Host:

Donna Mayer, Executive Director, Cholangiocarcinoma Foundation

Topic:
Using Patients Own Immune System to Knock-out Cancer: Adoptive
Cell Therapy
Date:
Date: Thursday, October 23, 2014
Time: 4:00 5:00 PM (Eastern)
Presenters:
Steven A. Rosenberg, M.D., Ph.D., National Cancer Institute
Eric Tran, Ph.D., National Institutes of Health Surgery Branch, Tumor
Immunology Section
Melinda Bachini, CCF Patient Advocate and NIH Research Study
Participant
Bios:
Steven A. Rosenberg, M.D., Ph.D.
Dr. Rosenberg is Chief of Surgery at the National Cancer Institute in
Bethesda, Maryland and a Professor of Surgery at the Uniformed
Services University of Health Sciences and at the George Washington
University School of Medicine and Health Sciences in Washington,
D.C. He. received his B.A. and M.D. degree at The Johns Hopkins
University in Baltimore, Maryland and a Ph.D. in Biophysics at Harvard
University. After completing his residency training in surgery in 1974
at the Peter Bent Brigham Hospital in Boston Massachusetts, Dr.
Rosenberg became the Chief of Surgery at the National Cancer
Institute, a position he has held to the present time.
Dr. Rosenberg has pioneered the development of immunotherapy that
has resulted in the first effective immunotherapies for selected
patients with advanced cancer. His recent studies of cell transfer
immunotherapy have resulted in durable complete remissions in

patients with metastatic melanoma. He has also pioneered the

development of gene therapy and was the first to successfully insert
foreign genes into humans. His recent studies of the adoptive transfer
of genetically modified lymphocytes has resulted in the regression of
metastatic cancer in patients with melanoma, sarcomas and
lymphomas.
Dr. Rosenberg is a member of the American Society of Clinical
Oncology and served on its Board of directors. He is also a member of
the Institute of Medicine of the National Academy of Sciences, the
Society of University Surgeons, the American Surgical Association, the
American Association for Cancer Research, and the American
Association of Immunologists among others. Dr. Rosenberg is the
author of over 950 articles in the scientific literature covering various
aspects of cancer research and has authored 8 books.
Eric Tran, Ph.D.
Dr. Tran received his PhD in biochemistry from the University of
Victoria in British Columbia, Canada, and is currently a postdoctoral
fellow in the lab of Dr. Steven Rosenberg at the National Institutes of
Health. Dr. Trans goal is to develop effective T-cell therapies against
common solid cancers. This has led him to investigate the T-cell
response against cancer mutations in patients with metastatic
gastrointestinal (GI) cancers. His recent work on a patient with
cholangiocarcinoma suggests that the adoptive transfer of T cells
targeting a mutation uniquely expressed by that patients metastatic
cancer appears capable of mediating tumor regression. Dr. Trans
current efforts are focused on determining how often mutationreactive T cells can be found patients with metastatic GI cancers and
on developing methods to better harness the mutation-specific T-cell
response against cancers.
Melinda Bachini
At 46 years old, I am a wife and a mother of six beautiful children. My
story began the end of October 2009 when I began to experience

some extreme heartburn symptoms, tightness around my epigastric

region and indigestion. I thought at the time that I might have
gallstones. On December 1st, 2009, I was diagnosed with Intrahepatic
Cholangiocarcinoma. Three weeks later I had 2/3rds of my liver
resected with good margins. Unfortunately, at my three month
checkup, metastasis was confirmed in my lungs.
I went to the Mayo Clinic in Rochester for a second opinion on my
options, but they recommended the same treatment of Gemzar and
Cisplatinin. They had no clinical trials available for me at that time.
I did the regimen of Gem/Cis for about 5 months with stable disease.
Due to the toxicity of the Cisplatin they put me on Gemzar alone
which resulted in growth in tumors. I was then switched to Avastin,
which held the tumors at bay for a few months. I began having toxicity
to the Avastin as well. After many attempts at trying chemotherapy, I
found myself not wanting to spend the rest of the life I had left using a
chemo that would not cure me but had already caused so much
damage. Chemo was toxic and it was not holding against this growing
cancer within me.
I found the NIH clinical trial shortly after this decision. It involved the
initial chemo to deplete my immune system but after that it was my
body fighting the cancer. In March of 2012, two years and four months
after diagnosis, I entered into this trial at the National Cancer Institute
in Bethesda, Maryland. I have had huge success with this treatment
and I am hoping and praying that it will also benefit many others!
Quick Cholangiocarcinoma Facts:
Of the 580,000 Americans diagnosed with cancer every year, 2,500 of
those cases are Cholangiocarcinoma. There is only a 30 per cent
chance of a five-year survival rate if the cancer is found early stage,
and the cause is still unknown. This disease can hit at any age, but
typically occurs in patients over 65 years old. Bile seeps back into the
blood causing the patients skin and whites of their eyes to become

yellow. Other symptoms include abdominal pain, high temperatures

and weight loss.
What:
Scientists and doctors have taken an important step forward in a new
cancer treatment. The therapy can apply to a wide array of cancers
especially patients who have been diagnosed with melanomas in the
lungs, bladder and gastrointestinal tract.
A study recently published by the National Cancer Institute, under the
National Institutes of Health, doctors sequenced the genome of a
43-year-old woman named Melinda Bachini, who had been struggling
a cancer that wasnt responding to chemotherapy. According to the
Times Dr. Steven A. Rosenberg and his colleagues preformed adopted
cell therapy, on the patient which involves identified cells from her
immune system that attacked a specific mutation in the malignant
cells. Then they grew those immune cells in the laboratory and infused
billions of them back into her bloodstream. Through this process the
tumors started to melt away. Rosenberg told NBC News Its the
first time we have been able to actually target a specific mutation in
the immune system,
Why:
This womans cancer is not cured. While her tumors are shrinking,
they are not gone. But this report shows an approach that can be
applied to most common tumors, which cause more than 80% of the
580,000 cancer deaths in the United States every year. This is a great
breakthrough in science. Rosenberg will discuss the techniques used in
hopes to continue to find the cure. Because of this study scientist may
one day use modifies E.coli to develop custom drugs, antibiotics, and
vaccines that were never possible before.