Being relatively healthy her entire life, Gemma McMillan was stunned when she was diagnosed. Ironically, she had quit a 30-year smoking habit just six months earlier. While there is no way to know that smoking caused McMillan’s lung cancer, it is known as a major contributing factor to the development of the disease.

According to the National Cancer Institute, the overall five-year survival rate for lung cancer is 17 percent. The five-year survival rate for advanced stage lung cancer that has spread to other parts of the body, as in McMillan’s case, is only about four percent. More than half of all lung cancer cases (64 percent) are diagnosed at an advanced stage, which can result in treatment challenges.

After receiving her diagnosis, McMillan’s daughter Nicole, a nurse practitioner, stepped in and started inquiring about clinical trials. Joseph Aisner, M.D., codirector of the lung cancer/thoracic oncology program at Rutgers Cancer Institute of New Jersey, thought McMillan might be a good candidate for a clinical trial involving the immunotherapy drug avelumab.

Immunotherapies are a new class of drugs that harness the body’s own immune defenses to fight off disease. Dr. Aisner is the sub-investigator in a multinational, phase I clinical trial examining avelumab in patients with locally advanced solid tumors or with tumors that have spread beyond the initial tumor site. With the Cancer Institute having the second-largest patient accrual to the lung cohort with this trial, Aisner and his team have the opportunity to see how this form of immunotherapy affects lung cancer patients.

Instead of focusing on standard lung cancer treatments, including platinum-based chemotherapy, Aisner recommended an avelumab regimen to McMillan. She had never heard of immunotherapy before. “I said, ‘why not?’” remembered McMillan. “I had full faith in Dr. Aisner.” Dr. Aisner also explained the minimal side effects associated with this particular drug.

McMillan received an avelumab infusion every two weeks with testing every six weeks to check her progress. By the fourth dose, she was back to gardening. Aisner was elated with the response. “Each time we did a CT scan, the tumors on her buttock and lung got progressively smaller, and the masses in her lymph nodes disappeared,” he said.

In March 2016, McMillan was told her tumors had disappeared. She has not experienced any side effects up until this point. McMillan will continue to receive the treatment through the spring of 2017. As far as the effect of the therapy beyond the end of her participation in the trial, Aisner said there is no firm answer. “We are now starting to see study results on those patients who completed similar treatment. Some patients, who after two years of completing therapy, show no signs of recurrence. And there are some four years post treatment that have not experienced a recurrence,” he noted.

McMillan encourages others to inquire about clinical trials. “All results are not the same for everyone, but if there is a clinical trial, don’t turn it down. It’s a chance,” she shared.


This Rutgers Health article is an edited version of a story that first appeared in the Summer 2016 edition of Rutgers Cancer Institute of New Jersey's Cancer Connection. [Read the full story]