Immunotherapy clinical trial gives hope to leukemia, melanoma survivor

An acute myeloid leukemia diagnosis (AML) in May
2016 came as no real surprise to Julia Dutton. She’d been fighting
debilitating fatigue for a couple of weeks. Then her gums became so
painful and swollen, “they felt like balloons and looked like if you
stuck them with a pin, they’d pop,” Julia says.

Thinking she had a gum infection, Julia went to her dentist for a
teeth cleaning. That brought no relief. When her vision became blurry,
too, Julia went to an urgent care clinic, where she learned that her
hemoglobin counts were very low. The doctor said she probably had cancer.

“I felt so bad that day that it really was no surprise,” Julia says.
“I’ve always been a real active person, but I was out of breath just
walking up the stairs. I was so tired I couldn’t even function.”

Choosing a clinical trial at MD Anderson

Within three days of her diagnosis, Julia had her first appointment
at MD Anderson. “My sister had been there
in 2014,” she says. “So I knew that’s where I wanted to be.”

During her first visit, Julia met with Alessandra Ferrajoli, M.D., who confirmed her
acute myeloid leukemia diagnosis with a bone marrow biopsy. Ferrajoli
asked Julia to consider a Phase I/Phase II clinical trial under Farhad Ravandi-Kashani, M.D. It involved an immunotherapy drug, nivolumab.

“At the time, I didn’t know anything about immunotherapy,” Julia
says. “But I called a doctor friend of mine, and he said, ‘Oh, yeah.
You want to be on it.’ So I joined. Once I read up about
immunotherapy, I was all over it.”

Pneumonia treatment reveals undiagnosed melanoma

Julia began receiving nivolumab intravenously in June. She also got
the chemotherapy drugs idarubicin and cytarabine to
prepare her body for a stem cell transplant. But before she could have
the procedure, Julia spiked a fever. Doctors discovered she had
pneumonia and ordered a CT scan to determine its severity. That’s when
they noticed the spot on her left lung.

“I thought, ‘There is no way I could have two cancers. There is just
no way,’” Julia says. But a biopsy showed otherwise: it was stage IV
melanoma.

Accepting hair loss solves mystery

Because melanoma is a skin disease, doctors knew that it did not
originate in Julia’s lungs. But determining its primary location
proved challenging. “They looked all over my body — even in between my
toes,” Julia says. They finally found the answer when Julia shaved her
head: a tiny spot on her scalp.

“The dermatologist described it as ‘very unremarkable’ when he
removed it,” Julia says. “It did not go very deep and only took three
stitches to close.”

Immunotherapy drug targets both leukemia and melanoma

A stem cell transplant was off the table until the melanoma was
completely gone, so Julia began receiving radiation therapy under Steven Lin, M.D., to treat the spot on her lung.

As luck would have it, the clinical trial drug she was on for
leukemia was the same one Hussein Tawbi, M.D., Ph.D., would have
prescribed for melanoma. “So the immunotherapy drug was working on
both types of cancer,” Julia says. “The melanoma in my lung was 1.3 cm
long when they found it, but by the time I got to see Dr. Lin, it was
only .7 cm. After I started radiation, it went down to .4 cm in just
one week.”

Advice for others considering clinical trials

Julia finished her chemotherapy and radiation treatments in October
2016, although she continues taking nivolumab today. She never did
undergo a stem cell transplant, although she did have a Gamma Knife® procedure under Ian McCutcheon, M.D., and Erik Sulman, M.D., Ph.D., in March 2017, after
an MRI revealed a tiny spot of melanoma on her brain.

Today, Julia is in remission. She tells everyone she knows to get to
MD Anderson if they have cancer — and
most importantly, to consider clinical trials if they’re ever offered.

“I had a really good result on my clinical trial and could not be
happier with the care I received,” Julia says. “Look at the rewards
versus the risks and the long term. It’s definitely worth talking to
your doctor about.”

Request an
appointment at MD Anderson
online
or by calling 1-877-632-6789.