Mantle cell lymphoma patient pledges $500,000 to personalized therapy clinical trial

Telltale Signs

A native of Boulder, Colorado, Wagener travels frequently as chairman of The Capital Group’s international division and has lived in Singapore. After experiencing a heart attack several years ago while in Asia, he began paying closer attention to his health. In December 2018, he realized something might be wrong when he lost his voice while attempting to speak at an outdoor event.

“We had a holiday party before Christmas, and I was a sponsor. I had to yell to be heard, and my voice went out,” Wagener says. “As January went on, it didn’t come back, and by February, I was tired and was having trouble swallowing medications.”

After returning to the U.S. from a Mumbai-to-London trip, he nearly fell asleep while driving on the freeway. One Monday in March 2019, he decided to visit an ear, nose and throat specialist before embarking on a long-planned visit with his son to the Los Angeles Dodgers’ spring training in Phoenix. A biopsy revealed MCL in his tonsils.

But the diagnosis wasn’t as simple as having the tissue removed. Because Wagener has two family members who had experienced cancer, his cardiologist researched the small community of MCL experts and contacted Wang.

“By Wednesday, I was in Houston,” Wagener says.

When other options exist closer to home, why MD Anderson?

“You figure out quickly that this is a special place,” Wagener says. “Not only the quality of the staff, which is amazing, but you also experience the significance of the research. Most important, you feel like you’re dealing with a group of people and an organization that have the best opportunity for success.”

Evolving Treatments

MCL is a subtype of B-cell lymphoma, which itself is a type of non-Hodgkin lymphoma (NHL). Of about 77,240 NHL diagnoses anticipated in the U.S. in 2020, MCL composes only about 5%. This rare cancer often develops resistance to therapy, increasing the likelihood of relapse. MATCH addresses this treatment resistance, which is key to managing its progression.

Wang is founder and director of the Mantle Cell Lymphoma Program of Excellence at MD Anderson. He also has served as coleader of the B-Cell Lymphoma Moon Shot® for five years.

“The therapy for MCL has evolved from chemotherapy to chemo-free targeted therapy and to the current era of cell and immunotherapies,” Wang says. “MD Anderson is the best example of translating the basic science and technology into patient outcomes.”

Wang led MD Anderson’s efforts on the multicenter Phase II ZUMA-2 study, in which 93% of patients responded to the chimeric antigen receptor (CAR) T cell therapy KTE-X19, with 67% achieving a complete response. CAR T cell therapy, which changes a patient’s T cells so they can recognize and attack cancer, could lead to longer periods of remission. Wagener started chemotherapy in March 2019 and missed the trial’s window of eligibility, but he stands to benefit as his treatment is modified over time. In July, the Food and Drug Administration approved KTE-X19 for relapsed MCL.

The MATCH trial will turn the spotlight on patients’ gene abnormalities to identify those that can be targeted with existing drugs and agents. Using molecular profiling to guide therapy, this approach embodies a basic tenet of precision medicine: treatment based on a patient’s genetic mutations that drive cancer progression and growth.

The outlook for such breakthroughs is promising, Wang says. “The next era will be precision medicine with genomics and personalized therapy. We need to prepare for the genomic era, the precision medicine era.”

Giving to Motivate Others

“Cancer is a life-altering experience,” Wagener says. “At the back end of that, you realize that you’re here because of the strength of the research of Dr. Wang and others. I don’t know enough about biology or cancer to be an expert. The role I play is remarkably small, but I’m grateful that we have the resources to help. I hope that others who have the wherewithal to help do so.”