“I prayed every night”
While CAR T (chimeric antigen receptor) T-cell therapy has been used most effectively against blood cancers, TIL therapy was originally developed to fight advanced skin melanoma. Dr. Kammula’s team has expanded TIL therapy to treat other challenging solid tumors such as advanced pancreatic cancer, mesothelioma, and uveal melanoma.
Back in 2017, Debra Miller, a psychiatric social worker, was diagnosed with leiomyo-sarcoma, a rare cancer that grows in the smooth muscles, including the intestines, stomach, bladder, and blood vessels. After three rounds of chemotherapy and multiple surgeries, her cancer continued to spread.
“When I first started this journey, there were no clinical trials for this type of cancer,” she said in a UPMC video. “I prayed every night that there would be some kind of breakthrough, something — and then this [TIL therapy] happens.”
After a small sampling of her TIL cells were removed and expanded in the lab, she underwent lympho-depleting chemotherapy — in order to transiently wipe out her immune system so that it could be built back up again with the new cells. Dr. Kammula uses the analogy of curing a computer virus by wiping your hard drive clean and starting over.
“I think it’s going to be neat no matter what my outcome is,” Ms. Miller said of the clinical trial. “And if somebody can benefit from this type of research that’s being done on me, then I’m happy for that.”
After her expanded, highly personalized cells were reinfused, Ms. Miller returned to work. “She’s got such an inspiring outlook,” says Mary Kate Ayers, RN, MSN, OCN, senior clinician at UPMC Shadyside who works with Dr. Kammula.
Along with other oncology nurses, Ms. Ayers finds a lot of satisfaction in safely and compassionately caring for patients participating in these trials. “Because this therapy is so new and rare, we are the ones who are developing the standards of care for managing these patients,” she says. “People have come to Shadyside from around the world to take part in the treatment.
“My late grandfather was an oncologist,” Ms. Ayers reflects. “I would love to be able to talk to him about how we care for cancer patients today compared to 50 years ago. He would be so amazed.
“And I have nothing but lovely things to say about Dr. Kammula,” she adds. “I really appreciate his attention to detail and how closely he monitors his patients. He is always very supportive of the nursing staff and accessible to us 24/7 if we ever have a concern or question.”
Dr. Kammula says that about 50 patients have been treated in clinical trials at Shadyside, “and we’re seeing responses even in cancers that are highly refractory. We’re now researching whether this therapy is going to be effective for different types of cancer. We’re also exploring ways in which bioengineering and gene therapy could be used to improve the process.”
Dr. Kammula appreciates the “unique, really collaborative effort between Hillman Cancer Center and Shadyside Hospital. That’s what drew me here from the NIH — because that’s the NIH model, with the laboratories right next to the patient care.
“Every single day I come to work is an exciting day,” he says, “because we’re going places that no one has ever gone before.”