Pancreatic cancer patient in partial remission after experimental drug treatment

In Clinical Trials by Barbara Jacoby

By: Ronda Wendler

From: mdanderson.org

Allison Lippman was 30 years old when she was diagnosed with stage 4 pancreatic cancer. A new drug that targets her cancer’s genetic mutation has shrunk her tumors in half.

Just before she was diagnosed with pancreatic cancer, Allison Lippman was on top of the world. She’d just celebrated her 30th birthday, been promoted at work, and met the man of her dreams.

“I thought I’d stay single for a while and focus on my career,” says Lippman, who managed a four-star hotel in Dallas. “Then I met Eric through a mutual friend, and we instantly became inseparable. Our first dinner date lasted three hours because we couldn’t stop chatting.”

The couple discovered they shared a love of travel, and embarked on a magical, weeklong tour of France. But when they returned home in April 2017, Lippman began feeling ill.

“I couldn’t digest food, my side hurt all the time, and my energy disappeared,” she says. “I’d always been healthy and active. Something was definitely wrong.”

Visits to various doctors produced no clear answers. Maybe a food allergy was to blame, they suggested, or work-induced stress.

“I was frustrated and lost,” Lippman recalls. “I didn’t know what to do or where to turn.”

An unexpected pancreatic cancer diagnosis

She toughed it out until one night when unbearable pain landed her in the emergency room. It was there that she got the shocking diagnosis: stage 4 pancreatic cancer. Lippman had a rare subtype called acinar cell carcinoma which affects only 1 percent of all pancreatic cancer patients. It was aggressive, doctors said, and had spread to her liver.

On her 31st birthday, Lippman met with her oncologist to discuss her treatment plan.

“All I heard was chemotherapy,” she recalls, “and I knew my hair would fall out. It was the worst birthday ever.”

Two months after she lost her curly blonde locks, Eric whisked Lippman away on a surprise day trip to Paris, Texas. At the base of the town’s iconic Eiffel Tower replica with the big, red cowboy hat on top, Eric got down on one knee and proposed marriage. Lippman enthusiastically accepted.

“I tell people we got engaged in Paris,” she says.

When the couple arrived home that evening, Eric had arranged for both their extended families to be there to celebrate their engagement.

“It was absolutely amazing and I couldn’t stop smiling all day,” Lippman says.

She continued chemo for seven months while planning a wedding.

“I was nauseated, weak, super skinny and bald,” she remembers, “but I was in love and happy.”

Tumor profiling uncovers genetic mutation, making clinical trial an option

In the midst of this whirlwind, Lippman consulted a second doctor in Dallas who suggested sending tissue from her tumor to a lab for genetic testing — a practice known as comprehensive tumor profiling. If the test uncovered the genetic mutation that caused her cancer, Lippman then could be matched with a cancer drug that targets her specific mutation.

“He warned me not to get my hopes up, that it was a needle in a haystack,” Lippman recalls. “But I could see how hopeful my fiancé and family members were. I knew I had to try.”

It worked. The test revealed that a rare genetic alteration known as a RET fusion caused Lippman’s tumor. The discovery meant she could stop chemotherapy and enroll in a clinical trial at MD Anderson, where a drug named LOXO-292 was being tested in patients with RET-fusion-induced cancer.

A better way to determine how a tumor will respond to treatment

“Every person’s cancer is genetically different, even when it begins in the same part of the body,” says Vivek Subbiah, M.D., associate professor of Investigational Cancer Therapeutics and leader of the MD Anderson arm of the national trial. “Two people with pancreatic cancer, for example, can have tumors with genetic profiles that look nothing alike.”

These mutations can control how, or if, a tumor will respond to a specific treatment. For this reason, doctors increasingly are interested in profiling their patients’ tumors.

Clinical trial offers hope, with no side effects

Since starting the LOXO-292 clinical trial in January 2018, Lippman says, “I’ve slowly recovered my strength, gained weight, and my hair has started to grow again.”

Four months after joining the trial, she married Eric, a Delta Airlines pilot, and became Allison Lippman Kuban. On their wedding day, she removed her wig to reveal a short, pixie hairstyle.

Today, her tumors have shrunk nearly 50 percent and she no longer has to deal with the side effects of chemotherapy.

“There’s still a long road ahead, but I’m on a positive path forward,” says Lippman Kuban. “This time last year, I was in a dark place full of uncertainty and unknowns. To be in partial remission and on the road to recovery today is truly miraculous.”

A needle in the haystack

She and Eric recently moved to Houston to be closer to relatives and MD Anderson.

“My drive behind everything is my husband and my family,” says Lippman Kuban. “I’m thankful I got the diagnosis, not them. I think it takes more strength for the family and friends watching than for the patient going through treatment.”

She’s in the midst of writing a book that she hopes will inspire others to explore all treatment options and never give up.

“Miracles do happen,” she says. “You might be the needle in the haystack.”