University of Vermont Cancer Center’s CAR T-Cell Therapy delivers world-class care close to home 

When University of Vermont Cancer Center launched its CAR T-Cell therapy program in February 2023, it was the only healthcare institution in Vermont and northern New York to provide the treatment. Now, 12 patients have been treated under the care of James Gerson, MD, assistant professor of medicine at University of Vermont Medical Center. Many of those patients are still free of cancer today.

The therapy, which uses genetically modified T cells from the patient to attack cancer cells, was approved by the FDA in 2017 for a variety of blood cancers. Though long-term data for CAR T-cell therapy is not yet available, the treatment has the potential to cure some types of cancer. Of the first patients treated more than 10 years ago with CAR T-cell therapy in clinical trials, few of those who achieved a complete response have seen their cancer return.

Eric Bergeron of Colchester, Vermont hopes to be one of these patients. 

“I just felt off.”

Bergeron was diagnosed with diffuse large B-cell lymphoma in 2006. After a five-month course of inpatient chemotherapy treatment Bergeron received the “all clear” in September 2006. It was a gift and a relief. 

Five years of surveillance scans passed, and in 2011 Bergeron was finally set free-—the scans stopped. “I was in remission for 16 years, until September of 2022,” says Bergeron. “It started with my balance being a little unsteady, but I didn’t think much about it. I remember over Labor Day weekend I was helping my neighbor move, and the next day at work I just felt off.” 

Sensing something was wrong, Bergeron called his primary care doctor and was prescribed medication for mild vertigo, but the medication didn’t help. Trusting his instincts, Bergeron went to UVM Medical Center, and within three hours, MRI scans showed his cancer had likely returned in his brain.

Further scans revealed that there was fluid surrounding the tumor pushing against his brain which ultimately caused him to lose use of the right side of his body.

Treatment began immediately under the direction of Oluwatosin Akintola, MD, assistant professor of neurological sciences. Bergeron once again received five months of inpatient chemotherapy, and this time a stem cell transplant followed. When the transplant failed to produce the results the care team was hoping for—the cancer was back in less than three months— Dr. Gerson recommended CAR T therapy. 

“Dr. Gerson is a people person. He was up front about the therapy, its potential side effects, and the outcomes data, too,” says Bergeron. “I figured, what do I have to lose? My options were limited, and this is my life.”

World-class care, close to home

Bergeron began treatment in 2023 and was prepared for a long hospital stay and difficult side effects but was home in 11 days without an adverse reaction. Previously, patients in Vermont and northern New York who wanted CAR T therapy needed to travel, usually to Boston, New York City, Dartmouth or Rochester, to access it. 

“Our goal is for patients to be able to access this therapy without uprooting their lives,” says Dr. Gerson, who came to lead the CAR T-cell program at University of Vermont from the University of Pennsylvania, where the therapy was discovered and developed. “The remote treatment can cause significant upheaval since it requires multiple episodes of care over the course of three to six months. Many patients need to live in the area where they’re being treated for four weeks.” 

CAR T works by training a patient’s own T cells — a type of white blood cell used by the immune system to kill viruses and other foreign bodies — to recognize and attack cancer cells. 

For Bergeron, the treatment had several steps. First, T cells were removed from his blood. Then, in the lab, they were modified by adding a receptor gene — a “chimeric antigen receptor” or CAR — that can recognize a protein on the cancer cell, latch onto it and kill the cell. Finally, these engineered cells were multiplied and given back to Bergeron. 

Bergeron’s first scan after the infusion showed no sign of cancer.

“I was admitted to the hospital on October 6, 2023, home on October 17 which was about a week sooner than I was expecting,” says Bergeron. “I handled the treatment pretty well with a high fever being the worst of it. I’ll take that, and my first scan at the end of November was clear. I feel hopeful, and I’m staying positive,” he adds.

The data has shown that if patients are cancer free for three months, around 80% of patients will go four years without relapsing and it could be longer as well. “I hope to be in that 80%.” 

UVM CAR T-cell Program Receives FACT Accreditation

The CAR T program at UVM Cancer Center recently received accreditation from a national organization called the Foundation for the Accreditation of Cellular Therapy (FACT), which means it has met or exceeded quality measures and standards. The CAR T-cell program also highlights the benefits that an academic medical center like UVM Medical Center — which combines cutting edge clinical care and innovative research — can bring to a community. 

Cancer science is changing rapidly. With new applications for CAR T-cell therapy on the horizon, we will continue to expand access to this life-saving treatment in our region. Providing world-class care close to home to reduce the burden of cancer for our patients and their caregivers — this is what the cancer center is all about.    

RANDALL HOLCOMBE, MD, MBA, PROFESSOR AND DIRECTOR OF UNIVERSITY OF VERMONT CANCER CENTER AND CHIEF OF THE DIVISION OF HEMATOLOGY AND ONCOLOGY.

Approved by the FDA in 2017 for a variety of blood cancers, CAR T-cell therapy induces a “complete response” — where no remaining cancer is detectable — in 50-80 percent of patients treated with it, depending on the cancer type, including in 70% of patients with mantle cell lymphoma and 80 percent with follicular lymphoma. Up to ninety percent of patients with these two cancers see a “partial response,” where the cancer has been significantly diminished. As was the case for Bergeron, the therapy is typically used after other forms of treatment have been unsuccessful. 

Blood cancers account for 10 percent of all cancer diagnosed in the United States every year, according to the Leukemia and Lymphoma Society.  

CAR T is currently approved only for blood cancers: lymphoma, multiple myeloma, and some leukemias including as recently as March of 2024, chronic lymphocytic leukemia. Research is ongoing to apply the method to other cancers. 

Patients interested in the therapy should discuss the treatment with their oncologist.