Thanks to a clinical trial at MSK, Conor Handley’s cancer shrank by 85% and he was able to graduate from college on time.
It was hard enough the first time Conor Handley was diagnosed with cancer, at age 17. He had a rare soft tissue cancer called synovial sarcoma.
Then three years after finishing treatment, early in his senior year of college, came the devastating news: His synovial sarcoma was back, and it had spread to his lungs, making it stage 4.
“I just kind of shut down when I found out, because I was in so much shock,” he says.
Thankfully, his parents acted quickly and decided right away he needed to go to Memorial Sloan Kettering Cancer Center (MSK).
Enrolling in a Clinical Trial for Synovial Sarcoma at MSK
His new medical team — led by sarcoma medical oncologist and cellular therapist Sandra D’Angelo, MD — offered him a treatment being investigated to keep his rare soft tissue sarcoma at bay. He could enroll in a clinical trial for an emerging type of immunotherapy called T cell receptor (TCR) therapy. TCR therapy works by teaching immune cells to recognize tumor markers inside cancer cells and attack them. He would receive an experimental one-time treatment called afamitresgene autoleucel (afami-cel).
“Dr. D’Angelo was very confident that this was a good option for me, and it really put my parents and I at ease,” Conor remembers.
Even better, Dr. D’Angelo arranged the treatment around his schedule, so he wouldn’t miss any classes. He was able to graduate from college on time.
After Treatment for Rare Sarcoma, Conor Is Enjoying Life Again With No Long-Lasting Side Effects
Now 23 and 18 months out from treatment, Conor says he feels great and is living a full life — playing golf, working, and hanging out with his friends.
After receiving TCR therapy, Conor was able to quickly go back to his regular activities, including playing golf.
More patients like Conor now have access to this treatment for synovial sarcoma, because the clinical trial that he participated in led to an accelerated approval by the U.S. Food and Drug Administration (FDA) of the treatment regimen. The drug is now also known as Tecelra®.
“Immunotherapy is a promising approach that may eventually offer a cure for many patients,” Dr. D’Angelo says. “It trains the immune system to be on the lookout for cancer cells and to attack them.”
What Is Synovial Sarcoma, How Common Is It, and How Is It Treated?
Synovial sarcomas are diagnosed in about 1,000 patients in the United States every year, most often in teenagers and young adults. Synovial sarcomas usually form in the soft tissue of the joints of the arms and legs. Conor’s original tumor was in his left calf.
Synovial sarcomas can often be eliminated with treatments like chemotherapy, surgery, and radiation therapy. But when these tumors spread to vital organs, they are much harder to bring under control.
“When synovial sarcoma comes back and spreads, it can be very aggressive and difficult to treat,” Dr. D’Angelo says.
TCR Therapy Is a New Type of Immunotherapy for Solid Tumors
TCR immunotherapy falls into a new category of treatment known as engineered T cell therapy. With this approach, a patient’s T cells (a type of white blood cell) are collected and sent to a lab, where they are engineered to recognize rogue cancerous cells. These supercharged immune cells are infused back into the patient, where they can seek out and destroy cancer cells anywhere in the body — including tumors not detected by scans.
Dr. Sandra D’Angelo is leading the development of TCR therapies for soft tissue sarcoma.
There are different ways to engineer cells to fight cancer. A similar treatment called chimeric antigen receptor (CAR) T cell therapy has been approved for treating certain blood cancers since 2017. CAR T therapy has been shown to identify cancer markers in liquid tumors, which are more visible to the immune system.
Treating solid tumors with cell therapies has been more of a challenge, because the telltale cancer markers often hide inside cells. But MSK researchers believe TCR may work better against solid tumors because the therapy can ferret out those markers.
To uncover the hidden markers and summon the immune system to go on the attack, TCR therapy deploys a group of genes called the human leukocyte antigen (HLA) system. Before Conor enrolled in the trial, he had blood tests to confirm that his HLA type was compatible with the afami-cel treatment.
How Conor Got Afami-Cel TCR Therapy To Treat Synovial Sarcoma
Conor had his blood drawn to collect his T cells a few months before his treatment was scheduled, so that they could be engineered and grown in a lab. Then, on the day after Christmas, while he was on semester break from college, he started treatment.
First, he got chemotherapy to tamp down his immune system and prepare his body to receive the engineered cells. A few days later, he was admitted to the hospital to be infused with the supercharged T cells.
“After getting the treatment, I was back on my feet pretty quickly,” Conor says. “I was in isolation because of my compromised immune system, but I was walking laps around my room.”
A few days later, he spiked a high fever, a common side effect of immunotherapy. He also had severe pain in his back. “I slept a lot, and within two days the fever was gone,” he says. “A week after getting the treatment, I was able to go home.”
One month later, scans showed the results he was hoping for: His tumors had stopped growing.
“My family and I were obviously amazed and very grateful,” he says. “I was able to resume normal life very quickly.” Not only did he finish his last semester of college at Sacred Heart University, where he majored in finance, he also returned to the school’s Division 1 golf team.
Since graduating, Conor has been working as a project analyst at a financial services company. His most recent scans show an 85% reduction in his tumors, Dr. D’Angelo says.
Having gone through a life-threatening ordeal at a young age, Conor has learned perspective. “It’s obviously scary, but if you can remain hopeful and take things one step at a time, it can make it easier to cope,” he says.
MSK Clinical Trial Innovation, Even for Rare Cancers
Conor and his family are grateful for the opportunity to participate in the clinical trial that gave him access to the TCR treatment before it was approved by the FDA.
Conor played golf in college as a Division 1 athlete. This photo was taken at the Kapalua Plantation course in Hawaii in 2022.
Dr. D’Angelo says clinical trials are especially important for patients like Conor, who have rare cancers. MSK is developing new ways to conduct clinical trials to treat rare cancers so a treatment’s effectiveness can be determined even in a small group of patients.
“Given the rarity of this disease and the need to select patients with specific HLA blood types, collaboration throughout the United States as well as internationally was important,” Dr. D’Angelo says. A centralized system was used to gather the data and quickly analyze the results.
“Conor’s success story is just one example of MSK’s innovative approach to researching new treatments,” Dr. D’Angelo adds. “There is a concerted effort to make clinical trials faster and more accessible to more patients, so we can present results to the FDA and get more drugs on the market to save more lives.”
