Closer to a cure
May 1, 2018
Sitting at his table on a Saturday morning, Woodring Wright, M.D., Ph.D., felt a sudden intense pain in the back of his neck. He grabbed his cordless phone and called his wife, Beth. He lay down on his bed; he couldn’t move. At the hospital, he learned that his second cervical vertebra had collapsed because multiple myeloma had invaded the bone. Between his cancer diagnosis in 2006 and the fall of 2015, Dr. Wright, a Professor of Cell Biology at UT Southwestern, had received — and grown resistant to — all the available treatments.
Reading the literature and speaking with a colleague, Dr. Wright, who studies the role of telomeres in aging and cancer, had learned about a clinical trial at the University of Pennsylvania. It was an anti-B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell trial for multiple myeloma. A similar clinical trial is now slated for 2018 at UT Southwestern.
Hoping for a Miracle
“We went with a suitcase full of medical records, and they did their evaluation,” he says. “I was eligible, and I was the third person on the list of people they’d treat.” It wasn’t long after Dr. Wright and his wife returned home to Arlington that they received exciting news. “We got a call that Patients 1 and 2 had dropped out. They asked, ‘Would you like to be Patient 1?’ We were on a plane the next day,” he says.
Dr. Wright was connected to a perfusion machine for seven hours. Blood was drawn from his body and centrifuged to isolate the T-cells, while the red blood cells and serum were re-infused. After this process, researchers infected his T-cells with a virus expressing a chimeric antigen receptor recognizing the BCMA antigen.“Since myeloma is a B-cell malignancy, the antigen is present on the myeloma cells,” Dr. Wright explains. The goal was to essentially train the T-cells to kill B-cells. When Dr. Wright returned to Pennsylvania three weeks later, researchers injected him with 10 percent of his T-cells on the first day and 30 percent on the second day. An extreme inflammatory response required an 11-day hospitalization. But that response, researchers believed, was actually a sign of the therapy’s effectiveness.
CAR-T Clinical Trial at UT Southwestern
Larry Anderson Jr., M.D., Ph.D., Associate Professor of Internal Medicine at UT Southwestern, who has managed Dr. Wright’s care since his treatment, is leading the trial of this therapy at UTSW, which is one of several sites across the U.S. and Europe. The phase one study is nearly complete, he says, adding, “It looks very safe, very promising.” Dr. Anderson hopes to enroll 10 patients who have failed to respond to at least three other treatments. “I think it’s absolutely magnificent that Dr. Anderson is doing this trial,” Dr. Wright says, noting the value to local patients. To understand the efficacy of the treatment, it’s important to look at Dr. Wright’s light-chain antibody numbers. A normal measurement, he explains, is between 3 and 19. Prior to the CAR-T therapy, his measurement was 6,775. Immediately after treatment, it was 5. “My wife shouted for joy,” he says. “They tested again to make sure it wasn’t an error.”More than two years later, his levels remain low. “They describe me as being in sustained, complete remission,”Dr. Wright says. “I consider myself cured. I’m alive because of this therapy.”