Joyce Charpentier’s annual checkup was uneventful, but a standard blood test revealed a low blood count. Then a colonoscopy detected a potential problem. Despite having no symptoms, Ms. Charpentier was diagnosed with stage IV colon cancer. After responding poorly to standard therapy, she was able to participate in a clinical trial and received advanced combination therapy. She is healthy and cancer-free today.
As the Leominster resident would find out, her particular cancer was unique, and her reaction to standard treatment was atypical.
“My primary care physician referred me to the Mass General Cancer Center, where I met Dr. Murphy,” she recalls. “She told me I could continue seeing her at Emerson, which meant I would have Mass General-level treatment with an easy commute.”
Janet Murphy, MD, MPH, a medical oncologist who specializes in gastrointestinal cancer and who also practices at the Mass General Cancer Center at Emerson Hospital – Bethke, had an immediate concern. “Joyce’s cancer had spread into her abdominal cavity, and the tumor was highly vascularized — the reason she was bleeding,” Dr. Murphy explains. “The plan was to stabilize her and then start chemotherapy.”
A short course of radiation was successful in stopping the internal bleeding, and Ms. Charpentier began chemotherapy that was intended to halt her aggressive colon cancer. She felt fine for the first month. “Then I had a sudden reaction: I couldn’t eat, and my white blood cell count dropped,” she says.
“Joyce did not tolerate the treatment,” says Dr. Murphy. “She developed chronic nausea, began losing weight and had no energy. Today I can often give patients with stage IV colon cancer good news about their response to treatment, but that wasn’t true for Joyce.”
Ms. Charpentier’s weight plummeted to 93 pounds, and she became so weak that she couldn’t turn over in bed without the help of family. “I told Dr. Murphy that all I wanted was to get to my son’s wedding,” she says. She was able to attend the wedding, but the following months were tough.
Somehow, Ms. Charpentier continued to function in her job as a human resources manager. “I needed to stay busy just to have some sense that things were normal,” she says. “But there were days when I drove to work and couldn’t get out of the car. Eventually, I mostly worked from home.”
Once on a clinical trial, a fast response
Dr. Murphy kept a close watch on Ms. Charpentier. “The bleeding had delayed the start of her chemotherapy, and then she did not respond to treatment. I wanted Joyce to catch a break.”
It came in the form of a clinical trial at the Mass General Cancer Center being overseen by Theodore Hong, MD, director of the gastrointestinal service in radiation oncology. Dr. Hong studies the potential impact of combining radiation with targeted drugs, such as immunotherapy — treatment that uses components of an individual’s immune system to fight cancer — on long-term survival and cure rates.
“Over the past couple of years, we have rapidly expanded our clinical trials portfolio that combines radiation with immune checkpoint inhibitors,” Dr. Hong notes.
“We have not found a way to harness the potential of immunotherapy in most individuals with colon cancer,” Dr. Murphy explains. “But Joyce has a unique genetic mutation, known as microsatellite instability, that strongly increased the odds of her responding to the potent combination of immunotherapy drugs in Dr. Hong’s clinical trial.” This was good news. Ms. Charpentier would receive two different immunotherapy drugs — typically used to treat melanoma — plus radiation.
“Joyce was in the system, we had tested her tumor’s DNA, and she was able to begin Dr. Hong’s trial at Mass General immediately,” Dr. Murphy notes. “That is the beauty of having the Mass General Cancer Center at Emerson Hospital.”
Ms. Charpentier couldn’t believe how quickly she responded to the aggressive treatment. “A couple of weeks after starting the clinical trial, and after not being able to eat for months, I realized I was hungry,” she says. “From there, I really bounced back.” Her strength returned, and she realized she had regained her health. Before long, she was heading off on a trip to Florida with her sister and daughter.
“There is no trace of cancer in me now,” she says. “It scares me to think about where I was, but today I feel better than I’ve ever felt. I’m working full-time, I reached my normal weight, I’m taking yoga and pilates classes and booking trips. I’m back.”
By participating in a clinical trial, Ms. Charpentier is helping to clarify the combination therapy that Dr. Hong is committed to studying. She is grateful that she had access to a clinical trial for which she qualified — and that rescued her from dire circumstances. “I feel like I’m not doing enough,” she says. “Shouldn’t everyone have the opportunity to be connected with a clinical trial that will work? What happens to people who don’t have a Dr. Murphy?”
Dr. Murphy is pleased that, despite a difficult start, Ms. Charpentier received the exact treatment she needed. “Joyce’s story is a phenomenal example of someone having success with a novel therapy,” says Dr. Murphy. “It couldn’t happen to a better person.”