Revolutionary treatment stops aggressive blood cancer in its tracks.
MedStar Georgetown is the only CAR T-cell therapy approved site for adults in the Washington, D.C., area.
Any type of cancer can be tricky to detect and treat. But blood malignancies are among the most devious—especially diffuse large B-cell lymphomas (DLBCL), the most common non-Hodgkin lymphomas among adults—and they can be the most serious. Complicating an accurate diagnosis and treatment, DLBCL has numerous subtypes. Some of the most malignant forms are even known to mimic normal cells and “hide” from treatments
It all makes for a formidable foe, as Ed Gershkovich can attest.
“I first noticed a sizeable lump on my shin in April of 2012,” the retired civil engineer says. “I didn’t pay it that much attention, thinking it was probably from an insect bite. But over time, it got bigger instead of better, and I figured I should do something about it.”
Ed’s youngest son was in Georgetown University’s School of Medicine at the time and began investigating possible causes. His sleuthing led him to recommend a visit to the Georgetown Lombardi Comprehensive Cancer Center— the only National Cancer Institute (NCI)-designated comprehensive cancer center in the Washington, D.C., area.
A biopsy revealed abnormal T-cells, an important component of the body’s immune system, leading to a diagnosis of slow-growing nonHodgkin lymphoma. The best offense at that point was watchful waiting. The approach worked until 2015 when Ed’s abnormal T-cells suddenly began multiplying, revealing a more aggressive and dangerous form of cancer. Ed began a series of chemotherapies and biologic therapies, but his cancer stubbornly remained. Then he developed a tumor in his groin.
Another round of chemotherapy held hope, visibly shrinking both leg and groin tumors. But in 2019, Ed’s cancer returned, morphing into yet another variant: the potentially deadly DLBCL.
The magic bullet
At that point, there was a promising new approach called CAR T-cell therapy, one of science’s latest attempts to combat certain difficult-to-treat blood cancers and disorders.
MedStar Georgetown had participated in the national clinical trials for the new therapy, and was the first and only site in the Washington, D.C., region authorized to perform the groundbreaking CAR T-cell therapy that the FDA approved only two years earlier.
“This is a new approach that works by genetically programming the patient’s infection-fighting T-cells to target and kill the tumor cells,” explains Pashna Munshi, MD, associate clinical director for the Stem Cell Transplant and Cellular Immunotherapy program at MedStar Georgetown, who performed the procedure on Ed. “Compared to many other advanced cancer treatments, CAR T-cell therapy is able to target the patient’s own immune system to fight cancer.”
T-cells are first extracted from the patient in a four-to-five-hour outpatient procedure similar to giving blood. The retrieved cells are then sent to a specialized lab where they are genetically modified and grown over the next four to six weeks.
When the cells mature, the patient returns for a preparatory chemotherapy session to “make room” for the new genetically modified immune cells. They are then re-infused into the patient the very next day. Most patients remain in the hospital for seven to 10 days postprocedure to monitor for potential complications.
In April of 2020, Ed became only the ninth patient to undergo the revolutionary treatment at MedStar Georgetown.
“My condition was really complicated,” says the 69-yearold. “MedStar Georgetown took great care of me throughout my treatment. In fact, the hardest thing for me with CAR T-cell therapy was not being allowed any visitors because of COVID-19!”
Dr. Munshi is optimistic about this new treatment. “There’s new information coming out all the time about CAR T-cell therapy’s effectiveness for other lymphomas, including mantle cell lymphoma and follicular lymphomas. It could be a gamechanger for the future of cancer treatments,” she says.
Call 202-444-3736 to make an appointment with a Stem Cell Transplant and Cellular Immunotherapy specialist.