Immunotherapy clinical trial gives hope to leukemia, melanoma survivor

An acute myeloid leukemia diagnosis (AML) in May 2016 came as no real surprise to Julia Dutton. She’d been fighting debilitating fatigue for a couple of weeks. Then her gums became so painful and swollen, “they felt like balloons and looked like if you stuck them with a pin, they’d pop,” Julia says.

Thinking she had a gum infection, Julia went to her dentist for a teeth cleaning. That brought no relief. When her vision became blurry, too, Julia went to an urgent care clinic, where she learned that her hemoglobin counts were very low. The doctor said she probably had cancer.

“I felt so bad that day that it really was no surprise,” Julia says. “I’ve always been a real active person, but I was out of breath just walking up the stairs. I was so tired I couldn’t even function.”

Choosing a clinical trial at MD Anderson

Within three days of her diagnosis, Julia had her first appointment at MD Anderson. “My sister had been there in 2014,” she says. “So I knew that’s where I wanted to be.”

During her first visit, Julia met with Alessandra Ferrajoli, M.D., who confirmed her acute myeloid leukemia diagnosis with a bone marrow biopsy. Ferrajoli asked Julia to consider a Phase I/Phase II clinical trial under Farhad Ravandi-Kashani, M.D. It involved an immunotherapy drug, nivolumab.

“At the time, I didn’t know anything about immunotherapy,” Julia says. “But I called a doctor friend of mine, and he said, ‘Oh, yeah. You want to be on it.’ So I joined. Once I read up about immunotherapy, I was all over it.”

Pneumonia treatment reveals undiagnosed melanoma

Julia began receiving nivolumab intravenously in June. She also got the chemotherapy drugs idarubicin and cytarabine to prepare her body for a stem cell transplant. But before she could have the procedure, Julia spiked a fever. Doctors discovered she had pneumonia and ordered a CT scan to determine its severity. That’s when they noticed the spot on her left lung.

“I thought, ‘There is no way I could have two cancers. There is just no way,’” Julia says. But a biopsy showed otherwise: it was stage IV melanoma.

Accepting hair loss solves mystery

Because melanoma is a skin disease, doctors knew that it did not originate in Julia’s lungs. But determining its primary location proved challenging. “They looked all over my body — even in between my toes,” Julia says. They finally found the answer when Julia shaved her head: a tiny spot on her scalp.

“The dermatologist described it as ‘very unremarkable’ when he removed it,” Julia says. “It did not go very deep and only took three stitches to close.”

Immunotherapy drug targets both leukemia and melanoma

A stem cell transplant was off the table until the melanoma was completely gone, so Julia began receiving radiation therapy under Steven Lin, M.D., to treat the spot on her lung.

As luck would have it, the clinical trial drug she was on for leukemia was the same one Hussein Tawbi, M.D., Ph.D., would have prescribed for melanoma. “So the immunotherapy drug was working on both types of cancer,” Julia says. “The melanoma in my lung was 1.3 cm long when they found it, but by the time I got to see Dr. Lin, it was only .7 cm. After I started radiation, it went down to .4 cm in just one week.”

Advice for others considering clinical trials

Julia finished her chemotherapy and radiation treatments in October 2016, although she continues taking nivolumab today. She never did undergo a stem cell transplant, although she did have a Gamma Knife® procedure under Ian McCutcheon, M.D., and Erik Sulman, M.D., Ph.D., in March 2017, after an MRI revealed a tiny spot of melanoma on her brain.

Today, Julia is in remission. She tells everyone she knows to get to MD Anderson if they have cancer — and most importantly, to consider clinical trials if they’re ever offered.

“I had a really good result on my clinical trial and could not be happier with the care I received,” Julia says. “Look at the rewards versus the risks and the long term. It’s definitely worth talking to your doctor about.”

Request an appointment at MD Anderson online or by calling 1-877-632-6789.