When Anthony Cannella was first diagnosed with mantle cell lymphoma, his youngest child was in kindergarten. He was told that the expected life span for someone with mantle cell lymphoma, an especially aggressive form of non-Hodgkin lymphoma, was three to five years.
"That was hard, worrying about her. He was like, 'I want to be here when she grows up,'" explained his wife, Mary Ellen Cannella.
"And now she's 26."
Three separate clinical trials helped to get Anthony to this point – living the semi-retired life in Myrtle Beach, working at a part-time job just to keep busy, being near grandchildren as well as friends from back in New York, enjoying the attractions and shows that Myrtle Beach offers and attending Coastal Carolina Chanticleers football games.
"He always wanted to do the most aggressive thing that would help him," Mary Ellen said.
When he was first diagnosed, that meant going with a new treatment regimen recommended by New York-Presbyterian, including an autologous stem cell transplant and chemoimmunotherapy. When the cancer returned, it meant enrolling in a clinical trial for Calquence, which has since been approved by the Food and Drug Administration.
By 2024, the couple was well-settled in Myrtle Beach, and Anthony was seeing an oncologist there twice yearly. So when his annual CAT scan showed that the cancer had returned yet again, his oncologist referred him to Brian Hess, M.D., at MUSC Hollings Cancer Center.
"He explained all the options to me," Anthony said. There weren't many. Existing therapies would likely work for months or maybe a couple of years. "And that's when he told me about option No. 3, which is the CAR-T trial."
CAR-T cell therapy trial at Hollings
CAR-T cell therapy is an option for some blood and lymphatic cancers. During this multi-step procedure, some of the patient's T-cells, a part of the immune system, are removed. They're brought to the lab, where scientists add a "CAR" – a chimeric antigen receptor that's designed to attach to a specific protein on the cancer cells.
The patient then undergoes intensive chemotherapy to make room for these new CAR-T cells, which are reinfused and get to work attacking the cancer cells.
The downsides to CAR-T cell therapy include the expense and the likelihood of severe side effects, including neurotoxicity, high fevers and trouble breathing that can require hospitalization in an intensive care unit.
In an effort to lessen these side effects and improve the longevity of the treatment, not to mention reducing the cost for South Carolinians, Hess and researcher Shikhar Mehrotra, Ph.D., are conducting a clinical trial of Mehrotra's own version of CAR-T cell therapy.
His patented version includes a special marker that allows the lab to isolate the most robust CAR-T cells so that only the "purified" cells are returned to the patient, rather than the typical mixture of a variety of blood and immune cells that can't be completely teased apart.
They have so far treated 11 patients, with seven in complete remission, and none of those in remission have relapsed at this point. The clinical trial will likely enroll a couple of dozen people.
Anthony didn't hesitate to try the trial.
"My options weren't that great. I did a stem cell transplant already. I did the Calquence. So now the CAR-T-cell transplant, I assume, is the up-and-coming technology to treat mantle cell lymphoma," he said. "There really isn't anything else out there that is appealing to prolong your life because mantle cell lymphoma is not curable. With this trial that I'm in now, it may become curable, but we won't know that for a long while."
After his T-cells were removed and Mehrotra's team engineered them in the Center for Cellular Therapy within the MUSC College of Medicine, Anthony was prepped for transplant.
"I had three straight days of a high dosage of chemo, which happened to be Father's Day weekend – so, Friday, Saturday and Sunday. I wasn't feeling any side effects from it, even though it was a high dosage. And then four days later, I came in and got my CAR-T cells," he said.
Hess warned the Canellas that Anthony could suffer some short-term neurological issues.
"Anthony's first language is Italian. So they said there's a possibility that he might wake up and start speaking Italian," Mary Ellen said.
As it turned out, that didn't happen. Although he was very weak, he didn't suffer the intense – and sometimes scary – side effects that can happen with CAR-T cellular therapy.
"I was in the hospital ward for about a week, and then three weeks after that as an outpatient. The first week as an outpatient, I stayed in Summerville with my daughter because we had to come back every day," he said.
By week four, he was down to one check-in for the week.
"That's when I finally got to go home. But I was moving very slowly. Felt like a really, really old man. I didn't have any strength to do much of anything," he said.
Week by week, he's been regaining his strength. He's still more vulnerable to illness than most people because the chemotherapy wiped out his immune system – he's in the process of getting all of his childhood immunizations again. But he's out enjoying life again with family and friends – even gathering with a group of friends nearly two dozen strong to celebrate St. Patrick's Day.
Mantle cell lymphoma is always nearby, though.
"From the very first time I got it in '05, there's not a day that goes by I don't think about it. Because I knew I was just in remission. There's never a cure," he said. "It's something that's always in the back of your mind."
Still, the clinical trials have gotten him this far. "I just try to stay positive, as much as I can."
He said that his fight is to be here for his family, which brings him happiness and inspiration, for as long as possible. Anthony fights to stay around for the loved ones who mean the most to him: his wife, Mary Ellen; his children, Christina, Stephen and Gabrielle; his step-children, Jennifer and David; and his grandkids, Gianna, Raelynn, Noelle and Christopher, and, of course, his siblings, nieces and nephews.
He has and will always be up for the next challenge – the next fight, he said. The strides that modern medicine and technology have made have given him encouragement, he said, and he feels blessed to have MUSC on his side.
