December 16, 2018
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Maine vet beats rapidly spreading cancer with experimental gene treatment

Photo courtesy of the Journal Tribune
Photo courtesy of the Journal Tribune
Michael Delia is shown during his days as a U.S. Air Force pilot in Vietnam. It is thought he contracted Stage 3 lymphoma from his exposure to Agent Orange during the war.

As a young pilot flying missions in Vietnam, Michael Delia never dreamed his military service would lead to a struggle to survive five decades later and provide an emotional story of hope and inspiration for untold generations to come.

Delia, 73, lives in Kennebunk with his wife of 50 years after a 27-year career in the U.S. Air Force and another 25 years as a defense industry executive and consultant. A father of three and a grandfather of eight, he has always been health-conscious, active as an athlete and a coach, as well as an avid skier.

But Delia’s world was turned upside down in late 2013 when he was diagnosed with large B-cell lymphoma stemming from what is thought to be exposure to Agent Orange in Vietnam. It was a pivotal moment in his life and led to a monumental struggle to overcome a deadly cancer.

While attending a class in Saco, Delia discovered a lump on his inner thigh and at first thought it was a swollen cyst. A biopsy indicated that the retired colonel, a decorated command and combat pilot, was suffering from Stage 3 lymphoma and he then endured two rounds of chemotherapy, but the cancer kept coming back.

“It spread to both sides of my body and into my lymph nodes and a lung,” Delia said. “I thought of my mother who we lost to cancer 25 years ago.”

Oncologist Dr. Helen Ryan at New England Cancer Specialists in Scarborough learned of a clinical trial program for a new treatment that was going to be conducted at Dana-Farber Cancer Institute/Brigham and Women’s Hospital in Boston and shared that news with Delia.

He applied and was accepted for extensive testing, eventually becoming the oldest person admitted into the clinical treatment program as a patient.

After three days of chemotherapy as an outpatient, Delia underwent a four-hour procedure in which some of his T cells were extracted and sent to a lab in California where they were re-engineered and modified.

The trial program Delia was involved with used a drug called axicabtagene ciloleucel (KTE-C19, axi-cel) and was developed by Kite Pharma to treat adults with refractory aggressive B cell non-Hodgkin lymphoma. He was one of just 101 patients nationwide to undergo the treatment.

His collected T cells were returned to Dana Farber and infused into him. At first, Delia didn’t know if the treatment would be effective.

“That’s when I felt really bad,” Delia said. “I didn’t have a loss of memory like some of the others who had received this, but I was extremely fatigued. I was in the hospital for eight days, but by the fifth or sixth day, I felt much better and was able to go home.”

During the nationwide clinical trial, 82 percent of the patients responded to the chimeric antigen receptor (CAR) T-cell therapy for adult cancers treatment, with 54 percent of patients having a complete response to therapy, according to results presented in June at the Lugano International Conference on Malignant Lymphoma.

All told, 36 percent of patients remain in complete remission six months after treatment, including Delia, and as a result of its success, the Food and Drug Administration approved its use for the general public.

“Treating patients with CAR T cells has been one of my most exciting professional experiences, and the FDA approval of this therapy offers hope and optimism to a subset of patients whose other treatments have failed them,” said Dr. Caron A. Jacobson, medical director of the Immune Effector Cell Therapy Program at the Dana-Farber/Brigham and Women’s Cancer Center. “It is extremely rewarding to be able to offer a new therapy to patients who had virtually no other options just 12 to 24 months ago.”

The CAR T-cell therapy, like all forms of cancer immunotherapy, aims to tune up and strengthen the immune system’s inherent cancer-fighting powers, Jacobson said.

It involves giving patients modified versions of their own immune system T cells ­– white blood cells that help protect the body from disease. If successful, the CAR T cells will continue to reproduce in the patient’s body, and serve as an effective fighting force against cancer cells.

“The successful development of CAR T cells as a therapy for cancer, on the heels of the success of immune checkpoint blockade drugs, is a testament to the progress we have made in understanding how our immune system is regulated and how cancer evades the immune system,” Jacobson said.

Delia has resumed his active life, remains cancer free to this day and is proud that many more people suffering from lymphoma will have a better chance to survive because of his involvement in the clinical trials of the new treatment.

“This summer I celebrated my first anniversary as Genetically Modified Organism,” he said. “I’m definitely sold on this treatment. Our family is looking forward to the snow flying and skiing at Sunday River.”

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