Remission Despite A Grim Diagnosis: Jan Overcomes Rare Deadly Cancer with Help of Clinical Trials at Stephenson Cancer Center

When Jan Bush from Wichita, Kansas was in a car wreck with an 18-wheeler on July 15, 2020, she wasn’t surprised when she developed back and side pain. After five months of continuing pain despite chiropractic visits, Jan went to see her doctor. Because of where the pain radiated from, her doctor thought that maybe Jan had damaged her liver in the crash. The news she received could not have been more shocking—Jan had Stage 4 metastatic uterine carcinosarcoma, a rare and aggressive form of cancer. And if that news wasn’t shocking enough, Jan was given 12 months to live.

Uterine Carcinosarcoma

Stage 4 metastatic uterine carcinosarcoma is a type of uterine cancer that has spread beyond the pelvis to other parts of the body. Jan had a tumor on the surface of her liver/diaphragm, and she was having trouble breathing.

The overall 5-year survival for uterine carcinosarcoma is around 20-35% for Stage 3, and the 5-year survival for Stage 4 disease is reported to be around 10%. Uterine carcinosarcomas begin in the lining of the uterus and more than 95% of uterine cancers are carcinomas.

In February 2021, Jan traveled to Texas for surgery, which included a hysterectomy and the removal of other non-vital organs to eliminate the tumors.Following surgery, she started a clinical trial called DUO-E, which involved a combination of treatments:

1. Carboplatin and Paclitaxel: These are the standard of care chemotherapy drugs used to treat endometrial cancer.
2. Durvalumab (IO): An immunotherapy drug that helps the immune system fight cancer.
3. Olaparib: P PARP inhibitor which targets how cells repair DNA.

The trial had different control groups, with some participants receiving a placebo, others receiving durvalumab and a placebo, another group received Olaparib and a placebo, and the final group receiving both durvalumab and Olaparib. This was a double-blind study meaning that neither the doctor nor the patient knew which group the participants were assigned. Jan received both trial drugs.

Transferring to Stephenson Cancer Center

Jan responded well to the drug. Because she lives in Kansas, her doctors in Texas recommended that she transfer to OU Health Stephenson Cancer Center, which was running the same trial. She transferred her care in August 2021 and continued the clinical trial at Stephenson Cancer Center.

Despite a positive response to the drug initially, Jan received bad news in September 2022.

“I found out that the cancer had returned, three days after my daughter’s wedding,” said Jan. “I’m so grateful that it was after the wedding, as it would have been a lot more somber.”

OU Health gynecologic oncologist Dr. Debra Richardson, M.D., FACS, FACOG, professor and Chief in the Section of Gynecologic Oncology at the University of Oklahoma College of Medicine, surgically removed the cancer. After the resection of the cancer the area received radiation therapy and Jan started chemotherapy with gynecologic oncologist Dr. Kathleen Moore, M.D., M.S., associate director of Clinical Research at Stephenson Cancer Center and professor in the Section of Gynecologic Oncology at OU College of Medicine.

The standard medications for Jan’s treatment included Lenvatinib and Pembrolizumab. Lenvatinib works by blocking the growth of cancer cells and cutting off the blood supply that tumors need to grow. Pembrolizumab is an immunotherapy drug that helps the immune system recognize and attack cancer cells more effectively. This combination has a high response rate in recurrent endometrial cancer. However, because Jan had significant side effects, Dr. Moore recommended she try something else, even though the medications were working against the cancer.

Phase 1 Clinical Trials

There was no way that Jan was ready to give up. In September 2023, she was enrolled in a Phase 1 clinical trial for a new drug called DB-1303, an antibody-drug conjugate (ADC). ADC is a special kind of cancer treatment that combines an antibody and a chemotherapy drug.

The antibody part of DB-1303 searches for a specific protein called HER2neu, found on the surface of some cancer cells. The antibody binds to cancer cells that express HER2neu, the cell internalizes the drug and releases the chemotherapy inside the cancer cell, killing it.

By delivering the chemotherapy drug directly to the cancer cell, DB-1303 helps to kill the cancer cells more effectively. This targeted approach also helps to reduce damage to healthy cells, which can minimize side effects.

By participating in this trial, Jan is not only given access to new drugs before they reach the market, but she is also helping researchers learn more about DB-1303 and its potential to treat HER2-positive cancers. This could lead to new and better treatment options for people with this type of cancer in the future.

Outstanding Results

Jan responded extremely well to DB-1303 with no side effects and a year later, at 71 years old, she has no detectable cancer.

“I couldn’t be more thrilled that Jan is thriving on this clinical trial,” said Dr. Richardson. “She has a complete response, which means we cannot detect any evidence of cancer on imaging or physical exam, and she has no cancer symptoms. This is always our goal when treating cancer.”

With such a fantastic response to the clinical trial, Jan will stay on the drug for the foreseeable future.

“The carcinosarcoma is very aggressive so I’ll stay on the medication and just keep doing what we’re doing,” said Jan. “I was given 12 months to live and here I am three years later. I was able to see my daughter get married, my son get sober, and my daughter give me a grandson. I feel I have a future now.”

Cancer clinical trials are research studies aimed at discovering new methods for diagnosing, treating, and managing cancer. These trials involve volunteers, both cancer patients and healthy individuals, to evaluate new treatments or innovative uses of existing ones. Stephenson Cancer Center stands out as the only facility in Oklahoma offering Phase I clinical trials.

“OU Health researchers work on new medical solutions every day. For many of us, trial drugs give us an alternative when we’re not responding to traditional treatment,” said Jan. “It’s so important that we participate in new drug testing. If you have the need, go to Stephenson Cancer Center. My experience has been great.”

While you wait for a diagnosis, seek a second opinion, or consider transferring care for yourself or a loved one, you can count on the expert teams at OU Health Stephenson Cancer Center to support you from diagnosis through survivorship. Complete this form or give us a call at (405) 271-1112 to request an appointment.