Frances’ Story: The Stars Align
Colorado woman comes to Cleveland for novel glioblastoma trial combining immunotherapy with laser-guided surgery
After years of catering to the stars, Frances Noonan has an eye for the best. The Colorado woman also knows one's luck can change in an instant, and traveling for a better experience can be well worth the trip.
Her initiative brought her to University Hospitals Seidman Cancer Center, where she is participating in a novel clinical trial that combines immunotherapy and minimally invasive brain surgery to treat recurrent glioblastoma multiforme. Andrew Sloan, MD, FACS, Director of the Brain Tumor & Neuro-Oncology Center, is the principal investigator for Case 3316, the first-in-human Phase 1 trial, pairing LITT with the immune checkpoint inhibitor pembrolizumab.
“No one has done this before, combining laser interstitial surgery with immunotherapy,” says Dr. Sloan.
Fran is thrilled to be a pioneer. Born at UH in 1953, she grew up in Mayfield Village and ventured to Colorado in the 1980s with the man who would become her husband. They settled in Montrose on the western slope, where she established a catering business providing in-flight meals for private jets of the rich and famous. She also served as the personal chef to Hollywood celebrities on their adventure trips, and one movie star even named her “Fran-tastic” signature dish, the creamy chicken enchiladas now known as Franchiladas.
When she came to UH, the retired chef served her specialty dish for the staff at UH Seidman Cancer Center, where she is being treated in the new Wesley Center for Immunotherapy.
A pioneer in a novel trial
At UH, Fran will undergo Laser Interstitial Thermotherapy (LITT), where Dr. Sloan will utilize intra-operative MRI to guide him. Through a tiny hole in the skin and the skull, the 3Tesla (3T) intraoperative MRI works as the surgeon's eyes, heating the tumor and using MRI thermometry to assess the tumor and kill cancer cells in real time.
Patients in this clinical trial previously had the LITT procedure first, followed two to five weeks later by an infusion of pembrolizumab (Keytrudaa), a novel immunotherapy checkpoint inhibitor. Fran is the first patient to receive the immunotherapy infusion first, followed by LITT a few weeks later and another infusion of the drug.
“We're so pleased to be here,” says Fran, who learned about UH's prestigious brain cancer program through a Facebook group of glioblastoma survivors. “The care, the consideration is unbelievable - the attention to every detail.
“It's a classy place. I'm honored to be there.”
An unexpected turn
Fran's first sign of concern that led to her diagnosis was an unexplained clumsiness in her left hand. She thought she was developing carpal tunnel syndrome. Before she had a chance to react, her sister was suddenly diagnosed with metastatic renal cancer. Her daughter came to tell her the news, and found her mother had some drool by her mouth. Fearing a stroke, her daughter took her to the ER, where imaging found a 3 centimeter tumor in her brain that proved to be a glioblastoma (GBM). Fran was quickly swept into her own cancer treatment, with a craniotomy followed by six weeks of combined radiation and chemotherapy and then a full year of chemotherapy.
When Fran went for the “all clear” scan after treatment, she discovered the brain cancer had returned. Her search for the best treatment in the country brought her to UH Seidman Cancer Center, where several clinical trials are underway for brain cancer patients.
“They are very, very good with communication,” Fran said. “We felt like family.”