T cells via infusion. He stayed in the hospital for two weeks as his body adjusted.

“It’s impossible to describe the high level of care I had—the professionalism, expertise, warmth and caring,” Dave says. “These are the best people on the planet!”

An exciting future

CAR T-cell therapy is currently under consideration to treat some forms of myeloma, a cancer of plasma cells. “CAR T cells are also being modified in the hope they can work on solid tumors—brain tumors, abdominal tumors,” says Dr. Cooper. “People are realizing that you can redirect CAR T cells to almost any target you want, as long as it’s on a tumor cell and not a normal cell.” Unlike in chemotherapy, which kills both healthy and cancer cells, the CAR T cells remain in the patient’s body for months and continue fighting the cancer.

“There’s a lot of work happening on ways to make CAR T cells stay in action even longer,” says Dr. Cooper.

Dave continues to return for scans to check on his progress. Meanwhile, his return to normal activity encouraging. “I’m as busy as ever,” Dave says, “feeling better and doing all the things I love doing.”

To learn more about CAR T-cell therapy at Rutgers Cancer Institute of New Jersey, go here or call 844.CANCERNJ (844-226-2376)