Lesa Kirkman: Reclaiming Health After Gene Therapy for Bladder Cancer

I have no family history of cancer. I never smoked; I lived a healthy lifestyle. So, in July 2016, when I was diagnosed with stage T1 high grade bladder cancer, it was a complete shock. After two surgeries in July and August 2016 to remove the tumors (both carcinoma in situ and Ta high grade bladder cancers), I was put on Bacillus Calmette-Guerin (BCG) therapy, a gold standard treatment for this disease. I received BCG for two years, with an additional surgery in December 2016 to remove tumors. When, in April 2018, tumors recurred, I was considered non-responsive to BCG and could not continue with the treatment plan. My oncologist talked to me about a clinical trial that was testing a novel gene therapy, nadofaragene firadenovec-vncg (Adstiladrin) for bladder cancer. I decided to participate because I believed that it was the best course of action for me. I first received the gene therapy in 2018 and have had no recurrences in the past five years. I ended treatment in 2021 and am just living my life.

In April 2016, I went to see my gynecologist after I noticed blood in my urine. They treated me for a urinary tract infection for about six weeks, but that did not resolve the problem. A follow-up evaluation with a urologist led to a CT scan of my abdomen and bladder, which found the tumors. I had never heard of bladder cancer and was scared. There was no history of cancer in my family. I was active and led a healthy life. So, this was a huge shock.

Immediately after my diagnosis, I had my first surgery. Later, in August, I underwent a second surgery to have additional tumors removed. About six weeks later I started on BCG treatment, which is considered the gold standard for bladder cancer treatment. I received an initial induction of six treatments over six weeks followed by a brief break. I went back for BCG treatments about every three months until the beginning of 2018. Over this period, I also had additional surgeries to have more tumors removed. Following my surgery in April 2018, my physician determined that I was no longer responding to BCG.

As we were evaluating the next course of action, my oncologist at the MD Anderson Cancer Center informed me that I would be an ideal candidate for a clinical trial that was evaluating a new gene therapy. I decided to participate and started on the trial in May 2018. For the next three years, I went back to MD Anderson every three months. The first visit was to have a cystoscopy, which looks at the bladder internally with a camera, to ensure there were no new tumors. Two weeks later, I went back to MD Anderson for the instillation of the medication, nadofaragene firadenovec-vncg. Since I started on this gene therapy in 2018, I have had no evidence of disease. In May 2021, we were able to discontinue the treatment. Currently, I’m just monitored periodically through CT scans, lung scans, and EKGs to ensure that no tumors have come back.

Fortunately, I didn’t have a lot of side effects from the treatments. I did experience some fatigue as well as muscle and joint pain, which all cleared up since stopping the treatments. Personally, I’m doing great. I play tennis. I walk with my daughter three to four times a week. I travel. In fact, we just got back from a monthlong trip to Europe. I am just living my life.

Making progress in medicine—finding the causes and cure for cancers—is of national importance. I don’t know anyone who has not been touched by cancer or whose family has not been affected by cancer. Therefore, the importance of funding cancer research or any type of medical research cannot be understated. We have lots of needs in this country, but saving people’s lives is what’s most important and we need to fund that. No matter your political affiliation, everyone must recognize that at some point their lives will be touched by cancer. That’s why this research is vital.

I’m thankful to those people who participated in the earlier phases of the clinical research, when the safety and efficacy of the drug weren’t known. I had an incredible experience participating in the trial. Giving other patients the opportunity to have a different course of medicine, a different course in life, is worth it. It takes many people to make advancements in medicine, and I believe we all must do our part.