“I thought my cancer diagnosis was a death sentence,” said Lynnette Williams-Briggs, 60, of Seaford, Delaware, who was diagnosed with advanced B-cell lymphoma in 2018.
Briggs’ cancer is now in complete remission thanks to successful chimeric antigen receptor – CAR-T cell – therapy she received in August at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute’s Bone Marrow and Stem Cell Transplant Program.
“I can breathe again. This is the beginning of my new life,” Williams-Briggs said following the treatment that restored her hope for a second chance at life.
She was the first patient to receive CAR-T cell therapy in Delaware. A second patient was treated in December 2019, and doctors are preparing several more patients for CAR-T cell transplants in coming weeks.
The U.S. Food and Drug Administration has approved CAR-T cell therapy to treat patients like Williams-Briggs with highly resistant, B-cell blood cancers, for whom other available options have failed.
CAR-T cell therapy is only available at select cancer centers with specialized expertise in cellular therapies that are recognized for quality by the Foundation for the Accreditation of Cellular Therapy.
The Graham Cancer Center’s Bone Marrow and Stem Cell Transplant Program is the only one in Delaware that is certified to treat adult patients with advanced B-cell lymphomas and children and young adults (to age 25) with acute lymphoblastic leukemia, using an FDA-approved drug.
CAR-T cell therapy is highly personalized medicine that attempts to use the body’s natural defenses to fight against cancer. The transplant team extracts millions of T cells, from the patient’s bloodstream, using a specialized blood filtration process called leukapheresis.
The collected T cells are flash-frozen and sent to a lab for reprogramming, and then later infused back into the patient using a process similar to a blood transfusion.
The therapy is considered a “living drug” with potential benefits that could last for years.
“When we first met Ms. Williams-Briggs, her cancer had progressed rapidly despite a third round of chemotherapy, so we knew we had to move quickly,” said Graham Cancer Center Hematologist Peter Abdelmessieh, D.O. He worked closely with the bone marrow/stem cell transplant team and Graham Cancer Center leadership over the course of just eight months to develop the CAR-T cell therapy program.
“It was truly a team effort to bring CAR-T cell therapy to our community so quickly,” Dr. Abdelmessieh said.
CAR-T cell therapy has been extremely effective for many patients like Williams-Briggs, whose PET scan at 90 days confirmed her remission.
The supercharged T cells Williams-Briggs received were genetically modified in the lab to sprout new surface tools that improve their ability to recognize, latch onto and destroy other cells (including cancer cells) that express a specific antigen called CD19. These reprogrammed cells continue to multiply in the body after treatment, remaining on guard to seek and destroy any new cancers that might develop.
“With continued success in increasing numbers of patients, it is conceivable that in the not too distant future, CAR-T cell therapy could become the new standard of care, replacing chemotherapy and stem cell transplants for many cancers,” Dr. Abdelmessieh said.
The extended recovery period for CAR-T cell therapy is generally two to three months. After the infusion, patients may spend up to three weeks in the hospital to monitor treatment response and any side effects.
During the first 30 days after leaving the hospital, patients are required to remain close to the treatment center for regular follow-up care.
“The ability to offer potentially lifesaving CAR-T cell therapy is one more reason our patients need not travel further than the Graham Cancer Center for state-of-the-science cancer treatment,” said Nicholas J. Petrelli, M.D., Bank of America medical director of the Helen F. Graham Cancer Center & Research Institute.
“The Bone Marrow and Stem Cell Transplant Program is an outstanding example of how well our clinical teams work together to drive innovation in patient care.”
Although patients normally do not experience the side effects associated with chemotherapy, such as nausea, vomiting or hair loss, CAR-T cell therapy is not without risks. A common side effect, which Williams-Briggs also experienced, is cytokine release syndrome. This is an inflammatory condition that causes flu-like symptoms that may be mild or severe.
The transplant team responded quickly to manage her symptoms while she received expert care on the Bone Marrow Transplant and Oncology unit at Christiana Hospital.
“From the moment I first met with my transplant team, I felt like I was part of one big loving family that extended beyond my own loved ones,” Williams-Briggs said.
“Dr. Abdelmessieh and my ChristianaCare family gave me hope to keep fighting when I really didn’t think I would make it. I would have driven anywhere to get lifesaving treatment, but I am thankful that I did not have to. I found my miracle closer to home.”