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Never Give Up: The Journey from Metastatic to Complete Response

Never Give Up: The Journey from Metastatic to Complete Response

Stephen Eisenmann saw his metastatic diagnosis as a problem to be solved… and PCF-funded doctors and researchers helped him do it.

Stephen Eisenmann met his wife Elizabeth in 1990 when they were both working together. There was an instant spark, but they didn’t think much of it at the time since they were both married to other people. Much later, after they had both divorced, Elizabeth moved to Switzerland. “He found me when I moved back to the United States,” says Elizabeth. “This friend of mine calls and says, OK, Steve Eisenmann is going to call you and ask you out on a date; he is so bad at this that you are not going to know that he is asking you out on a date… and you’re so bad at it that you are not going to realize what’s happening. So I’m telling you.”

If you’re the kind of guy who waits 12 years for a woman, I think it’s safe to say you’re the kind of guy who doesn’t give up easily.

So, when Stephen was diagnosed with metastatic prostate cancer in 2016, there was no way he was going down without a fight; “I determined this was a problem to be solved. And at that point, I kind of sat back and I said, ‘Hmm. What’s the first step?’” Stephen used every resource at his disposal, called on friends, and made connections. Eventually, he ended up speaking with PCF CEO Jonathan Simons who recommended he meet with PCF-funded researcher and medical oncologist Dr. Dana Rathkopf at Memorial Sloan Kettering Cancer Center.

Dr. Rathkopf put Stephen on the standard of care at the time – continuous hormone therapy combined with chemotherapy for 6 treatment cycles. Stephen responded to the treatment, and his PSA went down to undetectable. Nevertheless, after about a year, Dr. Rathkopf decided to perform repeat imaging to confirm the response. Despite an undetectable PSA blood test, the imaging showed enlarging lymph nodes. The prostate cancer was back, even though Stephen wasn’t making any PSA. “I said, ‘No big deal,’” recalls Stephen. “‘We’ll just go to the next drug.’”

Unfortunately, it wasn’t that simple. Dr. Rathkopf explained that most current treatments and clinical trials assume that the patient’s cancer cells are making some PSA. Approximately 5% of prostate cancer patients don’t make any PSA, and Stephen was one of them. “There are few trials for men in your situation who don’t make any PSA.”

“When you meet the love of your life so late in life – the whole thing is just like this gut punch,” says Elizabeth, “it was just devastating.” But Dr. Rathkopf, never one to give up either, clarified that while there were few treatment protocols for his cancer, there might be a precision drug. She biopsied his cancer to figure out if there were any genomic markers they could use. Meanwhile, just days before Stephen’s test results came back, a PCF-funded study out of the University of Michigan found that about 6.9% of prostate cancer patients had a mutation in a gene named CDK12, and that some of those patients had responded to pembrolizumab, an immunotherapy drug that was approved for the treatment of other cancers, but not prostate cancer. Then the best of the worst of news came in: Stephen had a CDK12 gene mutation marker. Dr. Rathkopf wanted to give the pembrolizumab immunotherapy a try, but she also wanted Stephen to get a second opinion to ensure that “no stone was left unturned”. She sent him down to Johns Hopkins to see another PCF-funded investigator and medical oncologist, Dr. Emmanuel Antonarakis. Stephen’s wife was unrelenting in her questioning of Dr. Antonarakis. Elizabeth asked if all Stephen’s cancer cells made CDK12. Dr. Antonarakis said they did. Elizabeth asked if pembroluzimab killed all cells that made CDK12. Dr. Antonarakis said that it did.

“So, are you telling me he could be cured?” Elizabeth asked. “We don’t use the word cure, we prefer the term complete remission,” said Dr. Antonarakis. Elizabeth looked at Stephen and said, “Okay honey, we’re going out to celebrate. We got this. You’re going to be cured. I know, it sounds crazy.”

Since all of the patients in the CDK12 Michigan study had prostate cancer that made PSA, the exact treatment protocol for Stephen was not set in stone. He was basically an “N of 1,” as doctors like to say, or his very own clinical trial of one person. They agreed to give Stephen 4 cycles of pembrolizumab, then retest.

But between cycles 2 and 3, Stephen began to feel that his urination had changed. Dr. Rathkopf decided to order another imaging study to evaluate this change, since PSA was not a reliable measure in this case. Stephen was already on his way to his fourth and final treatment the day he missed a call from Memorial Sloan Kettering about his test results.

When Stephen arrived at MSK within the hour, Dr. Rathkopf brought in her whole staff to tell him the news.

After only 3 cycles of pembrolizumab, results of his imaging showed a complete response to the treatment.

“The Prostate Cancer Foundation saved my life,” says Stephen, “Dr. Rathkopf saved my life. My wife and my family saved my life. I’m the beneficiary of all that, and I’m the luckiest person in the world.”

Stephen continues to receive pembrolizumab treatments every 3 weeks to keep his prostate cancer at bay. But he doesn’t mind. “I never looked at this like being defeated. My grandkids are a big motivating factor, you know? I want to be there when they get married,” says Stephen. “My father taught me: Never give up. Always fight. Always find a solution.”