Carol Roth speaks with the cheerful confidence of someone at peace. She loves her family, friends, and a job that keeps her traveling. And while treatment for her stage IV glioblastoma also fills her datebook, with help from Dana-Farber, she’s keeping it from becoming a defining part of her life.
Roth, who lives in Charlotte, North Carolina, flies to Boston every two weeks as part of an immunotherapy clinical trial. Initially told in mid-2016 that her cancer was terminal, she has experienced tremendous improvement in her condition since starting the trial ten months ago under the care of David Reardon, MD, clinical director of the Center for Neuro-Oncology at Dana-Farber. One tumor has disappeared entirely, while the other has been reduced by almost 90 percent.
Now, she is back to her full-time position as director of individual giving for the National Multiple Sclerosis Society – crisscrossing five southern states and Washington, D.C – while fitting in her Boston trips for infusions and MRIs around her work schedule.
“There is no time to be sick,” says Roth with the laugh that punctuates many of her conversations. “I deal with brain cancer the same way I would a broken arm. I just continue with my life and try not to let it interfere.”
She says she has always been an upbeat person, but Roth admits she was scared when she began having trouble moving the toes on her right foot in late 2015. When the mobility issues extended to her right arm she feared she might be experiencing a stroke or multiple sclerosis – which, she knew from her job, often displayed similar early symptoms. An MRI ruled both out, but revealed a tumor in her brain.
After surgery in North Carolina, and seven weeks of intensive chemotherapy and radiation, the tumor grew back, as did another. Roth’s oncologist Daniel Haggstrom, MD, knew Reardon and Dana-Farber’s work in immunotherapy, and reached out. Reardon met with Roth, and put her on a clinical trial that combines an immune checkpoint inhibitor – a drug, usually an antibody, that helps expose hidden cancer cells to the immune system – with an FDA-approved antiangiogenic drug called Avastin.
“The rationale for putting these two drugs together is fairly compelling, as is the rationale for many of the combinations that are now being studied and turning into clinical trials for patients,” says Reardon. “When we carefully block the mediator of blood flow into the tumor, it can actually enhance the immune system’s ability to get into the tumor and attack it successfully. It’s been demonstrated through ongoing research that this combination can potentially synergize if used properly, and this trial translates that laboratory research into the clinic for patients. Although not all patients are responding, results among others, like Carol, are encouraging.”
Given her remarkable response to this two-drug attack, Reardon says it is likely that Roth will be able to stay on the treatment even after the trial ends. Her cancer, she knows, is not cured. The future is still uncertain, and she will be continuing to meet with Reardon and nurse practitioner Jennifer Stefanik, RN, ANP. But she’s in control, and for Roth that’s all that matters.
Asked if Reardon has put any restrictions on how much she travels for work or pleasure – she has family in Vancouver – Roth laughs again. “He tries,” she says, “but he knows I won’t listen other than to take the occasional break each day.”
She prefers to keep moving.