When Amy Cheese came to the Nebraska Medical Center in October 2016, she had a tumor the size of a grapefruit in her chest, next to her heart and lungs.
She’d already been through three rounds of chemotherapy over the course of a year, but her non-Hodgkin lymphoma had rebounded.
About a month later, she participated in a clinical trial for a new type of therapy in which her immune cells were removed from her body and genetically engineered to recognize and attack her cancer.
Now Cheese, a third-grade teacher from Fort Collins, Colorado, is in remission and back to teaching full time. And on Monday, her doctors announced that the treatment she and two dozen others received through those trials now is available at the medical center for commercial use.
“When I heard that it was available for other people, I couldn’t stop smiling,” said Cheese, who was in Omaha for a three-month checkup. “You almost want to burst into tears because you’re just so happy that people will get the same treatment I had and be able to live — hopefully — long healthy lives, not hear that, ‘Sorry, there’s nothing else we can do,’ because that’s a horrible thing to have to hear.”
The Nebraska Medical Center, which has a nationally recognized lymphoma program, was one of the first centers in the Midwest to provide the therapy, known as CAR-T, or chimeric antigen receptor T-cell therapy, through clinical trials.
The Food and Drug Administration last fall approved the type of CAR-T therapy Cheese received, which is used for certain types of non-Hodgkin lymphoma, as well as a version for children and young adults with acute lymphoblastic leukemia, or ALL.
Dr. Julie Vose, Nebraska Medicine’s chief of hematology and oncology, said the therapy currently is for patients who really have no other options. “We see a therapy that potentially could keep them in remission for a very long time to come,” she said.
But the therapy, while exciting, can cause serious side effects in some cases, she said, and can be done only in certain centers. Nebraska Medicine currently is the only health system in Nebraska to offer the therapy. Staff involved in treatment had to undergo training and the hospital had to receive approval to administer it. A half-dozen patients are in the process of being screened to receive it outside a trial. Vose said she expects to receive approval to offer the second type of CAR-T therapy for acute lymphoblastic leukemia in the next several weeks.
Dr. Matthew Lunning, a Nebraska Medicine hematologist and an oncologist, said the health system “really invested a lot of time and resources in building this program” in order to bring the therapy to residents of Nebraska and the surrounding region.
Since the therapy has been approved by the FDA, she said, it should be covered by Medicare and insurers. But patients most likely will face costs beyond the treatment itself.
Meantime, the medical center is involved in other CAR-T trials and researchers globally have begun to study the technology in a variety of cancers.
“In the future, (this) could be used for a lot of different types of cancer, with a lot of further research,” Vose said.