Odds are...Better All The Time

Odds are...Better All The Time


Odds are...Better All The Time

How TGen Renewed the Hope of Elizabeth O’Conner

 Elizabeth O’Conner couldn’t have been happier.

Life was good for the 31-year-old school teacher, enjoying her second trimester of pregnancy and eagerly awaiting the birth of her second child … a boy. Fear soon replaced her happiness when she inexplicably began losing weight and developed digestive problems. 

Her doctors struggled to pinpoint the cause. When her son, Andrew, arrived 7 weeks premature by cesarean section, they realized something was terribly amiss with her ovaries. Because they were so inflamed, she underwent a full hysterectomy. Tests revealed her ovaries were cancerous, and specifically that she had late-stage pancreatic cancer, which had already spread to her ovaries. 

The joy of childbirth soon gave way to the unknown and the possibility that she may not live to see her children grow up. Her doctors believed it was too late. Elizabeth and her family heard the news that no one should ever hear: go home, enjoy the moments you have but prepare yourself for the inevitable. Her doctors promised to  make her as comfortable as possible, but indicated she likely did not have long to live.

Elizabeth’s father, Randy Dobbs — a highly successful CEO and board member of multiple companies — simply could not accept Elizabeth’s fate as offered by her doctors. Surrender ran counter to his natural instincts. He had spent a lifetime solving problems in business and wasn’t about to sit idly by and let cancer control his daughter’s life.

That instinct would prove prophetic. Initially, however, the news delivered a gut punch.

“My initial thought,” said Randy, “was oh, my God. What are we going to do?” He had learned that a diagnosis of advanced pancreatic cancer amounted to a death sentence for most patients. “She’s only 31. We can’t lose her.”

The odds were slim. At the time of Elizabeth’s diagnosis, less than 5% of pancreatic cancer patients survived five years. 

 

The Search Begins

Randy initially searched in and around Atlanta for the best oncologists, a journey that eventually led him to Phoenix and TGen’s Daniel D. Von Hoff, M.D., considered one of the nation’s leading authorities on pancreatic cancer.

Elizabeth still had a strong immune system and she was put on what, in 2010, was the FDA standard-of-care for pancreatic cancer, gemcitabine, plus oxaliplatin. The goal was to eliminate as much tumor as possible to pave the way for surgeons to remove the cancer in her pancreas. If the drug failed, surgery wasn’t an option. However, because no progress was being made against the cancer in 2011, Dr. Von Hoff put Elizabeth on a new drug combination of gemcitabine and nab-paclitaxel, also known as Abraxane, a combination that in 2013 would eventually become an FDA-approved national standard-of-care for pancreatic cancer. That combination was developed in the TGen laboratory with TGen Professor Dr. Haiyong Han.

“From Day one, I can’t tell you how good Dr. Von Hoff was, making Elizabeth feel that he really owned the case; that he was going to do everything that he could, and that he was going to make her a survivor,” Randy recalled. “He always said to Elizabeth, ‘We’re going to keep you alive until the next best thing comes along.’ ”

 

Hope Renewed

By early 2012, the tumor had shrunk enough to begin radiation treatment. These steps further reduced the size of the tumor, which allowed surgeons to remove the remaining cancer located on the difficult-to-reach tail of her pancreas. The day-long procedure involved removing one of her adrenal glands and rerouting her intestines and a number of blood vessels. After she recovered from surgery, Dr. Von Hoff added another agent, 5-FU (fluoruracil). 

By 2014, the cancer reappeared, requiring the surgical removal of a portion of Elizabeth’s left lung. Later that year, she began having seizures as a result of the cancer having reappeared in her brain. Neurosurgeons removed as much of the cancer as possible, but the procedure left her unable to use her right leg and foot, requiring extensive physical therapy. Follow-on radiation treatments to battle recurrences claimed the use of her right arm.

In 2015, Elizabeth began a triple-drug regimen of gemcitabine, nab-paclitaxel and cisplatin, another combination designed by Dr. Von Hoff and his colleagues, which clinical trials showed improved survival for 7 out of every 10 pancreatic cancer patients. That regimen worked for some time. When it stopped working, a newly developed agent was added that targeted a specific genomic signature in Elizabeth’s tumor, making it susceptible to a PARP inhibitor. 

 

Immunotherapies: A Godsend

In March 2021, under the care of Erkut Borazanci, M.D. and Gayle Jameson, N.P., TGen adjunct faculty members, at HonorHealth Research and Innovation Institute, Elizabeth began an innovative immunotherapy regime, using drugs that re-ignite her body’s own immune system to fight the cancer by targeting her specific DNA mutations.

 “After progressing through every treatment regimen possible,” said Randy, “the immunotherapy has been a godsend.”

His encouragement stems from Elizabeth’s ability to drive again, eliminate pain medication, overcome depression, and return to performing routine tasks. These past holidays, for the first time in years, Elizabeth wanted to decorate a Christmas tree.

As much as anything, Randy is grateful for the effect Elizabeth’s improvement is having on her children: Andrew, now 11, as well as her first child, Abigail, 16, who just started driving and is looking forward to college.

“The good news for both of them is that they’re getting to be teenagers, and getting to live their lives, instead of everything being, ‘What’s going to happen to mom next?’ The fact that she’s being a mom, and happy and engaged with her children, is really good,” Randy said.

“None of us knows what’s ahead, but I’ve been so blessed to still have my daughter and for her to be with her family,” he added. “I’ll do whatever is necessary to support her and everything I can to support the medical personnel who are supporting her.”

For Elizabeth, the moment is what’s most important 

She is grateful for having joined Dr. Von Hoff and his associates in the past decade’s journey toward ever-better cancer treatments. “I can’t put it into words how much it means to me; to spend more time with my family; to not have that fear that I wouldn’t be around for them,” she said.

 

The Road Ahead 

Never one to rest, Dr. Von Hoff continues to push the boundaries of what is possible. And while the past decade has seen innovations in treating pancreatic cancer, he knows patients need more.

“The improvements we have made in pancreatic cancer treatments would simply not be possible without the pioneering bravery of patients like Elizabeth, who have traveled with us in this journey toward increased survival and a higher quality of life.” 

Today, Randy is helping fund a clinical trial for yet another new pancreatic cancer treatment designed by Dr. Von Hoff, along with new technology developed by an Irish academic team that targets a genetic mutation present in up to 90 percent of all pancreatic cancer patients.

“There can never be enough for me to do to honor Dr. Von Hoff, his colleagues and team, and all they have done for me and my family,” Randy said.

And while Elizabeth continues to defy the odds, Dr. Von Hoff and his colleagues continue their pursuit of the next best thing.

 

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