“Sometimes miracles appear through human hands, research, and medicine,” says Grace Mansell, a cancer patient being treated at Sutter’s California Pacific Medical Center (CPMC). “I received so much support and incredible treatment here after helping care for others.” Grace’s story is a testament to courage, tenacity, and the good fortune of being in the right place at the right time.

After helping care for her sister, who passed away from pancreatic cancer in 2010, Grace began her own journey with cancer seven years later. While experiencing a couple months of initial symptoms, she had an inner intuition of something more serious. Her suspicion was confirmed after PET/CT scans and a tissue biopsy in February 2017, which showed early stage pancreatic cancer. Unfortunately, Grace’s cancer returned after surgery and was shown to be metastatic.

Participating in clinical research at Sutter was one of the best decisions.

“My sister’s legacy to me was helping me know the warning signs; I knew something was wrong and immediately sought expert diagnosis and care,” says Grace. Her husband, a gastroenterologist, was closely involved in Grace’s journey in seeking cancer treatment from the very beginning.

Improved screening and treatment have allowed patients with other types of cancer—particularly breast, prostate and colon cancer—the opportunity to live years longer than in decades past. Unfortunately, innovations such as immunotherapy haven’t been as effective yet in treating pancreatic cancer, so the disease continues to cause a significant number of cancer-related deaths across the U.S. Pancreatic cancer is the third-leading cause of cancer deaths in men and women.

As two women from a family of three daughters, both Grace and her younger sister were at elevated risk of pancreatic cancer, carrying a mutated BRCA gene that increases a person’s risk for several types of the disease, including pancreatic.

After performing Grace’s endoscopic ultrasound at CPMC, Kenneth Binmoeller, M.D., suggested she consider participating in a clinical study at CPMC’s Research Institute (CPMCRI) called the Cancer Avatar Project. The study was showing promising results in delivering treatment information to cancer patients with certain genetic mutations in their tumor. Grace consulted with her husband and agreed to participate in the study.

Grace’s pancreatic surgeon, Assad Hassoun, M.D., FACS, recommended immediate surgery to remove the cancer. After the surgery and with Grace’s consent, he provided part of her tumor tissue to the scientists conducting the Cancer Avatar Project.

Through this project, researchers at CPMCRI are studying aggressive, hard-to-treat cancers by growing human tumors in mice. A piece of Grace’s tumor would be implanted in mice, then studied for several months. Using this “avatar” model, the researchers can test the effects of different U.S. Food And Drug (FDA)-approved and investigational drugs on cancer progression and responses to treatment.

“As a scientist, it gives me immense satisfaction when actionable genetic alterations or novel discoveries identified through the Cancer Avatar Project help cancer patients in the management of their disease,” says Altaf Dar, Ph.D., a scientist at CPMCRI. “We strive to find and predict personalized treatment for each patient through this research.”

The Cancer Avatar Project at CPMCRI currently comprises studies in eight of the most aggressive cancers, including pancreatic cancer. “Little did I realize then how important that approach to cancer treatment would become for me: a way to predict what types of treatment would best target my unique type of pancreatic cancer,” says Grace.

After her surgery, CPMC medical oncologist Ari Baron, M.D., Chief, Division of Hematology Oncology, CPMC managed Grace’s care.

For almost one year, she traveled 170 miles from Paradise, California, to CPMC’s Pacific Hematology Oncology at least two times monthly for chemotherapy.
Grace remembers the moment when CPMC transplant surgeon Robert Osorio, M.D., shared exciting news: the tumors in some of the mice carrying samples of Grace’s cancer tissue had shrunk after treatment with certain chemotherapeutic drugs, providing new hope to Grace that her cancer might respond similarly.

Eleven months and two types of chemotherapy later to treat her residual cancer, February 2018 saw Grace in remission. “I will never forget my elation and joy when Dr. Baron smiled widely and hugged me as he shared the good news,” says Grace.

In remission but struggling with neuropathy, a common side effect of chemotherapy that damages peripheral nerves, Grace read about exciting advances in cancer research worldwide that were continuing to bring patients new treatment options. Some of these included targeted cancer drugs that boost immunotherapy to treat aggressive types of the disease.

So when Dr. Baron suggested Grace consider enrolling in a clinical trial at Sutter testing a new type of targeted cancer drug called PARP inhibitors, she enthusiastically accepted.

PARP is a substance that helps repair DNA when it becomes damaged, which occurs during treatment with certain anticancer drugs. In cancer treatment, blocking PARP may help keep cancer cells from repairing their damaged DNA, causing them to die.

In March 2018, Grace enrolled at CPMC in a national clinical trial called TAPUR™, in which she began receiving twice-daily doses of olaparib. Although lifted by the hope offered by this new experimental treatment, another blow struck Grace and her husband: the Camp fire ravaging Paradise, California, claimed Grace’s family home and their medical office.

She and her husband relocated temporarily to Chico, then to Lodi. Now Grace travels 85 miles to CPMC every month for TAPUR™ study treatment.

TAPUR™ is a national clinical trial determining the safety and efficacy of approved, targeted anticancer drugs based on genetic profiling in patients with advanced cancers who are not responding to standard of care. TAPUR™ study treatments are based on the genetic profile of study participants’ cancer, and offer access to medications that are otherwise not available.

“We are deeply proud that Sutter is the only center offering TAPUR™ in Northern California, and is one of the top enrolling sites in the U.S.,” says Dr. Baron. “Patients enrolled in the trial receive molecularly targeted treatments based on a genetic analysis of their cancer. By participating in the study, these patients are receiving cancer drugs that may slow or stop tumor growth—offering hope for remission.”

It’s February 2020, and Grace receives twice daily doses of olaparib and monthly injections of denosumab to prevent further growth of a small metastasis, now in remission, in her spine.

“In spite of the dark cloud that was hanging over my head, there have nevertheless been so many unsung heroes that have a special place in my heart. “Words are not enough to express my profound gratitude to God, my husband, and the physicians and researchers at Sutter for taking care of me and cheering me on with excitement about every little progress I have been blessed with. I would not be alive today, had it not been for all of them.”

“Participating in clinical research at Sutter through the Cancer Avatar Project and the TAPUR™ study was one of the best decisions I made during those dark hours,” says Grace.