Four afternoons a week, Louise Hubbard’s smiling face is a welcome fixture at the Nantucket Bake Shop. The island native works there alongside her daughter, who owns the shop, and granddaughter, greeting customers and selling a variety of cakes, pies, breads and donuts. She’s thankful for every one of those afternoons — even more so after her April 2019 diagnosis of multiple myeloma. Her cancer, which forms in plasma cells, was particularly aggressive, and Louise progressed through various standard treatments. Unfortunately none of the options presented a cure.
But thanks to a first-of-its-kind chimeric antigen receptor (CAR) T-cell therapy — the collection of white blood cells from a patient, altering them in a lab to find and destroy cancer cells, and infusing the T-cells back into the patient’s blood — developed in-house at Massachusetts General Hospital, she found what she calls “a miracle” three years after her diagnosis.
Just before Louise’s procedure at Mass General, her youngest daughter held the vial of Louise’s T-cells as a hospital chaplain performed a blessing. “The blessing was so beautiful, it put tears in my eyes,” says Louise, a mother of six, foster mother to three, grandmother of 10 and great-grandmother to seven children so far. The devout Catholic is now cancer-free and celebrated with a gluten-free lemon pie on her 79th birthday. “I get up every morning and I thank God that I’m here,” she adds.
From Curveballs to a Home Run
A bone marrow biopsy in the spring of 2019 revealed that Louise had multiple myeloma; she got the call while she was on the ferry back to Nantucket following a visit with her eye doctor on the mainland. Louise was treated with various chemotherapy injections and pills after that diagnosis, and she went into remission in early 2020.
But, just a few months later, life threw her a number of curveballs. In April 2020, her husband — in Louise’s words, “my partner, a blessing in my life who showed me unconditional love” — died of a stroke. Two weeks later, Louise’s oldest daughter died in her sleep. And then her cancer came back with a vengeance in the midst of the COVID-19 pandemic.
“The doctors said they didn’t know if they would ever get me back into remission,” Louise says. “I told them, ‘I will go back into remission.’ I had a mission. I had to get up every morning and I had to get through.”
Timing Is Everything
Her biweekly chemotherapy regimen resumed, which fortunately she could receive close to home at Nantucket Cottage Hospital, a Mass General Brigham hospital. Nantucket Cottage Hospital provides cancer services from Mass General clinicians like Andrew Branagan, MD, PhD, and an infusion room thanks in part to support through Mass General’s annual Swim Across America fundraiser.
Those chemotherapy treatments readied her for the CAR T-cell trial, which took place in April 2022. Dr. Branagan was able to take advantage of a therapy invented by Marcela Maus, MD, PhD, Director of the Cellular Immunotherapy Therapy program at Mass General, and developed in close collaboration with Matthew Frigault, MD, Administrative Director of Mass General’s Cellular Therapy Service.
“Our mission in the Cellular Therapy Service is to invent, develop, administer and understand these immune effector cells,” Dr. Frigault says. “CAR T-cell therapies are giving us new options for patients like Louise who have run out of standard options, and I’m thrilled this homegrown CAR was able to step in and treat her multiple myeloma where other therapies hadn’t.”
“It was really good timing that this therapy was available,” Dr. Branagan says. “Chances are she wouldn’t be alive if we didn’t have CAR T-cell options.”
Living the Island Life
To recover from the CAR T-cell procedure, Louise had to spend seven weeks near Mass General in Boston, a tall order for someone who lives year-round on the island. But her family came through: from their homes scattered across the East Coast, they convened via Zoom and every member picked days on the calendar to provide Louise with 24-hour care. She stayed in her sister-in-law’s condo with her children, grandchildren and foster children taking rotations.
“It’s incredibly hard to do a clinical trial from Nantucket,” Dr. Branagan says. “Doing a CAR T-cell procedure means you need close follow-up and have to stay locally, so we work to find ways to make it easier for patients to get into trials. Louise is so well-loved on the island that she was able to get into this trial quickly and safely, thanks to her strong support.”
Home and Keeping Active
Louise returned to her Nantucket home on May 26, 2022, and continues to live every day to the fullest. “Mass General has treated me so wonderfully,” she says. “The nurses were incredible and were key instruments in my healing, and Dr. Branagan has been my lifesaver. He told me the key was to get out there and walk as much as I can, so every day, I walk.”
She has a new companion on those Nantucket beach walks: a mini poodle named Sammy, who has been by her side for almost a year. She plans to participate in Swim Across America this year to share her experience and raise funds for future research and treatments.
“Myeloma is not curable, and most people ultimately succumb to the disease. We get better treatments, but the illness keeps mutating and progressing, and when we run out of options, there’s very little to do,” Dr. Branagan says. “CAR T-cell is a whole different frontier of gene therapy, and it’s changed the landscape of multiple myeloma. We’re getting responses unheard of for patients so far along in treatment, and it gives us hope that people can live with this disease for longer — and maybe even have a cure.”
If you would like to learn more about CAR T-cell therapies at Mass General, please contact us.
Mass General has treated me so wonderfully. The nurses were incredible and were key instruments in my healing, and Dr. Branagan has been my lifesaver.
