In 2011, Vida Chernoff was diagnosed in New York with advanced endometrial cancer, also known as cancer of the uterus. Treatment included a grueling schedule of surgery, chemotherapy, and clinical trials, but after three years, her cancer was progressing and her doctors at the time referred Ms. Chernoff to palliative care. “After battling my way through so much I was on the verge of giving up, but my former husband was determined to find someone with the right expertise,” said Ms. Chernoff. “We found Dr. Santin and he quite literally saved my life.”
Alessandro Santin, MD, is Professor of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine and Disease Aligned Research Team Leader for the Gynecological Cancers Program at Yale Cancer Center and Smilow Cancer Hospital. “Vida was very sick when I saw her here at Smilow for a second opinion,” said Dr. Santin. “She had a highly aggressive endometrial cancer that was now resistant to chemotherapy. She was given no other options to beat this disease.”
Based on a genetic analysis he performed of Ms. Chernoff’s tumors called whole exome sequencing, Dr. Santin was convinced the immunotherapy drug nivolumab could make a difference. Immunotherapy prompts the body’s immune system to attack the cancer and interfere with the ability of tumor cells to grow and spread. The problem was nivolumab at that time was approved by the U.S. Food and Drug Administration (FDA) for melanoma, not for recurrent endometrial cancer.
“Due to my knowledge in endometrial cancer genetics, having had multiples studies published on this topic, I requested permission to give Vida nivolumab on a compassionate basis,” said Dr. Santin. “I had to find a creative way to give her this chance.” Dr. Santin got his approval and Ms. Chernoff was treated with nivolumab bi-weekly for approximately a year and a half. It proved extremely effective in shrinking her tumors. “She responded in a miraculous way to nivolumab,” said Dr. Santin. “Today, she is free of disease.”
While nivolumab is not yet approved for endometrial cancer, pembrolizumab and dostarlimab, two similar antibodies targeting the same receptor of nivolumab (called programmed death-1 or PD-1) have been approved by the FDA for the treatment of endometrial cancers with genetic characteristics similar to Ms. Chernoff’s tumors. Accordingly, Dr. Santin has recently reported the results of an Investigator Initiated Phase II clinical trial confirming the impressive activity of this immunotherapy treatment in 25 consecutive endometrial cancer patients enrolled and treated at Yale.
Ms. Chernoff has lingering side effects from previous chemotherapy treatment, such as neuropathy and ongoing moderate kidney disease, but she said they are all manageable considering what she was facing. When she can, she doesn’t hesitate to offer advice to patients facing similar circumstances.
“You are your best advocate, so learn as much as you can about your condition, never hesitate to ask questions, reach out for a second opinion, and look for the right expert,” said Ms. Chernoff. “And rely on your family and friends for help. Along with Dr. Santin, I wouldn’t be here without them.”