Facing limited options, CAR T-cell therapy offers Markey patient a miracle

LEXINGTON, Ky. (April 17, 2024) — After seven years of living with an aggressive form of lymphoma unresponsive to treatment, Angela Roberts was running out of options. The Knox County resident would find a lifeline through CAR T-cell therapy. Just a month after receiving the treatment at the University of Kentucky Markey Cancer Center, Roberts was in remission, and she hasn't looked back. 

"It’s what I’d been waiting for all these years. I’m so happy I never gave up hope because this has been a miracle,” said Roberts. 

In 2018, the UK Markey Cancer Center became one of the first cancer centers in the country to begin offering CAR T-cell therapy, which harnesses the power of the body's immune system to fight cancer. Since then, the treatment has offered hope to 100 Markey patients with blood cancer unresponsive to standard treatments like chemotherapy or bone marrow transplantation. 

During CAR T-cell therapy, a patient's white blood cells, or T-cells, are collected and then modified in a lab to include special receptors called chimeric antigen receptors (CARs). The “supercharged” CAR T-cells are then injected back into the patient, where they locate and destroy cancer cells. Today, there are six CAR T-cell therapies on the market for the treatment of blood cancers including lymphomas, leukemias and multiple myeloma.  

In March 2024, as Roberts reached her one-year mark for treatment and remission, Markey Cancer Center’s Hematology and Blood Marrow Transplant Team celebrated treating their 100th CAR T-cell patient. 

"Reaching 100 CAR T-cell treatments is a major milestone for Markey Cancer Center,” said Reshma Ramlal, M.D., Interim Medical Director of Markey’s Bone Marrow Transplant and Cellular Therapy Program. “It demonstrates our commitment to offering cutting-edge therapies and providing hope to patients, like Ms. Roberts, who may have felt their options were exhausted." 

For Roberts, every day is now a celebration of life. As outdoor enthusiasts, she and her husband, Arnold, are enjoying an idyllic retirement: a home nestled in the woods with a fishing pond and plenty of land to explore. Roberts finds joy spending time with her grandchildren or curled up with a good book.  She's recently combined these passions by visiting their school for storytime, sharing her love of reading with a new generation. 

“The older you get, the more you realize how precious life is. These past years have taken that to another level,” Roberts said. “Some days are better than others, but I have just learned to enjoy every single day and every single moment. I'm just proud to be here.” 

Roberts’ cancer journey began in 2016, when a doctor's visit for a urinary tract infection and swollen lymph nodes led to a diagnosis. She had follicular lymphoma, a type of non-Hodgkin lymphoma that is known for its slow growth.  

Over the next six years, she had three rounds of the standard treatment – a combination of chemotherapy and immunotherapy. Each would be successful, initially. But the telltale symptoms, swollen lymph nodes on her neck and groin, would always come back.  

Roberts was referred to Markey when the lymphoma came back with vengeance after her third round of treatment. 

“My oncologist always assured me that if he ever thought he wasn’t the best man for the job, he’d send me to the best,” said Roberts. “He lived up to that promise. That’s how I found myself at Markey.” 

Roberts didn't know it at the time, but because her cancer was unresponsive to three rounds of treatment, she was now eligible for Yescarta, a type of CAR T-cell therapy that had just been approved to treat follicular lymphoma. Markey was one of the only cancer centers in Kentucky to offer it.   

Roberts found out she was a candidate during her first appointment with Markey oncologist Fevzi F. Yalniz, M.D.  

"Knowing Ms. Roberts had already had three lines of treatment and still had progression, she had a very biologically aggressive form of this disease,” said Yalniz. “We discussed the options and determined that CAR T-cell therapy could be a better option for her at this point.”  

Roberts, who was with her husband and son at the time, remembers the moment vividly. 

“My son said, ‘This is exactly what you’ve been waiting for,’” said Roberts. “I got the chills. I was just completely overwhelmed.” 

In between Roberts’ T-cell collection and infusion, she received one last dose of chemotherapy that would give her body the best chance at fighting off cancer with the new T-cells. During this time, her condition worsened, requiring her to remain in Lexington. She was able to get accommodations at the American Cancer Society’s Hope Lodge in Lexington through Markey’s oncology social work team.  

Roberts received her T-cell infusion on March 28, 2023. By April 28, she was in full remission.  

She now undergoes yearly PET scans. Follicular lymphoma is considered a chronic disease, so she must be closely monitored for the rest of her life. 

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Roberts was in the right place at the right time. When she was diagnosed in 2016, CAR T-cell therapy wasn’t yet FDA approved, and Yescarta wouldn’t be approved to treat follicular lymphoma until 2021. 

“God and my faith had much to do with getting me through those seven long years, knowing a treatment that would work would come along at just the right time,” Roberts said. 

The existence of six FDA-approved CAR T-cell therapies, with more on the way, underscores the incredible speed of medical advancement in this field. 

"One hundred patients is a significant achievement, but it's just the beginning," Yalniz said. "As more clinical trials prove the safety and effectiveness of already-approved CAR T-cell treatments for earlier lines of blood cancer, the number of patients who can benefit from these treatments will grow exponentially." 

Markey is also part of several clinical trials that represent the next generation of CAR T-cell therapies, including a groundbreaking trial for lung cancer, as well as "off-the-shelf" treatments that use donor T-cells instead those from the patient. Markey’s status as a National Cancer Institute-designated Comprehensive Cancer Center gives patients unique access to many of these cutting-edge trials, which are not available elsewhere in Kentucky. 

It's a reminder that today’s latest treatments, like the one Roberts received, were available through clinical trials first. Because of the rapid pace of research, it’s important for patients to explore clinical trials, Yalniz says. 

"Explore your options. Consult with a major cancer center like Markey,” he said. “This field changes rapidly, and a clinical trial could be your lifeline, even when you feel like other treatments have failed."