Honoring CAR T Patient and Pioneer Richard Grady

September 30, 2017 | by Behnam Badie, M.D., F.A.C.S.

City of Hope Neurosurgeon, Behnam Badie, M.D. Behnam Badie, M.D., F.A.C.S.

Twelve years ago, I lost my father to a malignant brain tumor.

As a neurosurgeon and director of the Brain Tumor Program here at City of Hope, the irony of my father passing from brain cancer is not lost on me. He died 10 years into my practice, but his death was very much a turning point in my life. That experience showed me the family side of brain cancer. My dad gave me a better understanding of what the families and the patients go through and, I think, completed me as a neurosurgeon.

My life is devoted to finding a cure for brain cancer. Patients come to us seeking miracles, but often what they give us back is invaluable knowledge.

Throughout history, patients have helped revolutionize science and medicine. Many patients, like my dad, do not survive. But they leave behind a legacy of knowledge and hope for other patients today, and for future generations.

Richard Grady 256x256 Richard Grady, M.D.

Richard Grady was that kind of patient. A skilled pediatric surgeon himself at the University of Washington Medical Center in Seattle, Richard — or “Rich,” as he liked to be called — was internationally known for performing complex surgeries on children around the world, including those in developing nations for whom he was a strong advocate to eradicate health care disparities.

Rich came to us two years ago presenting with recurrent glioblastoma, the same disease Senator John McCain recently disclosed having. It is one of the most heartbreaking of diseases, with a grim diagnosis for which survival is often measured in months, not years. Rich knew City of Hope was his best chance, his only chance, in fact. When I first looked at his scans, I had this feeling that research we began working on a decade ago — not long after my dad died — could show promise in his case.

Rich was enrolled in our chimeric antigen receptor, or CAR T cell therapy clinical trial, which uses a patient’s own modified T cells to fight tumors. There are only a handful of cancer centers in the country offering this kind of therapy. We were the first — and remain the only — cancer center to administer CAR T cells directly to brain tumors. It was a radical approach, and he was a courageous subject.

What happened next is unprecedented. Rich’s brain and spinal tumors had shrunk, nearly disappearing. At first I thought I was perhaps looking at another patient’s scans, but they were Rich’s. His tumors just weren’t there anymore.

Rich’s response to the CAR T cell therapy was nothing less than remarkable. Miraculous even. His glioblastoma had gone into remission and history was made. His largest removed tumor, where the CAR T cells were infused, never returned. Several CAR T cell infusions successfully slowed Rich’s disease and extended his life. That had never been done before. His tumors eventually returned in different parts of his brain, even more aggressively than before. In the end, we were unable to keep up with the rapid spread of his disease.

Rich’s contributions to advancing our research are immeasurable. He helped change the treatment paradigm for patients with glioblastoma. At a certain point along the way, I suspect Rich knew the cancer would eventually claim him. But as a physician himself, a patient, a scientist and a humanitarian, he wanted the research to continue in hopes that it would one day save the lives of others.

Richard Grady was in every way a pioneer. What we learned from him is a game-changer that has forever altered how brain tumors will be treated. He is an inspiration and a daily reminder to us of what is possible.

Behnam Badie, M.D., is vice chair and professor at City of Hope’s Department of Surgery. He is also chief of the Division of Neurosurgery and director of the Brain Tumor Program.  
Richard Grady, M.D. (1965-2017) was known internationally as an expert in surgical care for children with bladder exstrophy, a congenital anomaly affecting the urinary, genital, musculoskeletal and pelvic floor systems. He traveled the world to train surgeons in the procedure in underserved countries.
At his death, he left behind the following advice for friends, family and colleagues: “Go ride a bike, be kind to a stranger, take a swim in open water, read a comic book, listen to a favorite piece of music, sing with a child, breathe in fresh air after a spring rain, try something new, write a poem, dance with abandon, and always cherish each day.” July 26 would have been his 52nd birthday. 
Richard Grady’s widow, Laura Hart Grady, M.D., has set up an ourHope page in his memory to continue Badie’s research. You can find more information here.

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