- Associated Press - Sunday, April 10, 2016

AMARILLO, Texas (AP) - When Bruce Campbell got the news in 2012, it was a cold, gray day. One of his first thoughts would be if he’d live to see spring, his favorite time of the year. That was followed by the urge to get his affairs in order. That’s what hearing the sudden diagnosis of stage 4 lung cancer can do.

“I talked to my attorney and got my will all straightened out,” he said. “It was good therapy because I didn’t have time to think about what the inevitability was going to be.”

Last month, some four years later, Campbell, 81, ran in the Houston 5K Color Run. The four tumors in his left lung that seemed like a death sentence are all but gone.

“I do feel like it was a miracle,” he told the Amarillo Globe-News (https://bit.ly/235TxDl). “It’s a miracle drug. It’s the future of cancer treatment, and it’s exciting.”

The Time Magazine cover story last week is on immunotherapy, what oncologists are calling the most promising cancer breakthrough in decades, and likely ever. But there’s a “but” - there’s always a “but.”



The story also highlights the difference between the pace of scientific progress and the ability to deliver it to dying patients, and the clash between the priorities of scientists, drug companies and regulators on one side and anxious patients and their families on the other.

Campbell, former assistant to the general manager at Pantex, is one of the new treatment’s shining success stories - in both that he met the rigid specific standards for qualifying for the clinical trial, and that the drug worked just as doctors and researchers hoped.

“I was lucky. I was fortunate that I qualified,” Campbell said. “I think the Good Lord has his hand right on my shoulder.”

Cancer immunotherapy teaches the body’s immune system to seek out and destroy cancer cells like it fights off bacteria and viruses. Killer immune cells, known as T cells, are capable of that, but only if activated by specific new drugs.

What drugs, how much, and on what specific cancers are the focus of more than 3,400 clinical trials worldwide. Campbell won that version of the lottery back in 2013.

Two rounds of chemotherapy in Amarillo had not really done much. The tumors had not grown, but had not shrunk in size.

“My first visit to M.D. Anderson (in Houston) and also at Texas Oncology (in Amarillo), I said, ‘Man, if there is any experimental program, put me down as a candidate,’” Campbell said. “The first thing doctors told me, especially in Houston, was just to hang on. Great things are coming down the road.”

At M.D. Anderson, where Dr. James Allison was one of the medical pioneers in immunotherapy, Campbell was tested to see if he could enter a trial. Half the candidates don’t qualify.

Campbell had to endure another biopsy, a brain MRI, and was tested for a number of extremely specific markers. He met a key one for the PD-1 protein, which acts as an inhibitor to protect cancer cells from being attacked by the T cell.

New immunotherapy drugs work on the PD-1 protein, to release its brakes, and allow the T cell to attack the cancerous ones.

“Just waiting to see if you made it was pretty traumatic,” he said.

Campbell began the trial on Dec. 4, 2013. He traveled to M.D. Anderson to take the infusion drug - a $200,000 drug - for 30 minutes every three weeks for two years. No sickness like with chemotherapy.

The results were dramatic. His body was killing the cancer cells. In nine weeks, his tumors decreased by 26.9 percent, tumors that chemo didn’t touch. In four months, there was a 40.8 percent reduction.

By the end of the trial, and his last CT scan in October, his tumors had reduced by a hard-to-believe 72 percent.

“I would sit in a chair, they would plug me in, and boom, in 30 minutes it was over,” Campbell said. “I’d then go about my business.”

With just two small tumors left after the clinical trial, Campbell asked doctors in Houston if radiation might be able to kill what remained. They agreed to try. He took 15 treatments that ended on Feb. 19.

He and wife Carol Ann return to Houston for the 53rd time next week for one more CT scan. It’s certainly possible this will be his last trip, that the last of the deadly tumors are gone.

“We had to sign all kind of consent forms,” Campbell said, “and one was this drug is not provided to cure cancer. This is a clinical trial to determine the maximum amount of drug your body can handle. That brings you back to reality.”

Indeed, clinical trials are designed to answer scientific questions, not provide an immediate cure. For Campbell, his trial did both. He was not one of the 7 million annually who die from the disease.

In what could be groundbreaking treatment for cancer, science and human lives are trying to interweave. But much red tape still remains.

___

Information from: Amarillo Globe-News, https://www.amarillo.com

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