How an Experimental Cancer Treatment Led to Remission

After spotty luck with four other therapies, BiTE, or “bispecific T-cell engager,” put an Oakley woman in remission.
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Patty Livermore and her oncologist James Essell, M.D. who saved her life with BiTE therapy.

PHOTOGRAPH BY ANDREW DOENCH

Patty Livermore’s father was an original 1968 Bengals season ticket holder. They attended games together, and eventually, he passed the tickets to her. Now, Livermore’s son holds the tickets. He still brings his mom, but for a while, going to a game was a challenging proposition.

It was partially due to COVID—but it was also because of Livermore’s cancer treatments. Before any large outings, she sought advice from her care team, headed by James Essell, M.D., her oncologist at Oncology Hematology Care. She started treatment for follicular lymphoma, a slow-growing and incurable blood cancer, in spring 2019. She went into remission. In fall 2021, it came back. Then, two years later, during an October appointment discussing her cancer and treatment, Livermore says, Essell declared she was “in CR.”

“I don’t like ‘CR,’ ” says Livermore, of Oakley. “I want to hear the whole thing.”

Complete remission.

It’s thanks to BiTE, an experimental treatment. Where chemotherapy attacks both cancer cells and T-cells, the white blood cells that help the immune system protect against disease and germs, BiTE therapy acts as a sort of u-shaped magnet, Essell says. One end targets the cancer and the other, the T-cell, separating the two and attacking only the cancer.

BiTE, or “bispecific T-cell engager,” is Livermore’s fifth type of treatment, and it’s considered a clinical trial because it’s FDA-approved for a different kind of lymphoma, but not Livermore’s. At least not yet.

“Things are changing with cancer treatment,” Essell says. “Twenty years ago, it was, ‘How much poison can we give you and how much radiation can we give you where you’ll survive and the cancer won’t?’ Fortunately, we’re getting away from that.”

To receive a round of BiTE therapy, Livermore gets a small shot in her stomach. “It’s a very easy treatment to live with,” she says, especially compared to the side effects of other treatments, like CAR-T, which requires isolation. CAR-T wipes out a patient’s immune system and replaces their T-cells with donor or re-engineered T-cells. Livermore developed cytokine release syndrome—her immune system responded more aggressively than it should have. “I’m still living with that. It can take years to come back.”

Because Livermore’s cancer is incurable, even though she’s in remission, she will continue with the treatment, weaning off the shot until she receives it just once a month.

She still needs to be cautious with crowds, but it’ll be nice to feel more confident going to big outings. Though Essell was always good with the important things: In 2022, when Livermore’s son invited her to watch the Bengals in the Super Bowl (which she accepted), Essell joked, “Yes, you can go. As long as you take me.”

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