In November 2013, MaryAnn Anselmo was recovering from a horrific traffic accident. She's a jazz singer, who lives with her husband, Joseph Anselmo, in Morganville, New Jersey. During her recovery, she started feeling dizzy one afternoon, and her husband insisted she go back to the doctor. An MRI revealed that she had a glioblastoma, a brain tumor.
“You start doing research on that type of tumor and you’re saying, ‘Oh my god, you’re history.’ It’s like a death sentence,” Anselmo said.
Only for her it wasn’t.
Anselmo’s story shows how precision medicine, tailoring medical treatment to each patient’s genetic needs, is beginning to revolutionize cancer care.
At first, the outlook seemed grim. While Anselmo’s doctor was able to surgically remove most of her tumor, her body rejected traditional chemotherapy. But she and her husband were not ready to give up. He’d read about advances in targeted therapies — drugs that target cancer at the tiniest, molecular level. So they had her tumor genetically sequenced in the hope that there would be a drug able to target one of the specific mutations causing her tumor to grow.
The sequencing found that Anselmo’s tumor had a mutation common in skin cancer, but very unusual for a brain tumor. So her oncologist Dr. David Hyman at Memorial Sloan Kettering Cancer Center put her into a new kind of drug trial. Called a “basket” trial, the study is designed to include people whose tumors have the same kind of genetic mutation, rather than being designed around the location of the tumor within the body. Knowing more about the genetic mutations of a tumor enables doctors to find a potentially effective drug much more quickly and accurately.
"It's like you're in a parking lot," said Hyman, “And you have a key to one of the cars in the parking lot. And so one option is just to go to each car and try to open the lock. The other is to know that it's the third car on the right. What we're doing now is we're saying okay this key fits that lock. And we're only going straight to that car."
Today, MaryAnn Anselmo is doing well. She’s been on the clinical trial for a year now, and continues to take the daily pills that are keeping her cancer from growing. Now she can focus again on the things she loves, like singing. She’s back training with her vocal coach and is planning a comeback performance under her stage name, Mariel Larsen.
As this kind of genetic sequencing of tumors has become faster and cheaper, more patients will have access to this technology and more doctors will understand how to use the sequencing information to treat patients with a targeted approach.
Hyman cautions that these treatments aren’t considered cures. It’s likely that at some point the drug that is keeping Anselmo’s cancer at bay will stop working and there’s no way to predict when. But in the meantime, patients like Anselmo are grateful to have time they would not have had otherwise.
Our series is produced with NPR, and with ‘Ken Burns Presents: Cancer: The Emperor of All Maladies’ which will air on PBS stations March 30th, 31st and April 1st. Check your local listings for broadcast times.