In January 2019, after experiencing severe back pain for several months, Darren McLaughlin was at work when he was taken to a nearby emergency room. He was having trouble breathing and his pain was debilitating. Darren, who is chief of police in Merriam, Kansas, and his wife, Mindy, were building a new home. He chalked up the pain he’d been experiencing to the physical work he was doing moving his household.
That emergency room visit led to a diagnosis of stage 4 non-Hodgkin lymphoma, and Darren began chemotherapy treatments. By his second round of chemotherapy, his doctor recognized that the treatment wasn’t working.
“After my second round of chemo, my doctor basically told us there was nothing more they could do for me,” Darren says, “She had reached out to Dr. McGuirk at the cancer center because she knew they had more advanced forms of treatment that she thought I could benefit from.”
Joseph McGuirk, DO, director of hematologic malignancies and cellular therapeutics at The University of Kansas Cancer Center, took Darren’s case.
Because of his failure to respond to earlier treatments, Darren was a good candidate for a chimeric antigen receptor (CAR) T-cell therapy, Yescarta. It had just received limited FDA approval as a second-line treatment for the aggressive large B-cell lymphoma Darren had.
“Initially, and understandably, Darren was originally diagnosed with Burkitt lymphoma,” Dr. McGuirk says. “However, our highly specialized hematic pathologists, who focus only on these blood cancers, determined it was not Burkitt lymphoma, but that it was a high-grade B-cell lymphoma. This second-opinion diagnosis is what made Darren eligible for this treatment.”
Dr. McGuirk says that historically a patient in these circumstances had few options for treatment. Possibilities included trying to find another chemotherapy treatment or getting the patient to a stem-cell transplant, which saves about 35% of patients. New therapies, including CAR T-cell therapy, are leading to significantly higher rates of remission.
“I knew I was going to be OK when I met Dr. McGuirk the first time,” says Darren. “As passionate as he is about CAR T therapy and because of his ability to explain things, I knew right then and there that if there was anybody that could help me, it was going to be him.”
CAR T-cell therapy is a form of immunotherapy. Immunotherapies leverage knowledge of the body’s immune system and how it functions, manipulating the immune system to the advantage of the patient against their cancer. This therapy has come to the forefront as a treatment in blood cancers over the past decade. At the time Darren came into the cancer center, CAR T-cell therapy was still new.
“Based on research we had performed here and at other centers around the country, and based on the preliminary results of those studies, we felt we had a good shot here,” says Dr. McGuirk. “We needed to get Darren treated and treated quickly, because his disease was behaving very aggressively and growing rapidly.”
How CAR T therapy works
CAR T-cell therapy works by taking the patient’s blood and isolating the T-cells, which Dr. McGuirk describes as the conductor of the orchestra of the immune system. In a patient with cancer, the T-cells are dysfunctional. They should prevent cancer from forming, but for a number of complex reasons they fail to do so.
The isolated T-cells are sent to the laboratory and genetically reengineered to recognize the cancer again. They are then expanded into a billion cells, and a couple of weeks later, they are reinfused into the patient like a blood transfusion.
“The reengineered cells then sweep around the body, identify cancer cells, attach to them, punch holes in them and release molecules that go in and chop up the chromosomes inside the cell,” says Dr. McGuirk. “And that treatment demonstrated unprecedented responses and durable complete remissions like Darren achieved. This thing is in his rearview mirror and will never catch up with him again.”
Dr. McGuirk adds that there has been a paradigm shift in the years since Darren received his CAR T-cell treatment in August 2019. The treatment has moved from being used as a third- or fourth-line treatment to a front-line therapy for the highest-risk patients – those like Darren.
After his CAR T-cell therapy in August, Darren was back to work in the Merriam Police Department in September. He was named chief of police the same month. He continues to see Dr. McGuirk annually as he will for the rest of his life. Darren celebrated 5 years cancer free in June 2024.
As for what to do if you find yourself in his shoes with a diagnosis of cancer?
“Don’t ever lose hope,” Darren says. “Trust your doctors but advocate for yourself. Educate yourself about what they’re telling you.”
Dr. McGuirk agrees and recommends finding an NCI-designated comprehensive cancer center like The University of Kansas Cancer Center. It will have the most treatment options available and will also have more opportunities to participate in clinical trials.
“The therapies that we have today represent a revolution in cancer treatment,” Dr. McGuirk says.
Credit: KU Cancer Center
