Immune to Cancer: The CRI Blog



Sergei G’s Immunotherapy Story


The whole procedure is very well orchestrated…it’s almost like a CIA exploration.

Sergei’s Story

When doctors told Sergei German, 54, that his cancer warranted a watch-and-wait approach, he was unsettled. He knew that people with his type of cancer, follicular lymphoma, can live for many years without treatment, but didn’t like the idea of leaving his fate to chance.
That’s when he decided to seek out clinical trials. He found one he was interested in at Mount Sinai Hospital in New York, being conducted by Joshua Brody, MD The clinical trial involves three separate components. The first is injecting the tumor with a molecule, called a cytokine, which recruits dendritic cells (DCs) to the site of the tumor. DCs are known as professional antigen-presenting cells; their main job is picking up foreign and cancerous antigens and presenting them to the “attack” cells of the immune system.
The second part is localized radiation to the tumor to destroy cancer cells and release their distinctive antigens. The final stage is injecting the tumor with an adjuvant molecule that prods the DCs into a frenzy of antigen presentation.
Sergei began the treatment in early 2014. TheAnswertoCancer (TheA2C) spoke with him about what appealed to him regarding this therapy and how it is working for him.

Questions and Answers

How and when did you first learn you had cancer?

Like many other people, I found a bump on my neck. I couldn’t explain what it was and I didn’t pay much attention to it. Then it kept growing, slowly, and it kind of looked strange. So I went to see my doctor who immediately sent me to another doctor. He did a minimal biopsy. Then a PET scan confirmed that there was something in my neck. Finally, an incision biopsy gave me a diagnosis of follicular lymphoma.

How did you learn about immunotherapy and why did you decide to do it?

For patients with low tumor burden, like me, the solution was to do nothing, just wait. And it’s kind of disappointing. It really hurts psychologically—just watching the thing grow on your body is difficult.

I wanted to be in this trial because it’s the best of many worlds. For one, it has almost no side effects compared to other types of treatments. Also, it potentially could be repeated. With traditional therapies, the effect weakens with time, so you can’t really do the same type of sequence over and over again. With this one, it’s possible. And at the very least, it doesn’t preclude any other option. So you kind of get another weapon in your arsenal against this disease. I think it’s a fantastic opportunity.

What was treatment like? Did you have any side effects?

First I had three or so weeks of daily injections. Then they do the radiation. The node they wanted to destroy was on my neck. So they mark exactly the location of the node with a very tiny tattoo. Then they train the weapon on this node. It took maybe a few minutes at most. And then I had to come another time to repeat the procedure. Over the next few weeks, this node just melted away. Then the immune system, the T cells, starts to find those cancer cells and basically starts killing them. So the whole procedure is very well orchestrated. It’s measured almost to the minute, when they do what, and when. It’s almost like a CIA exploration.
In plain old English, the purpose is to train the immune system on the cancer cells. It sounds kind of simple on one hand: it’s pretty much to train the immune system to treat cancer cells as if it were like just a virus. But on the other hand, a lot of research is going into it, and I think it still continues to be researched.

The side effects are reasonably easy to tolerate. I got fevers over 100 degrees a few times. But it lasted only for a day, maybe a day and a half, and we could treat it with over-the-counter medication.

What would you want another patient to know about immunotherapy or about participating in a clinical trial?

I think that it’s a fantastic approach. You have pretty much nothing to lose if you are in this particular situation. If somebody requires immediate treatment, it’s a different story. But for people in a wait-and-watch stage, I think it’s too good a chance to miss.

And the other thing is that Science magazine voted cancer immunotherapy the breakthrough of 2013. So it’s really coming into fruition. It’s amazing how far the science has moved in the last 15 years.

With this trial, it’s just the beginning of research so hopefully they will continue to learn. I hope it will help other people, too.

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