Genomic Testing Reveals New Treatment for Patient’s Rare Cancer

New Immunotherapy  OSUCCC  James

In 2013, a screening colonoscopy resulted in Clara Whitaker, now 78, of Cincinnati, being diagnosed with stage IV colorectal cancer.

Although colorectal cancer is the fourth most common cancer diagnosis, Clara had a rare cancer type called neuroendocrine rectal cancer. This led to a period of her going in and out of intense treatments: surgery and combination chemotherapy/radiation therapy followed by a second round of chemotherapy/radiation therapy after a recurrence.

In 2017, her cancer spread aggressively, resulting in a 9-centimeter mass in her neck and additional tumors in her cervix and lung.

“My daughter, who is a nurse, encouraged me to get a second opinion at Ohio State because the care I was receiving locally was not working for my cancer. The treatments left me so tired I didn’t have the energy to do much but lie on the couch,” Clara recalls.

Clara was referred to Sameek Roychowdhury, MD, PhD, and the Precision Cancer Medicine Clinic at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) to discuss additional treatment options.

Genomic testing at the OSUCCC – James showed that her tumor had unique characteristics that made her a candidate for a newer immunotherapy drug called nivolumab (marketed as Opdivo). The drug has been shown to improve survival for patients with recurrent and metastatic head and neck cancer.

“Fortunately, novel gene testing of Clara’s cancer enabled her to receive a therapy to effectively boost her immune system against her cancer. We hope that more patients with rare cancers can benefit like Clara,” says Roychowdhury. “Most people do not know that up to 15 percent of cancer diagnoses are considered rare. That’s more than 200,000 patients per year. We hope that more resources can be devoted to understand these rare cancers.”

Clara has been receiving nivolumab treatment since September 2017, and her tumors have nearly disappeared. She will continue treatment for up to 18 months as long as the tumors continue to respond to therapy.

“After 12 weeks of therapy, I looked at Clara’s CT scan and I did a double-take. I thought I was looking at the wrong patient’s CT scan images because I could not believe how much the tumors had shrunk. I walked into the exam room and asked if this was indeed Mrs. Clara Whitaker!” says Roychowdhury.

Clara says she has energy and is able to do the things she wants to do, for which she is very grateful. 

“I see such a difference in her on this drug. She has energy to enjoy life again. The drive to Columbus every few weeks is worth it for her improved quality of life,” says her husband of 55 years, Shelby.

They are eager to encourage others to seek second opinions and clinical trial options. For now, they are focused on enjoying day-to-day life together and time with their six children.

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