Glioblastoma Patient Enjoys Steady Health and New Adventures

If you happened to be looking for Alex Epshteyn this past winter, you might have found him on the ski slopes. The Charlestown, Massachusetts resident took up the sport just two years ago and has since been enthusiastically sharpening his skills.

“I’m overcoming my fear and making progress, which is a great feeling,” Epshteyn says.

These proud statements could easily describe Epshteyn’s remarkable medical journey as well. In 2016, he was diagnosed with glioblastoma, an aggressive form of brain cancer. But thanks to his enrollment in an immunotherapy clinical trial at Dana-Farber in 2017, Epshteyn’s condition has remained stable the past four years and he has enthusiastically embraced new hobbies, adventures and relationships.

A serious situation

In the summer of 2016, life seemed to be going downhill for Epshteyn. The self-employed software developer was battling debilitating headaches and nausea for months.

“I wasn’t feeling good, I was depressed, and I couldn’t do much work,” he says.

After collapsing at his parents’ house, he was rushed by ambulance to a Boston-area hospital. An MRI detected a mass on his brain, which was surgically removed. A biopsy found glioblastoma.

“I wasn’t able to grasp the seriousness of the situation right away,” he says. “I thought, ‘OK, that explains why I was feeling so bad this summer, but they got it out now and I’m fine.’ But then I started reading more about it.”

He heard through the grapevine that Dana-Farber was conducting clinical trials for glioblastoma. He met with Patrick Wen, MD, director of the Center for Neuro-Oncology.

“He was serious and knowledgeable and showed a lot of compassion,” Epshteyn says.

At the time there, weren’t clinical trials at Dana-Farber for newly diagnosed glioblastoma patients, but Wen told Epshteyn to come see him if Epshteyn ever had a recurrence.

The right fit

Epshteyn underwent the standard course of chemotherapy and radiation, and was feeling good enough to join his friends on their annual trip to Mexico. Unfortunately, in December, an MRI showed that the glioblastoma had returned. So Epshteyn returned to Dana-Farber.

In February 2017, he entered a clinical trial for pembrolizumab, an immunotherapy PD-1 checkpoint inhibitor given by infusion every 21 days. Half of participants received their first infusion before surgery, while all the patients received it after surgery. Epshteyn was in the group that started before surgery.

“While pembrolizumab alone has limited ability to treat glioblastoma, we are confirming the encouraging results of the trial that Alex took part in suggesting that administering the drug before surgery is more effective,” Wen notes. “We are also looking at combining targeted drugs, vaccines and viruses with pembrolizumab to make it more effective.”

A new start

Recovery was a gradual process for Epshteyn. As he continued his infusions, he grappled with depression. He binge-watched Star Trek and laid low for a few months.

“At some point, though, I said, ‘I’ve been on the couch long enough. It’s time for me to start doing things again.’”

The avid traveler resumed his traditional annual trips with friends to Mexico and Montreal. He took his father with him on a whirlwind five-city tour through Spain in 2018. And he started dating.

It was his girlfriend, Briana, who introduced him to skiing in 2018.

“It has been a lot of fun,” he says. “It’s a new hobby I never thought I would have.”

This winter, though, he had to hit the slopes solo: Briana, his now-fiancé, became pregnant. Their son is due in May.

“Four years ago, I never thought I would have children or get married,” he says. ‘But as time went on, the treatment was going well and the MRIs didn’t show any changes, I got more hopeful. I resumed my normal life. And for the past several years, I’ve hardly been thinking about the cancer at all.”