Jan Janisch-Hanzlik had been having strange symptoms for several years. But it was a sensation that started in her toes and crept up her right side that really concerned her. “By the end of the week, I had a spinal tap, an MRI of the brain and spine and was diagnosed with MS,” she said. “I thought I would get on meds, and within a month or two, I’d be back to my normal self.”
But just three months later, the 49-year old’s condition had advanced to the point where she could no longer drive and had to move into a new home after falling multiple times.
She was referred to Rana Zabad, MD, a neurologist and MS specialist at Nebraska Medicine, who presented her with a new option: enrollment in a first-of-its-kind clinical trial using allogeneic CAR T-cell therapy. This therapy uses T-cells from a healthy donor that are genetically modified to target and destroy specific immune cells that contribute to the autoimmune attack in MS. It’s an approach previously used by Nebraska Medicine hematologists to treat blood cancers.
“This is a completely novel concept in MS therapy,” said Dr. Zabad, who also is a professor and director of the Multiple Sclerosis Program at UNMC. “We’ve never used allogeneic CAR T-cell therapy to target the immune cells responsible for driving inflammation and damage in the central nervous system. This trial is about pushing boundaries carefully and thoughtfully to explore what could be possible.”
Click Play below to watch this video on Jan Janisch-Hanzlik’s story.
Jan received the therapy on June 9 at Nebraska Medicine’s Fred & Pamela Buffett Cancer Center under the care of Matt Lunning, DO, a hematologist/oncologist specializing in CAR T-cell therapy. She was discharged on June 16 and has since returned for follow-up care.
“There is growing hope that this therapy can do more than treat patients with blood cancers like leukemia and lymphoma,” said Dr. Lunning, also a professor in the UNMC Division of Oncology and Hematology. “A year ago, we provided the first allogeneic CAR T-cell therapy to a patient with lupus, and she has seen excellent results. We’re hopeful Jan will have a similar experience.”
Jan says she’s honored to be part of something potentially transformative. “I feel blessed that Dr. Zabad chose me for this treatment,” she said. “I’m not just excited for me I’m excited for the whole MS community including the physicians and the patients because it’s really going to help all of us in the long run.”
The CAR T-cell therapy process required a short course of chemotherapy to prepare Jan’s immune system, followed by the infusion of genetically engineered donor T-cells. These modified cells are designed to seek out and destroy the specific immune cells believed to contribute to MS. Allogeneic therapy offers a readily available, “off-the-shelf” product, since the cells don’t need to be custom-made for each patient as they do with autologous CAR T-cell therapy, which uses the patient’s own cells.
“Jan’s courage and optimism have been incredible,” said Dr. Zabad. “She understands this trial is not just about today’s treatment, it’s about what this could mean for thousands of others living with MS.”
In addition to the groundbreaking clinical care, Jan says the personal care she received at Nebraska Medicine has made a lasting impact. “I cannot even explain the care I’ve been given here. It has been absolutely amazing,” she said. “The nurses are so responsive. I love that they have a mobility assistant to walk with you in the halls. And I really have a lot of faith and trust in Dr. Zabad.”