The Keck Effect: More Charity

Access to clinical trial helps provide a father of four with a dramatic recovery.

At the age of 29, Neil Navarro had a stomachache. It wasn’t the flu, or even food poisoning, and it wouldn’t go away.

He was diagnosed with a congenital cyst in his abdomen, which doctors surgically removed. But eight years later, the discomfort returned, and he was diagnosed with stones in the bile ducts leading to his liver. These were removed, as well. But the ache came back.

In 2012, three years after the removal of the liver stones, Neil found himself in pain once more. In denial of his agony, Neil delayed an examination until a visit to his primary care physician revealed the awful truth: at age 40, he had bile duct cancer — stage IV — and a life expectancy of only two years.

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Reeling from this news, he went for second and third opinions, which both confirmed the cancer and prognosis. Luckily for him, when he came to the USC Norris Comprehensive Cancer Center, he found Heinz-Josef Lenz, MD, associate director for clinical research and co-leader of the gastrointestinal cancers program at USC Norris, who quickly formed a plan of action.

“I appreciated his saying he would do his best to help me get through this,” Neil says. “He had a sense of urgency. Within a couple of days the port was installed in my upper chest for infusions and lab work, which confirmed to me that he would be a good fighter for me. About a week later, I started chemotherapy.”

According to American Cancer Society estimates, in 2017, approximately 41,000 Americans will be diagnosed with cancer of the liver and the bile ducts, the tubes that move fluids from the liver to the small intestine.

Dr. Lenz found that Neil’s cancer, which had spread to his liver, showed a rare genetic alteration called a HER2 amplification — an over-expression of a gene that appears in several types of cancers. For eight months, Dr. Lenz began a treatment regimen of FOFLOX (folinic acid, fluorouracil and oxaliplatin) and trastuzumab (Herceptin), which stabilized the tumors for a time, but were unable to stop regrowth. Dr. Lenz decided that Neil needed a new approach — he enrolled Neil in a clinical trial for a combination of four drugs originally designed for breast cancer. Targeting the HER2 pathway, the chemotherapy includes paclitaxel, trastuzumab, MM-111, and lapatinib.

“This second treatment melted his disease away,” Dr. Lenz says. “We continued the treatment for three years, and the tumor shrank in a very dramatic fashion. There was some leftover tissue, which we removed, and there was no cancer left. A recent CT scan shows that he is completely disease-free, which is unheard of for this type of cancer. His prognosis for a normal life span is very good.”

Now 44, Neil is very grateful for the high-quality care he received. “Everyone, from Dr. Lenz to the nurses at USC Norris, was very caring and professional,” he says. “They tried to give me the same nurse each time I went for treatment to help with relationship building. It was reassuring.”

He also appreciates the way his family was helped during a difficult time. With Dr. Lenz’s encouragement, three of Neil’s four children, then ages 14, 13 and nine, participated in Camp Kesem at USC — a free, week-long summer camp for children who have been touched by a parent’s cancer. “It gave them the perspective that they weren’t the only ones going through this,” Neil says.

Now a training officer for the Salvation Army at the organization’s college in Rancho Palos Verdes, Neil says there were “a lot of prayers on my behalf from colleagues, friends, and family.” When he counsels cadets who are dealing with cancer diagnoses, he believes he is paying forward what he received. “I encourage them to be strong, listen to their doctors, pray, and trust that no matter what happens, God has a plan,” he says.