With most of her hair shaved off and a long scar down the back of her head, Olivia Mitchell sat in an exam room at Medical College of Georgia Cancer Center awaiting the results of an MRI that would determine the next course of her life.
“We have good news,” said Dr. Olivier Rixe, her neuro-oncologist and director of the experimental therapeutics program in the Division of Hematology/Oncology. “The MRI looks great.”
“That’s a great scan,” said Dr. John Vender, her neurosurgeon and the vice chairman of the Department of Neurosurgery.
Then Mitchell wants to know the bigger question she faces battling her glioblastoma multiforme brain tumor: How long does she have? “It could be a year,” Rixe said. “It could be five years.”
Particularly in light of some clinical trials and new drugs in the pipeline that could offer hope to patients such as Mitchell.
“We see now patients at years three, four, five, six,” Rixe said. “That’s a totally new story.”
Dr. Rixe has been brought in to help lead the multidisciplinary neuro-oncology program at the cancer center but also to help bring in new clinical trials for tough-to-treat cancers such as glioblastoma.
“One of my No. 1 missions is to bring innovation here in town,” Rixe said. “We want all of the patients to have top, cutting-edge, innovative clinical research, clinical trials here in town.”
Rixe has been in on the development of several new drugs, the latest being Zaltrap, which was approved last month by the Food and Drug Administration to treat metastatic colorectal cancer. Rixe is trying to bring to the cancer center a glioblastoma vaccine clinical trial that he participated in elsewhere.
“The results are so promising,” he said.
He also participated in early clinical trials of a therapy that uses a monoclonal antibody to target a receptor on the outside of the glioblastoma tumor cells and then deliver a dose of toxins.
“We deliver the toxin to the tumor, not to the normal tissue,” Rixe said. “That’s another generation of molecular-targeted therapies. I have 10 examples like that.”
For decades, treatment of these brain tumors involved surgery, radiation and one chemotherapy drug, but that is changing quickly, he said.
“Now, during the next five years, it is going to be a total revolution,” Rixe said. “We have new tools. The goal is really to improve the survival.”
For Mitchell, the goal is to figure out what has changed and how to cope with it. Her last clear memory before the diagnosis was her mother’s 94th birthday in April. Then, after she returned home from hernia surgery, she began to have problems. Her son-in-law, who lives on the floor below her, became alarmed when he heard her complaining that she didn’t know where she was.
“He got my daughter up there, and I didn’t know her,” Mitchell said. “They didn’t know what was going on, if I had a stroke or a heart attack. I was out of it.”
It turned out to be a massive tumor stretching from the back upper left part of her brain toward the middle, Vender said.
“It was extremely large, and you had the hemorrhage,” he told her.
For now, the plan is to keep Mitchell on a chemotherapy drug and do an MRI every three months. If that changes, the cancer center is doing a genetic profile of her tumor to see what kinds of new therapies will work best, Rixe said.
“That’s the beauty of a comprehensive cancer center,” he said. “Because we get the (genetic) markers, we get the new trials and we can move to the next step.”
Mitchell might receive treatments that people used to leave Augusta and Georgia to get, Rixe said.
“We need to bring this kind of innovation,” he said. “That’s our mission. That’s why we are here.”