Oncology Patient: New Gene Therapy Offers New Hope

Diagnosed with large B Cell lymphoma, Lori “Jill” Trinkle is preparing for a groundbreaking gene therapy and will be receiving the revolutionary CAR-T treatment at IU Health – the only site in Indiana to administer the treatment.

She knows she’s a pioneer – one of the first to receive a revolutionary new cancer treatment. But Lori “Jill” Trinkle looks at it as a way to acknowledge the progression of a medical and scientific field that is out to slay the giant called “cancer.”

Diagnosed February 16, 2017 with high grade, aggressive large B cell lymphoma – Non-Hodgkin Lymphoma (NHL), Trinkle, of Michigan, was originally treated with chemotherapy. After six founds – administered during a 21-day hospital stay – a PET scan showed that her chest was clear. She completed the treatment on June 30, 2017 and four months later the lymphoma was back. Tinkle went through two more rounds of chemotherapy in preparation for a stem cell transplant. A year after her diagnosis, she was admitted to IU Health Simon Cancer Center for three weeks for the stem cell transplant. Anther PET scan came back clear.

But in May the cancer returned in her right lung. On June 13 she began 20 treatments of radiation to attack the mass in her chest.

Those two treatments – with relapses – were the pathways that lead Trinkle, 59 to a gene therapy that has only recently been approved by the FDA. IU Health is the only state-approved site to use the treatment known as CAR-T.

During a recent check-up Trinkle met with Dr. Michael Robertson, who specializes in hematology/oncology to talk about that next step in her treatment – CAR-T. Specifically, the groundbreaking gene therapy uses custom-made cells to attack a patient’s own specific cancer. As part of the Indiana University’s Grand Challenge Precision Health Initiative, CAR-T cell therapy allows doctors to isolate T-lymphocyte cells – the body’s cells that fight infections and are active in immune response. According to Dr. Mervin C. Yoder, M.D., a leader in IU’s Precision Health Initiative, the T cells are then engineered to express a chimeric antigen receptor (CAR) that targets a protein on a patient’s cancer cells, attaches to them and eventually kills them.

As Doctor Robertson evaluates Trinkle during her recent check up, he asks about her breathing, if she has fever, lumps or bumps. She tells him about a rash that could be from radiation and some back pain, she believes is caused by a degenerative disc. Otherwise, she says she feels great and is ready for the next phase of her treatment plan.

“I think we’re on track,” said Dr. Robertson. “The reason she’s one of the first for the CAR-T treatment and the reason she is a good candidate is because standard chemotherapy hasn’t done the job to control the lymphoma. We’re hoping the immune system can do what the chemo couldn’t do.” He tells Trinkle to expect to be fatigue – symptoms similar to when she went through her stem cell transplant. She will remain in the hospital for about three weeks. In addition to Dr. Robertson, Trinkle has been in the care of medical oncologist Dr. Karuna Koneru, medical radiation oncologist, Dr. Fred Wu, both of Bloomington, IUH Southern Indiana Physicians.

“It could be scary but I’m comfortable with my doctors and the process,” said Trinkle, who has an older brother, younger brother and two younger sisters. She has one daughter and they enjoy exploring Michigan together. “I’ve stayed positive through it all. My faith is strong. I’ve met fantastic people in the hospitals – both Bloomington and Indianapolis – very capable and caring. I look forward to having my energy back and doing the things I love – yoga, volunteering, walking and fostering animals.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
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