When she was 20, Stephanie Lipscomb started experiencing the blinding headaches. Doctors initially diagnosed her with a sinus infection and sent her home with antibiotics. When that didn’t work, they diagnosed her with migraines and gave her caffeine pills. But the headaches got more severe.
“I couldn’t bathe myself, dress myself,” Lipscomb says. “All I could do was just lay there in pain.”
When she lost 15 pounds, she finally checked herself into the emergency room. After an MRI, doctors found a mass the size of a tennis ball. They operated almost immediately. A biopsy of the tumor confirmed everyone’s worst fears: it was malignant.
Lipscomb’s brain tumor was a particularly vicious type. The normal way to treat such tumors is surgery followed by radiation and chemotherapy. These strategies delay tumor regrowth, but tumors tend to return in most patients. When they do, they kill 100 percent of patients, often destroying a patient’s personality in the process. For more than a year, Lipscomb and her doctors hoped for the best. But in June 2012, an MRI confirmed that the tumor was back.
The average survival for a patient whose brain tumor returns is just 22 weeks. Time enough to say goodbye to friends and family, but not much more. But unbeknownst to Lipscomb, her decision to seek cancer treatment at Duke University would make her the pioneer in a revolutionary new approach towards fighting brain tumors. Her options limited, Duke researchers enrolled Lipscomb in a clinical study that would use one deadly disease to fight another. That disease was the Polio virus.
The researcher who developed the idea is Matthias Gromeier, a researcher at Duke who had spent the past 15 years studying the unique characteristics of the Polio virus. Gromeier grew more interested in Polio, a disease that was particularly attracted to tumor cells.
“We discovered that the Polio virus receptor is actually abnormally expressed in most cancers, which is the reason why the Polio virus naturally likes to infect cancer cells,” Gromeier says. “And when that happens, it kills them.”
Gromeier had discovered a natural enemy of cancer. Now, Gromeier and his team at Preston Robert Tisch Brain Tumor Center at Duke had to figure out how to harness the virus’ lethality without killing off their patients. To make the therapy safer, they used a weakened vaccine form of Polio and used recombinant DNA techniques to combine it with a rhinovirus. Animal tests showed remarkable results and a solid record of safety. Before 100 million Polio virus particles were injected directly into Lipscomb’s brain in May 2012, it is worth nothing that the therapy had never been tried on a human.
Kelli Lusk, Lipscomb’s mom, needed to be convinced.
“Polio kills, you know,” Lusk says. “I didn’t think that was a good idea.”
Lipscomb vividly remembers her mother’s reaction: “She was like, ‘What?! You’re putting Polio in my daughter’s brain? Are you serious?’”
Compared to the many long weeks required for conventional radiation and chemotherapy, the treatment itself was amazingly fast. Before the surgery, Duke Neurosurgeon John Sampson used computer models of Lipscomb’s brain to determine where to infuse the virus. Six hours after a catheter was first placed into Lipscomb’s brain, the procedure was finished.
In the months after the infusion, Lipscomb’s tumor seemed to be growing. It was all her oncologist, Annick Desjardins, could do to keep from reaching for her traditional tool chest of radiation and chemotherapy.
“As a neuro-oncologist who deals with this cancer which is very aggressive and can really hurt my patients, when I was seeing the tumor growing, it was really scary for me to sit back and have faith that the polio virus will be working,” she says.
Desjardins ordered a PET scan, an imaging technique that could differentiate between living and dead cells. That scan told an incredible story. The growth was actually an increase in dead tumor cells killed off by the Polio virus, which was an inflammatory response. Lipscomb’s immune system now appeared to recognize the invading tumor, and was complementing the Polio virus with an attack of its own.
“The Polio virus is like the spark that unmasks the tumor to the body’s own immune system,” Gromeier says.
Nine months after treatment, Lipscomb’s doctors could tell for sure that the tumor was responding.
Lusk remains nervous whenever Lipscomb returns to Duke for tests, even as her daughter's health improves. When Lipscomb went in for her 14-month checkup last July, doctors again gave her a clean bill of health. The tumor continues to shrink. Lipscomb has now survived cancer for a year and a half, four times longer than most people with her type of tumor.
Still, Gromeier remains cautious.
“This is a diabolical disease,” he says.
He expects to monitor Stephanie for many years before he is confident his technique is a permanent cure. “Fighting brain tumors, it is foolish to ever feel victorious or feel like you have beaten it. We always have to keep our guard up and be conscientious of how difficult the challenge we are facing is. ”
Of the seven others who later enrolled in Desjardins' clinical trial, one patient responded like Lipscomb. Two patients, whose immune systems were already severely damaged, did not. It’s too early to tell with the remaining three patients, but animal studies suggest that once the body recognizes and destroys the tumor, it won’t return. If those results hold up, researchers hope to apply the same technique to a whole range of other cancers, including melanoma and prostate cancer.
As for Lipscomb, she’s just happy to be alive.
“I survived cancer,” she says. “I’m a cancer survivor. Not only just cancer, but brain cancer. And people actually look up to me. And I’ve grown so much...and realized I can go through anything if I can beat cancer.”