When precision medicine leads to immunotherapy for cancer treatment: Diane Lucey’s story

“Here at MedStar Georgetown, we partner with Caris Life Sciences to perform detailed molecular profiling of patients’ tumours,” says oncologist Dr Weiner. “In Diane’s case, we found the cancer cells were similar to those in clinical trials that have been shown to be sensitive to certain immunotherapy drugs.”

Watch this video to hear about Diane’s experience receiving immunotherapy based on Caris Molecular Intelligence.

Video transcript

Diane Lucey

I’m here to receive my immunotherapy infusion, that seems to be working right now.

My name is Diane Lucey, and I’m here at Medstar St Mary’s and it’s going very well. So I’m here to let everybody know that they should look into this as an option.

Diane’s cancer started with a bump in her mouth

July 2016

I’ll never forget that day. Dr Khan told me that it had metastasised into a stage 4 cancer in my liver and lungs and it’s not a very typical cancer. So he sent me up to Medstar Georgetown to see Dr Louis Weiner.

Dr Louis Weiner

We don’t know what kind of cancer this is. It’s a poorly differentiated neuro-endocrine cancer of unknown origin.  We said, “Wouldn’t it be great if this is a patient who might respond to immunotherapy?”

So what we decided to do was send her tumour for molecular profiling, and analyse the DNA and other factors to look at the mutation status of 600 odd genes that are present in the cancer. And when we did that, we found something quite remarkable.

First of all, we were happy to note that her cancer did express the PD-L1 marker, suggesting that this might be a cancer that would be potentially responsive to these immunotherapies.

Diane Lucey

Insert screenshot from 1:17

He says, “Your cancer has mutated 17 times.” He says, “That doesn’t sound good.”

I said, “No, it doesn’t.”

He said, “But what it’s telling me is that your immune system has probably already been trying to attack it, because you’ve had it for a while.”

Dr Louis Weiner

What it meant is that the immune system was activated and the cancer had decided to defend itself by expressing a lot of this PD-L1 molecule, and so when a killer T cell of the immune system wants to come and attack the cancer, the PD-L1 molecule kisses its partner, PD-1, on the surface of the T cell, and puts that T cell to sleep.

And what these drugs do is that they block the kiss. Block that interaction of PD-1 and PD-L1. And the cancers can then be effectively eradicated by the killer T cells.

Diane Lucey

So I’ve been receiving treatments. Today is my 12th infusion with Opdivo (Nivolumab), and I’m also getting my scan. And I’m really looking forward to seeing, hopefully, the results that I’m expecting.

Dr Louis Weiner

What you can see here, this is three months after you started your treatment and this is what’s left.

Diane Lucey

So I saw those results from my scan and it was just absolutely incredible.

Dr Louis Weiner

Do you see that, that blip?

Diane Lucey

Yes.

Dr Louis Weiner

That used to be a tumour. It’s gone. Okay? It’s gone!

Diane Lucey

The two tumours that I had in my lung are gone. They’re gone. My liver, that tumour has shrunk 50%. I just can’t believe it. It’s just amazing, how far they’ve come, and what they’re doing now for patients like myself. So we’re going to continue with treatment, and I am so thankful that there has been no side effects for me. And with immunotherapy, I go through my daily life every day. And I work every day. It’s just a normal life. It’s just been amazing.

So we are on the good road, the good path, to hopefully a good ending. And I’m excited.

 

(Source:  MedStar Georgetown University Hospital)

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