Mantle cell lymphoma patient benefits from clinical trial despite COVID-19 pandemic

Charles Salazar lives in New Jersey, but considers Houston his “second” home.

For four years, he and his wife, Debbie, have been traveling to Houston regularly so he can receive treatment for mantle cell lymphoma, a rare type of non-Hodgkin lymphoma, at MD Anderson.

“Sure, I could have sought care closer to home, but my wife is a nurse who knows her stuff,” he says. “As soon as I was diagnosed, she started researching where I could get the best treatment.”

Debbie’s diligence led the couple to Michael Wang, M.D., one of the nation’s foremost experts in mantle cell lymphoma.

“We made the three-hour flight to Houston to visit Dr. Wang,” Charles says. “As soon as we met him, that was it – we knew he was our guy. He’s not only tops in his field, but he’s also a passionate advocate for his patients.”

A wait-and-watch approach to mantle cell lymphoma treatment

Wang determined that Charles had a slow-growing form of mantle cell lymphoma, and placed him on a wait-and-watch protocol.

“Many patients like Mr. Salazar who have few to no symptoms can be monitored over time without any treatment,” explains Wang. “If their cancer begins to advance, we shift from surveillance to active treatment.”

That’s exactly what happened to Charles. Last year, after four years of holding steady, a PET scan showed his slow-growing mantle cell lymphoma had indeed begun to inch forward.

Phase II clinical trial offers new mantle cell treatment option

At this same time, Wang was launching the Windows II clinical trial, which would test a combination of three drugs to treat mantle cell lymphoma.

Participants would take the drugs rituximab, ibrutinib and venetoclax, which would allow them to either avoid chemotherapy and its side effects altogether, or take a reduced chemotherapy dose after the three-drug treatment.

Wang had already tested two of the drugs in a previous clinical trial called Windows I, with impressive results – 92% of participants had gone into complete remission.

He hoped that adding a third drug in the Windows II trial would bump that number up to 100%.

Salazar was on board.

“I said, ‘sign me up.’ Let’s do this.”

The treatment would be given over 10 cycles, accompanied by blood tests and scans to monitor progress along the way. Salazar made it all the way to cycle six before the novel coronavirus (COVID-19) put the brakes on his travel to Houston.

“I was doing great – a PET scan showed the drugs were working,” he says. “And then the pandemic hit.”

Continuing a mantle cell lymphoma clinical trial close to home

Wang presented Charles with three options: withdraw from the clinical trial completely, delay treatments until it was safe to travel again, or continue participating in the trial at an MD Anderson Cancer Network partner member facility closer to his home. Partner members integrate their clinical cancer care operations with MD Anderson and mirror the way we deliver cancer care here in Houston.

Charles chose the latter option, and became a patient at MD Anderson Cancer Center at Cooper in Camden, New Jersey, an hour and a half from his home.

“That’s the easiest decision I’ve ever had to make,” he says.

Striving for complete remission from mantle cell lymphoma

His doctor there, Andres Ferber, M.D., communicates frequently with Wang. Together, the two make sure their shared patient stays the course.

As he nears the end of the clinical trial, Charles will undergo a bone marrow biopsy, a colonoscopy and an endoscopy to determine whether he’s entered into complete remission – meaning all signs of cancer have disappeared in response to the treatment. The tests are required because cancer cells were found in his bone marrow and gastrointestinal tract when he was first diagnosed.

Once complete remission is confirmed, he’ll enter into the clinical trial’s maintenance phase, during which he’ll take medications to help prevent the cancer’s return.

Charles, for one, is pleased about his seamless transition of care.

“We didn’t miss a beat,” he says.

Back to Houston

This June, Charles will return to Houston to continue his participation in the clinical trial and receive follow-up care. He looks forward to reuniting with the health care team he views as friends.

“Everyone is so professional, warm and welcoming,” he says. “The doctors, nurses, physician assistants, technicians, receptionists and everyone I encounter treats me like I’m their only patient. They work as a team to make sure I receive the highest quality care.”

 Until they return to Houston, Charles and Debbie will continue enjoying their time in New Jersey with their three rescue dogs.

“We’re real homebodies now,” he says, “like everybody else during this pandemic.”

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