Excitement is growing for the promising potential of CAR-T cell immunotherapy, which was used to treat Harrison Morrow’s relapsing multiple myeloma.

A year ago, Harold “Harrison” Morrow of Lowell, Massachusetts, was grappling with a deadly cancer called multiple myeloma (MM). A rugged guy who had worked all his life as a construction equipment operator, he found himself in constant pain, rapidly losing both weight and strength. The disease commandeers plasma blood cells in the bone marrow, damaging bones and other organs as it spreads.

Mass General patients often have some of the earliest access to cutting-edge treatments.

Despite a variety of treatments, Harrison’s myeloma cells had rocketed out of control. “I knew at the back of my mind that I was facing death,” the 53-year-old says. “But I’m stubborn.”

He was also under the care of Noopur Raje, MD, director of Massachusetts General Hospital Cancer Center’s Center for Multiple Myeloma, who had been working with an experimental treatment called CAR-T cell immunotherapy.

Finding Hope at Mass General

Patients like Harrison often find hope at Mass General, which offers state-of-the-art care and ranks as the largest hospital-based research program in the United States. At any given time, an estimated 1,200 clinical trials are underway at Mass General. Many are overseen by researchers who are also physicians. As a result, Mass General patients often have some of the earliest access to cutting-edge treatments.

Immunotherapy is one of them. It taps the power of our body’s immune system to recognize tumors as a threat and launch an attack to destroy them. The Mass General Cancer Center has made it a top priority. Three years ago, it launched the Center for Cancer Immunotherapy. At the time, Nir Hacohen, PhD, its director, declared that cancer treatment had entered “the era of immunotherapy.”

When the Mass General Cancer Center launched the Center for Cancer Immunotherapy. three years ago, Nir Hacohen, PhD, its director, declared that cancer treatment had entered “the era of immunotherapy.”
When the Center for Cancer Immunotherapy was launched three years ago, Nir Hacohen, PhD, its director, declared that cancer treatment had entered “the era of immunotherapy.”

T cells orchestrate the immune system’s response to infections from foreign viruses and bacteria. CAR-T cell immunotherapy involves taking T cells out of a patient’s blood and altering them to rev up their ability to kill cancer cells too. The T cells are genetically engineered to produce chimeric antigen receptor (CAR) cells that target a molecule on the surface of a cancer cell and guide the CAR-T cells to the tumor. Then, with their new marching orders to destroy cancer cells, the T cells are infused back into the patient.

CAR-T Excitement

“It is a tremendously exciting time for T cell therapies,” says Marcela Maus, MD, PhD, director of Mass General Cancer Center’s Cellular Immunotherapy Program and a top researcher in the field. “They are offering a lot of hope to patients.”

CAR-T cell immunotherapy for multiple myeloma is still experimental. But in 2017 the Food and Drug Administration (FDA) approved the first two CAR-T cell therapies for treating two other advanced blood cancers: diffuse large B-cell lymphoma and acute lymphoblastic leukemia. Mass General Cancer Center is one of only 16 centers nationally that is approved to administer Yescarta, the CAR-T therapy for diffuse large B-cell lymphoma.

Mass General researchers are conducting seven clinical trials of engineered T cells for various cancers and several more are in various stages of regulatory review.

“This therapy is a game changer in the treatment of myeloma,” Dr. Raje says.

Milestone for Multiple Myeloma

People with MM used to live only two to five years following diagnosis. But over the past decade, thanks to new drugs, that time period has increased dramatically.

Dr. Noopur Raje’s research focuses on finding the best molecular targets and testing innovative therapies for MM. Recently, in addition to their work on CAR-Ts, her team has found another form of immunotherapy using monoclonal antibodies to be promising.

The 21 patients in the national, phase I CAR-T trial in which Harrison Morrow participated — designed to determine the safety and best dose of CAR-T therapy for MM — all had aggressive, relapsing MM. More than 90 percent of the 18 patients who received active doses of the CAR-T cells responded to the therapy and, without further treatment, many have no cancer cells one year later.

“This therapy is a game changer in the treatment of myeloma,” Dr. Raje says.

Read more about cancer immunotherapy research at Mass General:
Immunotherapy Effort Advances on Multiple Fronts
Immunotherapy Effort Seeks New Cancer Targets
Immunotherapy Gets Patient Back Into the Race

Until the therapy is FDA-approved, however, it’s only available in clinical trials, for which the number of slots are limited. Dr. Raje and her collaborators are ramping up a Phase II clinical trial of CAR T-cell therapy that will test its effectiveness in a much larger group of patients.

Destined to be Together

Six years ago, Harrison was recovering from a divorce when Karen Johnson, who worked in the bakery at Market Basket, attracted his attention. “From the start, I knew we were destined to be together,” he says about the woman who is now his fiancee.

But only about eight months into their blossoming relationship, he started experiencing pain on the side of his chest. It felt like a pulled muscle — only it didn’t go away. Turns out he had MM, which was “eating” into his ribs. Two days after diagnosis, his arm snapped in half.

Referred to Mass General Cancer Center, Harrison tried what seemed like every treatment that his oncologists had in their arsenal.

They tried chemotherapy as well as immunomodulatory drugs and proteasome inhibitors, classes of drugs that have been the mainstay MM treatment for a decade. He had a stem cell transplant to replace his damaged cells with healthy ones and received a monoclonal antibody treatment as part of a clinical trial.

“I had too much to live for,” he says. “I told Dr. Raje, let’s do it, let’s keep fighting this.”

Five Grueling Years

But for five grueling years, the cancer kept coming back.

“Karen was there for me the whole time, even though she didn’t sign up for this,” he says. Karen, her three grown children and five grandchildren all became part of Harrison’s support team.

“I was hurting,” he says. “Karen even cut up my food for me.”

When Dr. Raje suggested that he might be a candidate for the CAR-T immunotherapy a year ago, he knew he was running out of options. Despite the unknowns of another experimental drug with potential side effects, “I had too much to live for,” he says. “I told Dr. Raje, let’s do it, let’s keep fighting this.”

Accepted for Experimental Trial

Thanks to her, Harrison was one of the 21 patients accepted into the Phase 1 CAR-T clinical trial.

Harrison Morrow was only a few months into his relationship with Karen Johnson, now his fiancee, when he was diagnosed with multiple myeloma. She became part of his support team.
Harrison Morrow had just begun his relationship with Karen Johnson, now his fiancee, when he was diagnosed with multiple myeloma. She became part of his support team.

After his T cells were removed, it took about a month to engineer them to program his immune system to destroy his cancer. “They hung a bag with my T cells and it only took about ten minutes to infuse them back into me,” he recalls. “Karen and I walked around Lunder 10, hoping for the best.”

He stayed in the hospital for about 11 days as his team watched him closely for side effects. When they visited him before his discharge in March 2017, their beaming faces said it all. He had no more cancer cells left — and still doesn’t.

“It has taken me months to absorb the fact that the myeloma is actually being eradicated,” he admits.

Making Future Plans Again

He is now making future plans and thinking about saving for retirement. Though he doesn’t have the stamina to return to construction work, he’s starting a job selling construction-related products. Soon he and Karen will set their wedding date.

Meanwhile, the treatment Harrison received has left him with powerful feelings of gratitude and hope. “I feel real love for Dr. Raje, the nurses on Lunder 10 and the others at Mass General Cancer Center who absolutely saved my life,” he says. “I’m totally reborn.”

For more information on cancer immunotherapy at Mass General Cancer Center, please contact us.