From Incurable to Cancer-Free: A Young Woman’s Remarkable Journey with Experimental Immunotherapy

Emma Dimery’s story is one of hope and resilience, a testament to the power of medical innovation and the unwavering spirit of a young woman facing an unimaginable challenge. Two years ago, Dimery received the devastating diagnosis of stage 4 colon cancer, deemed incurable by medical professionals. Today, she stands healthy and cancer-free, a remarkable outcome attributed to a last-resort clinical trial that harnessed the cutting-edge potential of genetic therapy.

Dimery’s journey began at the young age of 23, a time when most individuals are focused on building their careers and exploring life’s possibilities. However, she found herself battling a disease that is increasingly affecting young adults: colon cancer. The incidence of colon cancer in individuals under 50 has been rising sharply in recent years, prompting concerns and renewed efforts to understand and address this alarming trend.

Her initial symptoms were seemingly innocuous: abdominal pain and abnormal blood work. These warning signs led Dimery to undergo a colonoscopy, a procedure that revealed the stark reality of her condition. Two tumors were discovered, one the size of a softball and the other the size of a golf ball. The diagnosis marked the beginning of a long and arduous battle against a relentless disease.

Dimery underwent multiple surgeries, chemotherapy regimens, radiation therapy, and various combination therapies in an attempt to eradicate the cancer. Despite these aggressive treatments, the cancer proved resistant and continued to spread throughout her body. This led to what she described as a "low point" in her journey, a moment of despair when she felt she was running out of options.

"I was basically treading water, doing immunotherapy every other week for probably four years or so," Dimery recounted. "I had exhausted every other standard of treatment, and even some not-so-standard ones." Hope, however, remained in the form of a clinical trial, a potential lifeline that Dimery had been eagerly anticipating.

When she learned about a new trial at the University of Minnesota, led by Dr. Emil Lou, a medical oncologist and scientist who had previously treated her, Dimery knew she had to seize the opportunity. "It wasn’t a tough decision," she said. "I was on board pretty much from day one."

The trial focused on an experimental genetic therapy that Dr. Lou described as the "next frontier of immunotherapy." Unlike traditional immunotherapies that target the outer surfaces of cells, this novel approach targeted the insides of cancer cells. The therapy aimed to disrupt the mechanisms that prevent the immune system from effectively attacking the cancer.

"Some of the targets inside the cell are preventing the immune system from activating against the cancer," Dr. Lou explained. "It’s kind of like a shield that protects the cancer cell from the body’s immune system."

The trial involved retrieving cancer cells from the participants and then altering them in a laboratory using CRISPR-Cas9 gene editing technology, a revolutionary tool that Dr. Lou likened to "genetic scissors." The process involved reprogramming the cells to exhibit a more potent anti-tumor response.

Once the cells were genetically modified, they were reintroduced into the patients’ bodies through infusion. "They trained the cells to be able to fight my cancer specifically when they were reintroduced into my body," Dimery noted.

The treatment process was lengthy and demanding, accompanied by challenging side effects. However, Dimery persevered, focusing on the positive aspects of her situation and drawing strength from her support system. "You just get through it and try to focus on the good," she said. "And I had a lot of good around me. I had a really amazing support team."

A total of 12 patients participated in the study, and while all participants benefited to some degree, Dimery’s response was exceptional. The vast majority of advanced colorectal cancers are not considered curable, and the available treatments, such as chemotherapy, are typically palliative, meaning they aim to manage the disease and alleviate symptoms but cannot induce a cure.

"The chemotherapies or whatever other treatments we have available, while there are a number of them, are palliative – meaning they don’t have the capability to induce a cure in patients with metastatic stage 4 colorectal cancers," Dr. Lou explained. "Emma was in that category until she came onto our trial."

Dimery’s response to the experimental immunotherapy was described as "remarkable" by Dr. Lou. After just one infusion of the engineered cells, she was pronounced cancer-free, an outcome that is "almost unheard-of" with advanced colorectal cancer.

"We term this in oncology as a ‘clinical complete response,’ which is something that you see in 10% or less of all patients," Dr. Lou said. "And it’s less than 10% for stage 4 colorectal cancers. What we saw in Emma was a magnificent and unprecedented level of response, going from a metastatic stage for an otherwise incurable cancer … where now we don’t see any cancer."

Two years after the trial, Dimery is thriving. "The trial worked almost immediately – and I’ve had no evidence of disease since," she said. While she remains cautious about using the word "cure," she acknowledges that the trial has profoundly changed her perspective on cancer.

"Until now, the best I could hope for was remission to the point of no evidence of disease … and had to accept that it could rear its head again at any point, even if they can’t detect it on a scan," Dimery said. "All of my scans have just been coming back better and better."

Dimery’s story was recently presented at the American Association for Cancer Research (AACR) Annual Meeting in Chicago, where it garnered significant attention. Researchers are now working to understand the factors that contributed to her exceptional response in hopes of replicating similar outcomes for other patients.

"Emma is exceptional in many ways, but what we learned from her case, we hope to replicate and decipher how we can achieve this on a more consistent basis across the board for more patients like her," Dr. Lou added.

Dimery’s experience also sheds light on the growing issue of early-onset colorectal cancer. Studies have shown that in 2023, one in 10 colorectal cancer diagnoses were considered early-onset, affecting patients under 50 years of age. The American College of Surgeons predicts that early-onset cases will double by 2030.

Dr. Lou emphasized the importance of screening for colorectal cancer, even at younger ages. "Colorectal cancer remains one of the few cancers for which we have validated screening tools," he noted. These tools include blood-based tests, stool-based tests, and colonoscopies.

In 2018, the American Cancer Society changed its colorectal screening recommendation from age 50 to age 45, and other medical organizations have followed suit. However, Dr. Lou has observed a disturbing trend of patients being diagnosed at even younger ages.

"I’m seeing something in the last five or six years that I really did not see earlier in my career – teenagers, people in their 20s, 30s and 40s," he shared. "Just last week, I saw someone in their early 40s with widely metastatic stage 4 colorectal cancer."

What is particularly concerning, according to Dr. Lou, is that about half of the cases of colorectal cancer are diagnosed at stage 4. "A lot of times, they don’t even have symptoms, or they have symptoms that were construed as something else," he said.

Dimery is encouraged by the increasing awareness of early-onset colon cancer. "The more people who are aware, the better," she said. "I think it’s really important to not panic, but to stay informed and connected to the community."

She also stressed the importance of genetic testing to determine eligibility for clinical trials. "That can tell you a lot about your individual type of cancer," Dimery said. "Luckily for me, I had just the right kind of cancer for this treatment."

Emma Dimery’s story serves as a beacon of hope for those battling cancer, demonstrating the potential of innovative therapies and the importance of early detection and awareness. Her remarkable journey from an incurable diagnosis to a cancer-free life is an inspiration to patients, researchers, and medical professionals alike, fueling the ongoing quest for more effective treatments and ultimately, a cure for cancer.