Immunotherapy Clinical Trial Brings Hope to Lung Cancer Patient

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Television news seems to bring regular updates and hope about  the new immunotherapy treatments for late-stage cancer.

For 73-year-old Dr. Stephan Silverman, a retired clinical and school psychologist, immunotherapy is his miracle.

Admittedly a heavy smoker for 21 years until he quit cold turkey in 1979, Dr. Silverman developed a persistent dry cough, along with fatigue and malaise, in 2014. His primary care physician, Thomas Sacks, MD, “immediately started the process of saving my life,” he says.

“A CT scan found a tumor in my right lung, between the size of a peach and a baseball, three affected lymph nodes, and a spot on my clavicle,” says Dr. Silverman. After more tests, the diagnosis of stage IVB lung cancer was confirmed.

He was placed in the care of thoracic oncologist Deepa Subramaniam, MD, a member of the Phase 1 Experimental Therapeutics Program at MedStar Georgetown University Hospital. “Dr. Silverman was in good shape with no other major medical problems,” she says. “He was a good candidate for a clinical trial in which we add an immunotherapy to the standard chemotherapy.”

Chemotherapy interferes directly with the cancer cells’ ability to multiply and grow; immunotherapy harnesses the body’s immune system to attack the cancer cells. The combination had the potential to be an effective one-two punch. “Normally, we all develop cancers every day, but our immune system recognizes these cancer cells as being ‘foreign,’ and eliminates them,” Dr. Subramaniam explains.

Dr. Silverman was enrolled in a Phase 1 clinical trial of an immunotherapy drug called atezolizumab, in combination with two chemotherapy drugs, carboplatin and nab-paclitaxel.

After four cycles of the triple-drug combination, he has been on maintenance therapy with atezolizumab every three weeks. His lymph nodes and his lung tumors have shrunk considerably.

“When patients’ tumors respond to immunotherapy, the response appears to be much more durable than we would expect with standard chemotherapy,” says Dr. Subramaniam. “A few patients with advanced cancer are even able to achieve complete remission with such therapy.”

Giuseppe Giaccone, MD, PhD, associate director for clinical research at MedStar Georgetown’s Lombardi Comprehensive Cancer Center, adds, ”The results of this experimental Phase 1 trial for Dr. Silverman and others have been encouraging to the point that several larger studies are now underway and hopefully will show improved survival compared to chemotherapy alone.”

One year after his diagnosis, Dr. Silverman is “living a pretty normal life” traveling, looking after his car collection, playing drums and overseeing the renovation of a home in Vermont.

Dr. Silverman is jubilant. “I am so grateful for a spot in this clinical trial with Dr. Subramaniam. It was divine intervention. I am going to make it.”

Immunotherapy: Clinical Trials Point to Treatment of the Future

The emerging field of cancer immunotherapy is making progress harnessing the body’s own immune system to turn the tables on cancer.

“MedStar Georgetown currently offers more than a dozen clinical trials featuring new immunotherapy agents or combinations,” says Michael B. Atkins, MD, deputy director of the MedStar Georgetown Lombardi Comprehensive Cancer Center. “Many of our current immunotherapy trials are testing approaches that are likely to be the standard therapies of the near future.”

“Every successful cancer has to find a way to evade the immune system in order to survive,” explains Dr. Atkins. The principal defense that many cancers use against the immune system is to establish checkpoints that defuse the immune system. However, new immunotherapies block these checkpoints and reactivate the immune system to attack the cancer. Because the activated immune system can attack the cancer at many different points simultaneously, immunotherapy can produce long-lasting tumor regressions.

“At MedStar Georgetown, we have led many of the early investigations of these checkpoint inhibitors, used either alone or in combination with other immunotherapies or standard cancer therapies,” Dr. Atkins says. Several of these studies have led to U.S. Food and Drug Administration approvals for the agents and combinations in patients with melanoma, kidney cancer and lung cancer.

Learn more about the immunotherapy clinical trials online, or call 855-546-2088.