Annual Report 2013

Dr. Hans-Peter Kiem, center, Dr. Jennifer Adair, left, and patient Charlie Burgess.

DR. HANS-PETER KIEM, CENTER, DR. JENNIFER ADAIR, LEFT, AND PATIENT CHARLIE BURGESS, LOOK AT PROTEIN DATA, KNOWN AS WESTERN BLOTS, DERIVED FROM CHARLIE’S OWN SAMPLES. Photo by Matt Hagen

'The cancer is really gone'

On the Fourth of July in 2009 Charles Burgess experienced the first symptoms of the aggressive brain cancer that would change his life forever.

Charlie, as his friends and colleagues call him, had a demanding but rewarding career working as a psychiatrist. Serving his Homer, Alaska community, he treated patients including children and the elderly, over a large territory. The holiday was a rare chance to relax with family and friends, but the celebration ended abruptly when Charlie blacked out. When he came to, he couldn’t speak.

"I would slip away and slip back. I was confused. My friends thought I was having a stroke," Charlie said.

Within the next week, tests would confirm what Charlie's medical training had led him to suspect: A glioblastoma tumor was growing fast within his brain. The news only got worse from there.

For glioblastoma patients like Charlie, the average survival time is just 12 months, and no one survives longer than four years. It was a prognosis Charlie wouldn’t accept. He had a community that needed him, a daughter entering college in the fall and his wife of 40 years whom he planned to be with for many more years to come.

"I was determined to fight," Charlie said.

CHARLIE AND HIS WIFE ELAINE ARE JUST BEGINNING TO BELIEVE THAT CHARLIE’S BRAIN CANCER IS GONE.
CHARLIE AND HIS WIFE ELAINE ARE JUST BEGINNING TO BELIEVE THAT CHARLIE’S BRAIN CANCER IS GONE. Photo by Matt Hagen

So Charlie assembled a team of advisers that included doctors and a social worker with 30 years of experience supporting cancer patients. Charlie's team supported his decision to enter a radical clinical trial being led by Dr. Hans-Peter Kiem at Fred Hutchinson Cancer Research Center in Seattle. Kiem’s approach was completely new. It called for protecting healthy cells with a gene therapy while attacking cancer cells with a powerful type of chemotherapy. It was a long shot, but it was the best one Charlie had.

For Charlie's type of cancer, chemotherapy is combined with a second drug called benzylguanine. Benzylguanine helps kill tumor cells by preventing them from repairing the severe DNA damage caused by the chemotherapy. Unfortunately, benzylguanine also kills blood cells. The result: Physicians have a powerful therapy they cannot fully use.

To offer such patients potentially curative amounts of chemotherapy, Kiem developed an approach that protects blood cells by inserting an engineered gene that shields them from benzylguanine. This allowed physicians to "take the gloves off" and use benzylguanine to beat back the cancer with more force than ever before.

Charlie Burgess, left, is greeted by Drs. Jennifer Adair and Hans-Peter Kiem in the lobby at Fred Hutch.
CHARLIE BURGESS, LEFT, IS GREETED BY DRS. JENNIFER ADAIR AND HANS-PETER KIEM IN THE LOBBY AT FRED HUTCH. Photo by Matt Hagen

"Without protecting the blood cells, most patients might receive one or two cycles of therapy; the most any patient before ever received was four cycles. Charlie was able to receive nine," said Dr. Jennifer Adair, a member of Kiem’s research group.

The therapy regimen was tough, but Charlie and the Fred Hutch team formed a strong bond. "I've had such good people coming and taking care of me," said Charlie.

Four years later, Charlie is cancer free. Six other patients who have received Kiem's treatment have not shared Charlie’s miracle, but their lives were extended well beyond other glioblastoma patients.

It's been a long road for Charlie and his wife Elaine, but finally that sense of relaxation they last felt together on that fateful Fourth of July is back. "A little over a year ago, I allowed myself to think for the first time that the cancer is really gone,'" Elaine said.

Kiem, who draws inspiration from Charlie’s story, continues to enroll patients in this small clinical trial.

"This is why I do medicine," said Kiem.

Dr. Hans-Peter Kiem holds the José Carreras/E. Donnall Thomas Endowed Chair for Cancer Research at Fred Hutch, which was established with a generous contribution from the Friends of José Carreras International Leukemia Foundation and gifts from Fred Hutch faculty and staff.

DR. HANS-PETER KIEM OF THE CLINICAL RESEARCH DIVISION.
DR. HANS-PETER KIEM OF THE CLINICAL RESEARCH DIVISION.
Photo by Matt Hagen

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