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The letdowns

Over the next couple of years, David went through multiple rounds of chemotherapy, 3 episodes of radiation, and 4 lumbar punctures before his doctor gave him the news of being in “full metabolic remission.”

I’d cycle between sick days and sicker days, I couldn’t even walk around the block or up the stairs because I was so weak. So, when my doctor told me the news, I didn’t really know what it meant. All I heard was ‘full’ and ‘remission.’ I was thrilled.

Unfortunately, that feeling didn’t last long. After receiving a bone marrow biopsy, he quickly deflated after hearing the results—he still had cancer in his marrow.

Determined not to fall prey to a negative mindset, David looked for next steps. “I was always committed to pressing on. I prayed for the strength to keep going,” he says.

An allogeneic stem cell transplant was David’s next option. “We couldn’t find a donor right away,” says David, “so I was on maintenance medications to help me tread water while a transplant could be lined up.”

After months of waiting, a donor was finally found, and the transplant was scheduled. Two weeks out from the procedure, David went in for a scan, which revealed 2 new tumors. The location of the tumors proved to be an obstacle for the transplant to move forward. David could no longer go through with the procedure.

I was too diseased. Finding out that the transplant fell through, well, it was some of the worst news of my life.

The knocks kept coming

When I couldn’t get the transplant because of the tumors, I didn’t know what my options were. Where could I turn? I was scared and at one of my lowest points.

The only option remaining was to use radiation in an attempt to reduce the tumors enough for an autologous transplant, a procedure David’s doctors warned was risky. David agreed to the plan and, once recovered enough, was finally able to get his stem cell transplant. After spending 28 days in the hospital and weeks of hoping for positive results, David had reached remission.

I was hoping that would be the end of my treatment. But, after a couple of months, the transplant failed—I started to feel the tumors coming back in my armpits, and knew that couldn’t be good news.

Feeling like he already knew what was going on, David went in for a scan. Sure enough, he was right. “My cancer was stronger than I gave it credit for.”

David’s doctors were at a point where they didn’t have a clear treatment direction left for him. “David was pretty much out of options. He’d been given about 6 months to live if he didn’t have another treatment,” says Audrey, David’s wife. His doctor gave him the option of foregoing further treatment, conceding to the cancer, and living his remaining days as comfortably as possible. “Conceding” was not in David’s vocabulary. He told his doctor that he still had too much to live for and would continue the fight.

Never give up

I wanted to keep fighting. It was fear of dying, but it was also a renewal of faith and confidence. I was 58 years old and my kids were still in high school. There was no way I was going to give up when there was still too much to do in my life.

Because David had received at least 2 previous treatments that didn't work or stopped working, the doctor called David and told him about a clinical trial for CAR T cell therapy, now known as Breyanzi. David was very interested in learning more. They went over the procedure and talked about potential serious side effects of Breyanzi that can be life-threatening and can lead to death, such as cytokine release syndrome and neurologic toxicity, as well as other common side effects including fever, low white or red blood cells, severe diarrhea, or severe nausea.

With few options remaining, David believed that Breyanzi would be right for him. “I promised to try everything possible, and while I understood the risks, the alternative was giving in to cancer in palliative care.”

When the doctor called and told David that he was accepted into the clinical trial for Breyanzi, we were incredibly excited to get started. He was running out of options, and we really felt like CAR T cell therapy was the right choice for David.

—Audrey, wife and care partner

About 4 weeks after apheresis, David received his Breyanzi cells and found that the day of infusion wasn’t as long as he thought it would be. “Two vials in, and then I was sent to recover,” says David. After getting a low-grade fever, David was admitted to the hospital for almost a week to be treated for cytokine release syndrome. Side effects like cytokine release syndrome and neurologic toxicity can be life-threatening and can lead to death. Because of the risk of cytokine release syndrome, neurologic toxicity, and other side effects, patients like David must remain at, or close to, where they received treatment for at least 4 weeks after the infusion for side effect monitoring.

A few weeks later, when it came time to receive his scans, David’s results came back clean. “At the first clean scan at the end of 1 month, my doctor told me there were too little data to form any clear conclusions,” David said. After the second clean scan another month later, David asked the doctor what that meant. David said that his doctor responded, “Well, 2 clean scans are better than 1!”

David was getting better as 2 clean scans turned to 3, then 4, and his scans continued to remain clear.

I was overjoyed once David went into remission again because we had been given a pretty dire prognosis before that, and the fact that he had repeated clean scans was amazing.

—Audrey, wife and care partner

While David’s scans were clean, they do not mean he’s cancer-free. David continues to be monitored for possible disease recurrence and long-term side effects from CAR T cell therapy.

Life as we know it

David believes that his faith had a part to do with his recovery. It instilled confidence in him, and that confidence was shown to his doctors and those around him. There was a commitment to keep fighting.

David is going to ball games and traveling with his family on vacations. “I felt better after the infusion,” he says.

I feel indebted to Bristol Myers Squibb because
CAR T cell therapy is why I’m here today, living day to day.

If there is one thing David wants others to know, it’s to commit yourself to pursue every reasonable opportunity to get better.

Hopefully it never gets so bad that you lose all hope. Have confidence in your doctors, in your treatment plan, and in yourself.