According to the Leukemia and Lymphoma Society, blood cancers such as leukemia, lymphoma and myeloma accounted for nearly 10% of all new cancer diagnoses in 2020. Blood cancers are also responsible for 10% of all cancer deaths.
Fortunately, there is a major advancement developing in personalized treatments for these deadly cancers: chimeric antigen receptor T-cell (CAR-T) therapy. This cutting-edge treatment involves separating T cells from a patient’s blood, manipulating them to bind with a specific protein on their cancer cells and then growing large quantities of the modified T cells. Then, when given back to the patient by infusion, the modified T cells kill the cancer cells.
Currently, CAR-T is available in the Bay Area only through academic research centers—but this is about to change. Thanks to the generosity of community donors and physician leaders, Alta Bates Summit Medical Center in Berkeley is positioned to become the first community hospital in Northern California to offer this innovative therapy.
ABSMC’s Comprehensive Cancer Center is an ideal location for CAR-T therapy, owing in large part to the clinical expertise of Sutter East Bay Medical Group hematology oncologists Rajesh Behl, M.D., and Oleg Krijanovski, M.D. The two specialists have also partnered with philanthropy to bring this state-of-the-art treatment to East Bay residents.
“Patients often travel long distances to receive CAR-T, and they must stay nearby for at least a month to watch for side effects,” explains Dr. Behl, oncology site lead for the Sutter East Bay Medical Foundation and physician sponsor of the CAR-T therapy philanthropy campaign. “Also, currently, CAR-T is a last line of treatment, forcing patients to be away from their families during a very difficult time. Therefore, bringing this kind of treatment to our community, closer to home for patients, will be a huge benefit.”
Dr. Behl has spent 18 years in the hematology field and joined the ABSMC Comprehensive Cancer Center staff in He has led the blood and bone marrow transplantation and malignant hematology programs at different times and now heads up several oncology committees. He firmly believes that over time, CAR-T therapy will be able to help even more cancer patients than it does currently.
“At least 30% to 40% of the patients I see have a kind of malignancy that can benefit from CAR-T therapy, and the list of treatable cancers is growing rapidly,” Dr. Behl says. “My hope is that our cancer center can be at the forefront of using these innovative therapies much earlier in the course of disease, rather than as a last treatment option.”
Endorsing Community Hospital Excellence
Inspired by Dr. Behl’s compassionate clinical work and vision, noted area philanthropist Nadine Tang, MSW, signed on as a lead donor with a gift to launch the ABSMC CAR-T program. Nadine, a licensed clinical social worker practicing in the East Bay for 40 years and an adjunct faculty member in the University of California, Berkeley psychology department, sees immense value in bringing this treatment to a community hospital. “Academic institutions are wonderful if you can get in, but there is a level of personalized care you receive in community-based medicine that is not available in an academic setting,” she explains.
Nadine experienced this difference firsthand when Dr. Behl took over care for her husband, Bruce Smith, after a complicated diagnosis confirmed advanced lymphoma in May 2019. Bruce, who had been experiencing neuropathy and was losing his ability to walk, was originally diagnosed with Guillain-Barre syndrome. “Bruce’s illness was a big mystery,” Nadine shares. “It took several weeks to arrive at the diagnosis of lymphoma.”
Nadine and Bruce consulted with specialists at the University of California, San Francisco and Stanford University but ultimately selected Dr. Behl for his exceptional character. “The entire care team, from the nursing staff to the receptionists, was really terrific,” she says. “Dr. Behl, in particular, is a wonderful physician who is emotionally and psychologically supportive. He even gave us his personal cell phone number, which helped to relieve anxiety.”
The couple was also impressed by Dr. Behl’s willingness to collaborate with physicians from other institutions, including a Stanford specialist he had trained with at the Dana Farber Cancer Institute at Brigham and Women’s Hospital in Boston. This further reassured them in their choice to keep Bruce’s care close to home.
“At one point, we were consulting with a lymphoma specialist from UCSF when Dr. Behl walked into the room,” Nadine recalls. “He stepped right in and was so collaborative—which is not always the case—and for us to hear the discussion between these highly trained specialists was very unusual and enlightening.” This kind of collaboration will grow even stronger with the new cancer care joint venture between Stanford Medicine and Sutter Health in the East Bay.
Bruce succumbed to lymphoma in September 2020, but Nadine’s gratitude for the care Dr. Behl and his team provided paves the way for the CAR-T program at ABSMC. She has been very involved with philanthropy at UC-Berkeley, leading a successful $1 billion campaign there. With this important gift to ABSMC, Nadine is validating the unique culture of a community hospital and its ability to elevate the level of healthcare for everyone.