After Isolated Limb Infusion, People with Melanoma Get a Second Chance at Life

By Meredith Begley,

Wednesday, February 7, 2018

Summary

Behind the incredible discoveries that happen in MSK labs are the equally incredible patients who walk through our doors and bring the science to life. Here, meet three MSK patients who took part in a clinical trial led by surgeon Charlotte Ariyan for the treatment of melanoma.

Nearly every cancer treatment available today exists because of a clinical trial. These studies give experts insight into new or current therapies.

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MSK surgeon Charlotte Ariyan recently led a trial to study a combination of two treatments in people with melanoma. Each person received immunotherapy, which uses the body’s own immune system to fight off cancer, along with a specialized form of chemotherapy called isolated limb infusion. The treatment involves a high dose of chemotherapy injected directly into the arm or leg with the cancer. Unlike in other chemotherapies, the medication is prevented from spreading to the rest of the body.

After three months, 85% of the participants in Dr. Ariyan’s clinical trial had their tumors shrink as a result of the treatment. Of those who responded, more than half had a complete response —their tumors completely disappeared. Today, 58% of those people are disease free, even after they stopped receiving treatment. The findings of the lab research and phase II clinical trial were recently published in the journal Cancer Immunology Research.

Meet three people who were a part of Dr. Ariyan’s trial and learn how it changed their lives.

Bob Fontaine

After being diagnosed with advanced melanoma in 2014, the then 56-year-old from Cape Cod began winding down his small businesses. Despite several surgeries, a local hospital had given him just one year to live.

As a prostate cancer survivor, Bob knew he couldn’t accept that prognosis without exploring other options. He sought alternative treatment in Boston, and experts there told him that his only hope was Dr. Ariyan’s trial in New York. When he found out he had been accepted into the trial, he and his family could finally take a breath: There was new reason to have hope.

“No one was making any promises, but I was glad to get in because I had no other option,” he says.

After undergoing an isolated limb infusion and follow-up treatments in New York, Bob remembers exactly when he started to notice the treatment was working.

It was the best news. For this to look so dreary and then have it turn around before my eyes was unbelievable.
Bob Fontaine

“I remember lying on my couch, and my leg was itching like crazy,” he recalls. “I thought, Something’s going on. I could feel it. Something was happening.”

A few months later, when Dr. Ariyan took a biopsy of the area, there was no cancer present.

“It was the best news,” Bob says. “For this to look so dreary and then have it turn around before my eyes was unbelievable.”

Today, his scans are good, he is feeling much better, and he’s getting back to his life. He is grateful for the many people who made the clinical trial possible.

“I’d cry, hug them, and say thanks,” he remarks. “You are making a profound difference in the lives of entire families. You are actually giving people their life — what an amazing gift for mere humans to be able to give.”

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Lois Weiss

Lois, 73, had already been treated for melanoma at MSK in the late 1990s. So when the disease came back in 2010, she returned to her MSK doctors. This time, though, her melanoma presented differently, and she needed a new approach to care. Her doctor recommended her to Dr. Ariyan, who thought she would be a great candidate for the trial.

“That was the beginning of a glorious relationship,” says the former teacher from Suffern, New York. “Dr. Ariyan presented a very good case for the trial, and at that point I was committed.”

After the grandmother of five had the limb infusion, Lois began the immunotherapy medication. It caused some side effects on her skin, but MSK’s dermatology experts were able to quickly clear them up. In Lois’s next scans, Dr. Aryian didn’t find any new melanoma.

“That’s when I breathed a sigh of relief,” Lois recalls. “That’s when I felt, Wow, this is working.”

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Lois had such a good reaction, in fact, that she served as a mentor to another woman who was contemplating starting the trial. Lois emphasized MSK’s team approach to care, which she said made all the difference in her own decision-making.

“I knew that if I had a problem, there was somebody knowledgeable, caring, and interested fighting for me,” Lois says.

The woman Lois mentored ended up joining the trial, and she and Lois are now friends. Lois also stays in close touch with Dr. Ariyan, bringing her cookies every time she visits.

“She’s my hero,” says Lois, who has welcomed four more grandkids since beginning the trial. “When I got sick, I was in Florida, and Dr. Ariyan was on the phone and emailing doctors until 11 o’clock at night. Where do you find a doctor like that? She gives you the feeling that you’ve got somebody in your corner.”

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Frank Buckman

MSK patients Lois Weiss and Frank Buckman

With fair skin and bright red hair, Frank Buckman knew from a young age to be on the lookout for melanoma.

“It was something I was always so afraid of because it has such grim statistics,” says Frank, 42, an ear, nose, and throat doctor from northern Virginia.

So when he found a jelly bean–size lump on his thigh in 2014, he asked one of his medical colleagues to check it out for him. Frank drew a circle around the spot and even numbed himself so his colleague could perform a biopsy. A few days later when he found out he had melanoma, he was stunned.

“I knew enough to know that it hadn’t come from there and that it had spread there,” the father of three recalls. “I was completely resigned to the fact that I was a goner.”

After undergoing an initial surgery at a local hospital, Frank spoke with another doctor friend of his who had found Dr. Ariyan’s name after researching melanoma studies. He put the two in touch.

“MSK, in my mind, is like what the New York Yankees are to baseball,” says Frank. “Derek Jeter doesn’t just call you. But you could tell she cared.”

Frank was equally impressed when Dr. Ariyan told him about the study.

MSK, in my mind, is like what the New York Yankees are to baseball. Derek Jeter doesn't just call you. But you could tell she cared.
Frank Buckman

“I felt good about the whole leg being treated,” Frank says. “I knew the cancer wasn’t in only that one spot, and I didn’t want to just cut it out and wait for it to come back. I had confidence in the idea and in her.”

About a week later Frank had limb infusion chemotherapy at MSK. He and his wife stayed with family in Brooklyn so they could easily travel back and forth for follow-ups. Once he started the immunotherapy medication, he had some side effects, so he did not finish it. But the abbreviated course of treatment still did the trick. The next biopsy of the area showed no signs of disease.

Frank is now back to the activities he loves, like running, playing soccer, and spending time with his family. He follows up with Dr. Ariyan once a year and even takes what he’s learned from his time with her into his own practice.

“I understand the patient perspective a little better after going through this,” he says. “It’s a privilege to get back in the game and give back.”

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Comments

Thank you MSCC And Dr.Aryian for your genius work. Lois Weiss is part of my family and her courage and strength has helped everyone see that you never give up. Congratulations Dr. Aryian, a life saver!

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