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One Year Research Update:
Chrystal Louis, MD, at Baylor College of Medicine, studies new treatments for nasopharyngeal carcinoma (NPC), a rare metastatic solid tumor that forms in the head and neck. The current treatment for NPC is intensive radiation and chemotherapy, which leads to debilitating long-term side effects like deafness and chronic dry mouth. Dr. Louis's research examines a new treatment protocol that includes cellular immunotherapy specific to the Epstein-Barre Virus (EBV), which is associated with the development of NPC.
As a CureSearch Young Investigator, Dr. Louis has developed a Phase II clinical trial studying the impact of including cellular immunotherapy in treating patients with NPC. Her research builds on a Phase I clinical trial with a smaller number of patients. The Phase I trial showed promising results in using cellular immunotherapy to treat patients with NPC. Other kinds of immunotherapy have been used to treat tumors, but this cellular immunotherapy, called EBV-CTL, specifically targets EBV. When patients received EBV-CTL, they needed less radiation and chemotherapy to achieve remission and saw significantly reduced tumor growth and improved overall survival rates. In addition, these patients had far fewer side effects compared to standard treatments. The first phase of the trial showed that patients had almost no dose-limiting toxicities, meaning all the patients in the study could tolerate the treatment without serious complications. Dr. Louis has used the first year of funding from CureSearch to design a protocol for a Phase II trial, which will expand the study of EBV-CTL to a larger group of patients. During this time, she has also been able to apply for several other grants and awards to pursue this research.
In her progress report to CureSearch, Dr. Louis reports that cellular immunotherapy has previously been considered a "boutique agent" only offered by select hospitals. Dr. Louis hopes that her Phase II trial will show that it is feasible to provide EBV-CTL to patients all over the country. Expanding access to cellular immunotherapy can improve progress for NPC patients, and it has potential to impact other cancers, especially other metastatic solid tumors. The results of Dr. Louis's initial studies have enabled her to design a well-reviewed Phase II clinical trial that she expects to open for patients in the next year.
CureSearch is pleased to provide these initial results, and looks forward to sharing updates on Dr. Louis's continued research.
Nasopharyngeal carcinoma (NPC) is the most common cancer originating in the nasopharynx, the area behind the nose where the nasal passages and auditory tubes join the remainder of the upper respiratory tract. It is known that the majority of cases are associated with Epstein-Barr virus (EBV), one of the most common human viruses, most notably known as the cause of mono. While not continuing to make a person sick, once contracted, EBV always lives in a person’s body. In some cases, EBV can lead to cancers like NPC or lymphoma. Chrystal Louis, MD a researcher at Baylor College of Medicine plans to study alternative ways to treat NPC cases caused by EBV, in order to one day try to reduce treatment side effects.
Most commonly found in pediatric patients between 10 -17 years old, NPC often goes undiagnosed until it reaches an advanced stage and has spread to the lymph nodes. Due to its location, surgical removal is not an effective treatment option, so doctors rely on high doses of radiation and chemotherapy. Because the high-dose radiation treatments are to the face and neck, the side effects of current treatment can leave patients with long term affects such as hearing loss, dental issues, and chronic dry mouth.
Dr. Louis plans to study the effectiveness of adding immunotherapy to the current chemotherapy and radiation therapy, such that if successful, the dose of radiation can be reduced in the future. Immunotherapy is a treatment option that allows doctors to use the body's own immune system to help fight disease. Dr. Louis and the research group at Baylor College study different ways to engineer (or modify) T-cells, a major component of the body's immune system, to recognize and attack viruses and tumors. This form of immunotherapy is being successfully used for patients who have undergone bone marrow transplants for various reasons, including cancer, has been proven to treat infections caused by EBV and other viruses, and used to treat patients with solid tumors.
Dr. Louis hypothesizes that since T cell immunotherapy has been helpful in treating patients that have a recurrence of their NPC caused by EBV, that it should also be helpful for children if used when they are first diagnosed. To do this, Dr. Louis has developed a Phase II clinical study to evaluate the feasibility of adding immunotherapy to the current treatment protocol for pediatric patients with EBV positive NPC treated at different locations around the United States. Dr. Louis will also study how patients with newly diagnosed NPC react to chemotherapy, radiation and immunotherapy and compare the location of relapse, 3-year disease free, and overall survival rates after treatment to those patients who do not receive immunotherapy. Dr. Louis's goal is to deliver new, non-toxic, treatment options to NPC patients who need it most.
Dr. Louis is funded through CureSearch's Young Investigator Program for two years. CureSearch is excited to provide updates to Dr. Louis's research.