Rebecca A. Gardner, MD is an Assistant Professor at the University of Washington and Attending Physician at Seattle Children’s Hospital. She received a 2013 Conquer Cancer Foundation of ASCO Career Development Award (CDA) for her project “Autologous T cells genetically modified to express a CD19 specific chimeric antigen receptor to treat pediatric relapsed acute lymphoblastic leukemia.” She was also named Geek of the Year in 2012 by GeekWire, an independent technology news site based in Seattle, Washington. Read more about Dr. Gardner’s Geek of the Year award at www.geekwire.com/2012/geek-week-dr-rebecca-gardner-reprogramming-cancer/.
ASCO recently spoke with Dr. Gardner about the impact of the Career Development Award on her research.
Career Development Award
What is the focus of your research?
The focus of my research is developing clinical trials where we use T-cell therapy to treat pediatric leukemia.
Describe your 2013 Career Development Award (CDA) research project.
The CDA provides support for me to conduct two clinical trials for patients with recurrent acute lymphoblastic leukemia (ALL). The first trial is for patients who have recurrent disease and have never made it to a stem cell transplant and the second trial is for patients whose disease recurs after their stem cell transplant.
Does your research have any direct or future impact on patient care?
The really exciting thing about this research is that it has direct impact on patient care right now! We’re taking patients who have no other treatment options and offering them a chance at a new therapy. Our preliminary results are very promising. Several patients who are refractory to other therapies have gone into remission after they received the T cells. When we look ahead, I think this research is going to change the way we treat not only leukemia but also other types of cancer. I really hope we’re able to make this paradigm shift where we rely less on chemotherapy and radiation and more on targeted therapy.
What impact did your grant have on your career and your ability to pursue your research?
It’s very important! Basically the CDA grant allows me to have protected time to actually be doing this research which otherwise would be very difficult to find the time to do. It allows me to focus my professional effort on taking care of the patients on these clinical trials.
Adoptive T-Cell Therapy
What is the purpose of T cells and how does modifying these T cells to express a chimeric antigen receptor (CAR) help patients with ALL?
T cells are one of the more important types of cells in your immune system. We extract the T cells from the patient, modify them in the lab with a gene to express this new type of receptor, then we then grow the cells in the lab, and finally, reinfuse the T cells back into the patient. T cells are a “living therapy” so once you modify the T cells and give them back to the patient, they should be capable of reproducing. After you give one dose of T cells, hopefully those T cells get rid of the cancer cells that are present at that time and also stick around to survey and prevent a recurrence if the leukemia were to come back.
Are there any negative side effects of adoptive T-cell therapy?
The most common negative side effects are typical of those seen with a cold or flu virus, such as fever, body aches, and chills. The patients typically recover within a few days. We’re not sure about long-term effects of T-cell therapy yet.
How do you determine if the treatment is successful?
We monitor patients by their peripheral blood and bone marrow to see if we can (1) detect the T cells that we gave the patient and (2) detect the presence of any remaining leukemia cells. The measures of success include being able to make a T-cell product for a patient, being able to detect the T cells in the patient after we infuse them, and then hopefully having patients go into remission.
Learning From Young Patients
How does helping children with cancer motivate you?
Children don’t complain. One minute they feel really awful from chemotherapy or their treatment and the next minute they’re like “Hey, I’m going to go ride my bike.” It’s that resilient spirit that they have that really motivates me to keep doing this. And I think everyone in pediatric oncology is here because we don’t want to see kids diagnosed with or suffering from cancer.
What’s the most extraordinary response you’ve seen in your years as a pediatric oncologist?
This clinical study that I’m doing has led to the most impactful moment that I’ve had in my career so far. The first patient that enrolled on our study had refractory leukemia and wasn’t responsive to chemotherapy. We gave her the T-cell therapy and a week later we couldn’t find any detectable leukemia at all. To me that was like “Wow!” You do all this planning and you have these ideas about how things are going to work, but you don’t know it’s going to work until you try it. And then you try it and it works beyond your best expectations. It’s just really amazing! She is 9 months out from therapy now and still disease-free.
Watching children in this realm, what have they taught you?
It puts life in perspective. When bad things happen, you have to ask yourself, “Is it really that bad or is it just an annoyance?” Watching families with a child who has cancer, it makes you really grateful for everything you have in your own life.
Message to Donors
Why should people donate to the Conquer Cancer Foundation Grants and Awards program to support programs like the CDA?
Research funding right now is so tight, and one of the things that moves the oncology field forward is research and innovation. The Conquer Cancer Foundation Grants and Awards program, particularly the CDA, really enables young investigators to have that protected time to jumpstart their career. Without young investigators getting into research, it’s really hard to move research, diagnosis, and
therapies forward.
Is there any message you’d like to pass on to our donors?
It’s always important to know when you’re donating your money that it is making a difference and that it is being used wisely. You want to make sure it is going to something meaningful. The Conquer Cancer Foundation Grants and Awards program is really meaningful in terms of allowing physicians to do impactful
research. ■
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