‘In the middle of a miracle’

Local man heralded as “miracle patient” after targeted cancer therapy trial offers new lease on life.

Marnie Smith recently enjoyed a glorious April afternoon at the Louisville Zoo with Jeannie, his wife of 45 years, and their two grandchildren. As they walked the hilly paths for nearly three hours, Marnie’s wheelchair — brought just in case it would be needed — remained unused in the car.

These days, when staff at Norton Cancer Institute see Marnie arrive, smiles and hugs abound as they refer to him as their “miracle patient.”

It was a far different picture just four weeks before that zoo trip, when Marnie arrived at Norton Cancer Institute to start a clinical trial for advanced bladder cancer. After previously completing several chemotherapy regimens, he came to that March 22 appointment unable to walk without assistance. He was fatigued. With cancer in both lungs, he struggled to breathe.

“We were fighting to simply get him to the clinic, with oxygen tanks and wheelchairs in tow,” said Lauren Zutt, R.N., clinical research nurse, Norton Cancer Institute Research Program.

One week after starting an investigational drug not yet approved by the Food and Drug Administration and available only through a clinical trial, Marnie’s oxygen level was back up to 90 percent. He quit using his oxygen tank.

By week two, Marnie stopped using his walker and manned the grill for a cookout to celebrate his son’s birthday.

By week three, the 76-year-old was on his tractor breaking ground for a summer garden on his Nelson County farm.

Arash Rezazadeh, M.D., medical oncologist, Norton Cancer Institute, is a lead investigator for Marnie’s clinical trial, which is assessing the use of targeted molecular therapy to treat bladder cancer that has spread to other body parts and cannot be surgically removed. The research is being conducted at top cancer centers throughout the world.

Marnie’s bladder cancer was initially diagnosed in January 2014; his bladder was removed that July. After a reoccurrence that same year, he began chemotherapy, which continued throughout 2015.

“In January 2016, we were told the chemo had done all it could do,” Jeannie Smith said.

Marnie’s oncologist referred him to the trial because his tumor carries a specific altered gene that responds to the investigational drug being studied. As a clinical trial participant, Marnie sees Dr. Rezazadeh weekly and keeps a log of all study medication he takes. This proves pretty doable since he takes just two pills daily.

“Marnie’s is one of the most amazing responses to drug therapy I’ve witnessed during my oncology career,” said Dr. Rezazadeh, who has a special interest in prostate, bladder, kidney and testicular cancers.

Targeted molecular therapy involves blocking cancer cells’ ability to multiply. Ongoing research is moving various types of targeted therapies forward. For example, immunotherapy — one type of targeted therapy recently in the news for its success in treating President Jimmy Carter — triggers the immune system to destroy cancer cells.

Dr. Rezazadeh describes the identification of molecular targets as an evolving and exciting field in oncology.

In simple terms, targeted therapies are the opposite of the past “one-size-fits-all” approach to treating cancer. Because cancer is not one disease but a broad class of diseases with many causes, experts say it’s simplistic to talk of a single cure. Targeted therapy allows oncologists to offer “personalized medicine” based on the individual characteristics of each person’s specific cancer.

Researchers see great promise in the not-too-distant future in moving cancer from a life-threatening disease to a chronic illness that can be managed with daily medication.

As an added benefit, targeted therapy also tends to have far fewer negative side effects than traditional chemotherapy.

The Smiths are humbled and thankful for the opportunity to be a part of groundbreaking cancer research. They are beyond grateful for the time and quality of life Marnie has gained.

They also praise Norton Cancer Institute staff’s medical skill, care and, of prime importance, they say, their “truly wonderful” compassion and genuine concern.

Dr. Rezazadeh calls Marnie at home to see how he’s doing. While on vacation, Zutt called Jeannie to make sure she had seen some key blood test results.

“I feel we’re finding ourselves in the middle of a miracle,” Jeannie Smith said.

If you are interested in learning more about research at Norton Healthcare, call (502) 629-3449.


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