While a new CAR-T cell therapy developed at Penn Medicine's Abramson Cancer Center might have saved Barbara Beaudry from non-Hodgkin's lymphoma (NHL), her deep faith — and love from and for her family — saved her long before.
Barbara's cancer journey began in August 2006, without the typical whirlwind of tests, scans, and consultations, when routine blood work came back with an abnormality. The next year she was diagnosed with indolent, non-aggressive NHL, kicking off a three year period of watchful waiting with regular blood work, doctor visits, and annual CT/PET scans.
Over the course of the next 10 years, as her cancer progressed, Barbara underwent four different drug therapies, speech therapy and countless hospitalizations for everything from shingles to pneumonia to surgery for a fractured hip. She saw her children married and her grandchildren born, and experienced her "worst/best day" when her daughter got engaged at her bedside during a hospitalization over the holidays.
As time and treatment after treatment went on, and she continued to relapse, Barbara was beginning to run out of options.
In September 2013, she moved her care to Jakub Svoboda, MD, at Penn Medicine and in July 2015, took part in a clinical trial of chimeric antigen receptor (CAR)-T cell therapy Kymriah™ (formerly known as CTL019). This revolutionary treatment modifies a patient's own immune T cells, which are collected and reprogrammed to potentially seek and destroy the patient's cancer cells. After being infused back into patients' bodies, these newly built "hunter" cells both multiply and attack.
The JULIET trial, based on Penn's initial clinical trial, led by Director of the Lymphoma Program, Stephen Schuster, MD, included 27 sites in 10 countries across North America, Europe, Australia, and Asia. In total, 81 patients with NHL were infused with CAR-T cells and evaluated for a response. At three months, 26 patients (32 percent) achieved a complete response, while five (six percent) achieved a partial response.
About 74 percent of patients who responded remained cancer-free at six months. These results supported the Penn pilot trial that demonstrated that the responses to the new therapy can be highly durable. This is an important milestone in the fight against a type of cancer which is diagnosed in nearly 75,000 patients per year in the United States.
"About a third of patients who fail all current therapies, even transplant, could now have a form of therapy that may offer them durable remissions," said Dr. Schuster.
One month after re-infusion, Barbara was cancer free. She "graduated" from the trial in June 2017, and now needs to receive only a monthly IVIG booster.
When Barbara and John Beaudry married in 1971, they had plans for a simple life: live off the land, plant roots, and watch them grow. John built their first house, a cabin in the woods, placing every single nail. A mother and homemaker active in her church, Barbara was always game to challenge herself and take on more — going back to school to finish her bachelor's degree in organizational management once her children had grown. Never did they expect to be a part of a history making new cancer therapy.
After decades of taking care of of others, Barbara turned to Penn Medicine to care for her. Her coordinated care teams worked together to get her strong enough to be home to help prepare for and attend her daughter's wedding.
A woman of deep and unwavering faith who believes nothing is random, Barbara has had to reconcile her own survivor's guilt for being put on a path that led her to this CAR trial while others were not.
"I feel better and better, the on-going improvement in my health is definitely noticeable. I'm so grateful to have been given this opportunity for a second chance, and even more so to be part of something that can help others through their journey in the future," said Barbara.
The CAR-T cell therapy for non-Hodgkin lymphoma, developed by Penn, has been approved by the FDA and will be widely available for more people like Barbara.
John and Barbara Beaudry with Dr. Carl June, celebrating the FDA approval of CAR-T cell therapy for non-Hodgkin lymphoma