Two years ago, 17-year-old Raphael Ordan found out he had stage 4 Hodgkin’s lymphoma.
He soon received reassurance at Children’s Hospital of Wisconsin.
“When I was first diagnosed with cancer, I barely had time to register my fear before the doctor was already telling me that this was one of the more curable types and that they were very confident they could make it go away and stay away,” Ordan said.
Standard treatments, however, would come with side effects. Radiation would have targeted the neck and chest, potentially producing long-term issues. Chemotherapy medications can be hard on the heart, while others can cause pulmonary problems later in life.
Ordan was presented with the option of participating in a clinical trial, led by Dr. Paul Harker-Murray, a pediatric hematologist-oncologist at Children’s Hospital of Wisconsin and assistant professor at MCW. It would use the standard chemotherapy approach, but eliminate one medication that can cause pulmonary fibrosis, while adding another targeted therapy. Ordan was initially hesitant.
“I didn’t know what that meant,” he said. “Did that mean this was the first time someone was getting this treatment? Does it work? Etc. And Dr. Harker-Murray noticed that, and said this is the same treatment they give to patients when they relapse as adults and it has fewer side effects and is more potent in a certain way.”
Ordan opted for the clinical trial and after two cycles of therapy, he was in remission.
“What you see in movies or what they describe in books about a regular cancer patient as someone who is miserable, throwing up, bald and can’t live daily life – for me, I was pretty much the exact opposite,” he said. “I wasn’t miserable. I didn’t lose all my hair. I was rarely nauseous. I didn’t even throw up once from the chemo. I was able to live my day-to-day life.”
Now 19, Ordan touts the importance of clinical trials.
“I like to say I’m proof that clinical trials are very important and that they really do work and improve the quality of life for patients that are on them,” he said.
Leaders of Children’s Hospital of Wisconsin and the Medical College of Wisconsin say Ordan’s story is indicative of where cancer treatment is headed: less invasive and more targeted therapies that result in a higher quality of life for patients.
A new $25 million commitment from the MACC Fund is aimed at enabling the institutions to advance medical discoveries to that end.
The MACC (Midwest Athletes Against Childhood Cancer) Fund announced in September its commitment to CHW and MCW – its largest-ever investment – with a focus on fighting pediatric cancer and blood disorders.
The leading disease-related cause of death among children, pediatric cancer causes more than 1,800 deaths each year in the United States.
The funding is aimed at accelerating the development of therapies through the research process, from concept to trial to outcomes assessment, and growing high-impact discovery science where early findings can lead to promising research opportunities to advance therapies.
Dr. Cindy Schwartz, an oncologist at CHW and section chief of pediatric hematology and oncology at MCW and professor of pediatrics, said it’s a critical time to invest in such research.
“This is the beginning of an exciting era in this field,” Schwartz said. “Things are really going to change. Most of my career we’ve been doing good work in curing people with kind of the same old therapies, but there are some really new therapies on the brink now.”
Among them is immunotherapy, a treatment that uses a patient’s own immune system to help fight cancer. Whereas commonly used treatments like chemotherapy and radiation kill both cancer cells and damage healthy cells, an immunotherapy approach called CAR (chimeric antigen receptors) T-cell therapy genetically reprograms a person’s immune system to target cancer cells, mitigating the negative side effects.
MCW and Froedtert Hospital have seen promising results from a unique product developed by researchers at the Milwaukee Regional Medical Center campus in Wauwatosa. The new product is a dual-targeted CAR T-cell therapy that takes aim at two proteins on the cancer cells, called CD19 and CD20, which are prevalent in patients with mantle cell lymphoma. FDA-approved products only target one protein.
MCW researchers point to the promising results of a middle-aged male patient, who received the therapy in 2017 to treat mantle cell lymphoma, as an indicator of immunotherapy’s significant cancer-fighting potential.
After seeing positive results among adult patients, CHW and MCW have submitted an application to the FDA to pursue those therapies for childhood leukemia.
“We’re hoping that in the near future that we’ll actually open the trial to children with leukemia,” Scwhartz said. “We’re really excited about that because nobody else has that – CARs that have these two particular antibodies we can deliver here.”
While CAR T therapies are effective at fighting leukemias and lymphomas, CHW is also making progress in using what are called “natural killer” cells to target cancer cells in solid tumors, including brain tumors and sarcomas.
“It’s very innovative therapy,” Schwartz said. “That’s what’s exciting. You can’t do every innovative therapy that exists. You have to focus and find things that work for your institution. Or you don’t do anything. But our group, with the MACC Fund, has the resources to bring some of these new ideas and developments and actually bring them to the clinical arena where we can actually bring them to patients. That’s the exciting part, but it takes a lot of money. The insurance companies don’t pay for this kind of stuff.”
Currently, 90% of CHW’s cancer patients are enrolled in a clinical research program.
Building out a robust research arm with support from the MACC Fund also plays an important role in attracting talent to the region, according to Dr. John Raymond, president and chief executive officer of MCW.
“That’s really the hallmark of success, that we bring good people in and we give them the resources they need to develop new treatments and cures for childhood cancer,” Raymond said “… Even though we’re all proud that Milwaukee is a rising exciting city, it is still a medium-sized city. It is so important for talented faculty members and clinicians to know they have the support of the community, that there is a true investment in the work they’re doing.”
Other focuses of the MACC Fund funding include creating new methods of delivering health care to optimize the length and quality of life for pediatric patients.
“We’re really focusing now on survivorship as well because we know there are effects from the cancer treatment and we want these kids to grow up and be healthy and resilient,” said Peggy Troy, president and chief executive officer of CHW. “So part of this gift is going to allow us to do a better job of understanding the outcomes, the psychological impact, the social impact, how they re-enter in school and community.” n
