Woman hopes experimental 'living' cancer therapy will stop her myeloma

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Cheri Letts, whose multiple myeloma has not responded to treatment, is helping test a new "living" therapy to harness her immune system to fight her cancer.

For 48-year old Atlanta mom, wife and dog groomer Cheri Letts, the realization she was sick came slowly.

"I was starting to feel rundown, and it seemed like I had a cold that just wasn't going away," Letts says.

She went to a series of healthcare practitioners, getting different diagnoses.

But she was growing worse, not better.

When Letts finally came here to Emory's Winship Cancer Institute, oncologist Dr. Sagar Lonial had bad news. She has multiple myeloma, cancer of the plasma cells.

"I was expecting to get this pep talk, of, 'We're going to do everything we can and we're going to fight this,'' Letts says.  "Instead, he said they were going to do everything they could to keep me as comfortable and happy as long as possible. And that's when I realized how serious multiple myeloma is."

Letts has tried every available chemotherapy, even a bone marrow transplant.

But, her cancer keeps coming back.  So, this spring, when she heard about a clinical trial of an experimental "living" therapy that might harness her own immune system to fight her cancer, Letts was the first in her trial at Winship Cancer Institute to sign up.

"I was just really hoping that it would be a cure," she says.

It's known as CAR T-cell therapy.

"T-cells are sort of the smart cells of the immune system if you will," Dr. Sagar Lonial says.

In March, a sample of Letts' white blood cells was collected and shipped to a biopharmaceutical company called Celgene.

There, in a lab, the cells were altered to add receptors, known as chimeric antigen receptors (CARs), that would act like a weapons system, helping her immune cells detect and kill her cancer.

"So, it sort of sends a smart bomb, with an immune cell attached to it, to go after it," Lonial explains.

Cheri underwent a low-dose chemotherapy to prime her immune system. Then an IV-bag with Lett's altered cells was shipped back and reinfused on March 19, 2018.

"My husband and I asked them if we could look at it before they hooked me up," Letts remembers.

Hospitalized for 2 weeks, Letts' immune system was quickly flooded by the altered cells, triggering a reaction known as cytokine release syndrome.

For days, she felt like she had the flu.

"That is actually a sign the cells might be doing something," Dr. Lonial says.  "Because it's the immune system revving up, revving up, causing high fevers, low blood pressure."

Five months after her infusion, Cheri and her 16-year old daughter Madison are back at Winship for a follow-up.

"Every couple of days, I start to notice I'm feeling better and better, I'm getting out more, doing more," Letts says.

Lonial is optimistic.

"She's done well; I think she's achieved, almost, a complete remission," he says.

It's still early, but for the first time in a long time, Cheri Letts and her husband Bill have hope.

"I was worried I wasn't going to make it to my daughter's graduation," Letts smiles.  "And, now I'll be able to see her get married."

Currently, there are no FDA-approved CAR T-cell treatments for myeloma.

Emory Winship Institute is leading 3 national clinical trials using CAR T-cell therapy for multiple myeloma.

The treatment has already received FDA clearance for certain patients with non-Hodgkin lymphoma and acute lymphocytic leukemia, or ALL.