Newly approved CAR T-cell therapy puts patient’s lymphoma in remission

By Margaret Tucker

Dec. 1, 2020 – Gall bladder problems ran in the family. That’s what Cindy Osborne told herself when she visited her doctor in February 2016 for a seemingly minor health complaint, convinced that her gall bladder was the source of the trouble.

But it wasn’t her gall bladder. It was an aggressive case of non-Hodgkin lymphoma. That simple doctor’s appointment marked the start of a cancer journey that would see Osborne make history by becoming the first patient at Siteman Cancer Center to undergo CAR T-cell therapy after it was approved by the FDA. Today, her lymphoma is in a lasting remission.

“This is my future,” Osborne said. “I’m living my future right now, and I wouldn’t have had that without the CAR T.”

Osborne lives in Mount Vernon, Ill. She and her husband, Nick, have been married for 35 years, and they have five children and seven grandchildren.

“I decided early on that I was going to be strong. You never know how strong you are until you have no other option but to be strong,” Osborne said. “My husband and I, we just took a deep breath and said, we can do this.”

When it came time to select a treatment center, Osborne and her husband didn’t hesitate. They’d heard good things about Siteman from others in their community and were impressed by its reputation.

“I knew that it was the best place near me to go to,” Osborne said. “Why travel somewhere else when Siteman is nearby?”

From the very beginning, Osborne’s lymphoma resisted treatment. She underwent two different kinds of chemotherapy and then a stem cell transplant, all of which failed to control the disease. Finally, after surgery and a course of MRI radiation, she started feeling better. She came in for a PET scan in October 2017 in good spirits, convinced that her cancer was in remission.

Instead, she got terrible news. Though the radiation had prevented the lymphoma from recurring in her original tumor site, she had new patches of lymphoma in other areas of her body. It had metastasized. And, at that time, there was nothing more that could be done.

“It was devastating to hear that there were no other options,” Osborne said.

Osborne’s oncologist, Washington University medical oncologist Brad Kahl, MD, mentioned that there was a new treatment called CAR T-cell therapy nearing FDA approval that would probably be a great fit for her condition. But all of the clinical trials had closed, and there was no way for her to access it.

“It was a long ride home,” Osborne said.

Then, the next morning, something incredible happened. Her phone rang, and it was Dr. Kahl, telling her that CAR T-cell therapy had been approved the previous night, possibly even during her appointment. He told her that she was a perfect candidate for it and that she would be able to receive it at Siteman.

Osborne was overwhelmed.

“I felt that the opportunity was being handed to me, and that I was meant to receive this treatment,” she said.

Washington University medical oncologist Amanda Cashen, MD, supervised Osborne’s CAR T-cell therapy. In December 2017, Osborne’s T-cells were collected and sent away to a laboratory for modification.

“There, in the lab, they genetically re-engineered my cells to become cancer-fighting cells,” she said.

Osborne received her new CAR T-cells shortly after New Year’s Day in 2018. She was the first patient at Siteman to be given CAR T-cell therapy as a licensed treatment, not as a clinical trial.

Everyone realized that Osborne’s T-cell infusion marked an important milestone.

“There were a lot of doctors and nurses around,” Osborne said. “It was kind of a ground-breaking time, I guess!”

Following the infusion, Osborne stayed in the hospital for 50 days, recovering from side effects that included confusion and memory loss. Her husband hardly left her side. To encourage her, he would talk about all of the trips they would take and exciting experiences they would have after she got better.

“You have to have things to look forward to – to get healthy for,” Osborne said.

And, slowly, she got healthy, with the help of her Siteman care team. Dr. Kahl, Dr. Cashen, and her other physicians and nurses reassured her with their expertise and compassion.

“I just knew that everything was going to be OK. I always trusted the doctors and the nurses,” Osborne said. “I love them. I love them for what they’ve done for me. They’re the best.”

Since her CAR T-cell infusion, Osborne’s PET scans have been completely clear of cancer. She and her husband have been tackling those plans they made during her tough days in treatment. They’ve explored Europe and New England, and spend as much time as they can with their grandchildren. She’s thankful she was able to receive CAR T-cell therapy at Siteman just in time to reverse the course of her lymphoma.

“I was meant to be healthy.  I was meant to thrive,” Osborne said. “It’s truly a miracle treatment for those of us who didn’t have hope before.”