This article is the fifth in a five-part series about emerging vaccines for multiple myeloma. It tells the story of a patient who participated in a myeloma vaccine clinical trial.  The first article in the series provides an introduction to the concept of a myeloma vaccine, the second article provides an introduction to the various types of myeloma vaccines that are currently under development, the third article describes vaccines for which clinical trials have been completed, and the fourth article focuses on ongoing myeloma vaccine research.

Tom Liebert diagnosed himself with multiple myeloma in 2006 at the age of 49 after piecing together his symptoms of proteinuria (large amounts of protein in the urine that cause it to foam), osteoporosis (porous and brittle bones), and a fractured vertebra.  Physicians confirmed his diagnosis soon afterward.

“I am a researcher,” said Liebert, who has held professor positions in computer science and engineering at a number of universities in the Boston area. After his diagnosis, he began researching treatment options.  “I was doing a lot of research because I wanted to get my head around this thing and figure out a treatment plan.”

Aware that myeloma is generally considered incurable, Liebert became interested in innovative treatment methods.

Liebert had just started Velcade (bortezomib) when he found information on the Internet about dendritic cell vaccine therapy, an immunotherapeutic treatment strategy that trains one’s own immune system to recognize and destroy myeloma tumor cells.

He immediately recognized the potential of these myeloma vaccines.  As a treatment personalized to each recipient, they could offer long-term outcomes by minimizing the likelihood of the cancer becoming treatment-resistant.

“The idea is to take [your own] tumor cells, mush them together with [your own] dendritic cells, and introduce them into your body. Then, the dendritic cells teach your immune system to recognize myeloma tumor cells as invaders,” Liebert explained. “I thought, ‘Wow, that’s great.  If that could work, that would be perfect.’”

He asked his doctor about myeloma vaccine clinical trials and was subsequently enrolled in one at Beth Israel Deaconess Medical Center and Dana Farber Cancer Center in Boston. Liebert was one of 18 myeloma patients to receive a novel dendritic cell vaccine therapy.

Liebert entered the vaccine trial in early 2007.  Participation required a regular commute from his home in Maine to the treatment center in Boston.  First, researchers collected Liebert’s tumor cells via bone marrow aspiration, followed by dendritic cell collection via leukapheresis, in which white blood cells are removed from the blood.

He underwent an autologous stem cell transplant a few months later and was then responsible for administering the vaccine, comprised of his own tumor and dendritic cells, along with granulocyte macrophage colony-stimulating factor (GM-CSF), on his own.

“They gave me all of the syringes with pre-measured doses [of the vaccine] in a lunchbox size cooler in order to keep them refrigerated until use,” explained Liebert.  He recalled having to inject himself with the vaccine and GM-CSF multiple times a day on a specific daily and weekly schedule, but this did not seem to disrupt his routine or leisure activities.

“I remember clearly one day I was at the beach near Portsmouth and had my beach chair and my cooler,” laughed Liebert. “I reached into my cooler, took out a syringe, and stuck myself in the thigh right there.”

After completing the vaccine regimen at home in Maine, Liebert returned to Boston for follow up, which included several blood tests and a tumor challenge. “They got some of the tumor cells they extracted and killed them through irradiation,” explained Liebert. “Then they gave me a little shot in the arm to see if I exhibited an immune response and if so, to what degree.”

The researchers never disclosed the results of the trial or any related medical tests to the participants, but Liebert has not had active disease since he completed the trial two years ago. The trial’s organizers recently published favorable results showing that most patients exhibited an immune response to myeloma tumor cells and that a majority achieved stable disease after completing the trial.

While Liebert is no longer receiving treatment and his blood and urine tests continue to come back with good results, he has not completely left multiple myeloma behind him.

“Of course I don’t want to lie to you and tell you I’m 100 percent because I never will be,” said Liebert. “I call it a new normal.” He still experiences chronic fatigue and back pain due to a vertebral compression fracture he sustained in 2006, but he keeps a positive attitude and continues to give back to the myeloma community.

Liebert runs a myeloma support group that he founded in the Maine-New Hampshire area in 2007. He also worked with the International Myeloma Foundation on their patient advocacy and legislative endeavors by testifying on their behalf in front of a state senate for equal drug coverage for oral and intravenous cancer treatments.

Participating in a clinical trial can be a viable and affordable treatment option for many patients, and for Liebert, the treatment appears to have worked. “I’m still very much alive and living large!” he joked. “I’m still young: I’m 54, and I’m hoping that I’ll live to a ripe old age.”

To learn more about participating in clinical trials, please refer to the Beacon’s Guide to Clinical Trials for Multiple Myeloma Patients.  For more information about the dendritic vaccine trial, please refer to the Beacon news coverage of the results published in the journal Blood (abstract).