Meryl Selig has had a unique experience at the Stanford Cancer Institute (SCI). She began as a patient volunteer in 2009 before being diagnosed with cancer and becoming a patient. She became one of the first patients to receive a novel chimeric antigen receptor (CAR-T) cell therapy when she enrolled in a phase-one clinical trial in 2023. Throughout these years, she has been active among SCI’s donors as a powerful voice on how the SCI may evolve.
Selig said, “My cancer saga is pretty long now, which I guess is a good thing because I’m still pretty healthy. I like to call myself the healthiest cancer patient I know.”
You can watch her tell her story on our YouTube channel.
Selig’s personal experience with Stanford Medicine started in 2009 when a friend encouraged her to volunteer at 875 Blake Wilbur Center. However, she was diagnosed with cancer shortly after beginning as a volunteer. She and her Stanford Health Care doctor in the hematology-oncology section opted for a “watch and wait” approach to monitor the disease progression. After five years, the cancer became active. Her treatment included monoclonal antibody infusions and progressed to chemotherapy, which put the disease in remission.
Life progressed normally for a few years until the disease transformed into a more aggressive type of non-Hodgkin lymphoma, which necessitated another chemotherapy treatment. Selig noted that even though she’s had many rounds of different treatments, including different types of chemotherapy and antibody treatments, each of which have worked for a limited amount of time, she’s thankful that her Stanford Health Care doctors always had another possible treatment for her to try.
“I was optimistic that if I failed something, the cancer came back or transformed, there always seemed to be something else. That’s one of the benefits of being at a top-notch academic medical center. They’re way in the forefront of research, clinical trials, and also successful new therapies. I’ve been lucky to be treated here.”
She added that living close to Stanford means there is a world-class medical center just a few minutes away.
Cancer recurrence and CAR-T
At the beginning of the COVID pandemic in 2020, the cancer returned and was aggressive. Her oncologist worked in both the lymphoma clinic and BMT-CT (bone marrow transplant/cell therapy) and offered a CAR-T cell therapy treatment, which she noted had received FDA approval just a few years prior. CAR-T cell therapy involves modifying a patient’s T cells, a type of white blood cell, in a laboratory so it can seek and destroy cancer cells. The modified T cells are infused back into the patient. Meryl agreed to the treatment and spent two weeks in the hospital receiving the therapy.
She labels herself a pushy patient who asks a lot of questions but affirms her trust in her team of doctors.
“I didn’t have too many choices, but I had faith in the doctors…I know it’s not just one solo expert or researcher. They really work in teams and raise each other up in every way.”
Enrolling in an early-phase CAR-T cell clinical trial
The first CAR-T cell treatment knocked out the cancer, but it reappeared in January 2023. By March 2023, she underwent a phase-one CAR-T cell clinical trial.
“I had very few targets left for the CAR-T to go after. They have to target a certain protein or a series of proteins in the blood, and none of the FDA-approved CAR-T treatments were appropriate for me. My doctor, Dr. Matthew Frank primarily, started literally looking under every rock and behind every closed door for a clinical trial for me. It turned out that Dr. David Miklos, who’s head of the Blood and Marrow Transplantation and Cellular Therapy Division (BMT-CT), happened to be the site investigator for a very early phase clinical trial. Luckily, given the nature of the lymphoma, this looked like a viable option for me.”
Because it was a phase-one trial, there wasn’t yet data to support its efficacy in humans. Selig expressed that the lack of data was a “scary prospect,” but she opted for the clinical trial because she didn’t have another treatment choice and she also had confidence in her doctors.
“The whole experience—it’s an overused word in Silicon Valley, but it was transformative—not only physically, but also emotionally transformative. The expertise, determination, support, encouragement, and compassion of Dr. Frank, Dr. Miklos, the in-patient BMT-CT team and every care provider whom I met during that month were extraordinary.”
Selig was hit with both pneumonia and a C. Diff infection before the start of the trial, so her inpatient time was longer than usual. The prolonged stay enabled her to get to know the entire staff. She speaks highly of her care team’s dedication, especially the nursing staff.
“Everybody. Their kindness and compassion. Their skills. I felt that not one person looked at their work as merely a job. The housekeeping staff—one person came in full of happiness and chatted every day. Her energy raised my spirits. It's hard to actually talk about it and not tear up a little bit because the kindness of individuals, the kindness of the staff, it's remarkable…I credit them., I credit the standards to which they're expected to perform, and I credit the training too…I have to say it added to the totality of the experience, not just getting my CAR-T, but launching me on the road to recovery.”
She underscored the importance of how instrumental a dedicated, caring team of providers is during treatment and recovery.
“That emotional connection really goes a long way…That's not just showing up, that's saying, I'm helping someone get their life back. And it's an almost indescribable experience to be carried forward by people like that…that's a main reason why I did so well.”
Becoming a donor
Selig and her husband Rob continue their long-standing commitment as donors to support the SCI and have a voice in its direction. She is also active on the Cancer Council, the SCI’s development arm.
“We both feel very strongly about the extraordinary things happening at Stanford, especially in oncology. It affects people’s lives in the clinic and in treatment. Our hope is that the remarkable advances and the extraordinary care will be made available to more people.”
She noted that she was once a lymphoma patient of Ron Levy and that his leading work on the discovery of rituximab for treating lymphoma saved lives in every country of the world. The application of rituximab has since expanded to other inflammatory diseases. Selig cites Levy’s breakthrough as demonstrating the importance of supporting early-stage innovators and researchers so that they can develop therapies that could potentially change and save people’s lives.
Selig and Rob feel strongly about supporting young investigators and researchers who are at the earlier stages of their medical and research careers so their discoveries can be available sooner.
“What they’re doing is going to change people’s lives, probably all over the world.”
She describes that she and her husband supported a doctor conducting CAR-T cell therapy research and that the therapy is proving to be effective.
“We're thrilled because right now, the therapy is getting tremendous results. It's looking good, beyond promising. I feel like we've got a shining star that's just about to explode and create a whole new universe for lots of patients in the CAR-T space. I like to think that we had some little thing to do with that. It's just tremendously exciting since I'm a two-time CAR-T person, but also to see one of our own at Stanford at close range, conducting his research, and having real success thus far. So that certainly motivates Rob and me to keep engaged this way—it’s so uplifting and exciting.”
Early on in their support as donors, Selig championed outpatient palliative care to help patients transition from curative treatments to quality-of-life care until it’s time for hospice. In addition to supporting clinical research, they’ve activated a plan to acknowledge the nursing team.
“I don’t know how often their role is appreciated. They are absolutely fundamental to each patient’s experience. The nursing staff were on the front lines laughing with me, tolerating the silly things I did, reminding me every day that I was human…while being vigilant about my meds and monitoring my status and the path to recovery.”
While Selig was undergoing cancer treatment, she completed a master’s program in bioethics at Columbia University. She underscored her dedication to improving access through philanthropy.
“There's a lot of attention now on improving access, and I applaud that. As a medical community and as a medical center at Stanford, we must continue to focus on providing the best possible access to the best possible care for the biggest number of people. It's just so important.”
She mentioned that there are countless healthcare discrepancies in the United States but that access to good medical care is a critical issue, and it’s an issue she hopes to focus on as a donor.
“I think that it’s our responsibility as a world-class and certainly leading institution in the United States to focus steadily, to dedicate ourselves to providing the same care I received to more people. I feel it's my mission for the rest of whatever time is left...That’s what I hope to be focusing on.”
Looking ahead to the future
Selig hopes she can return to volunteering with Stanford cancer patients but understands it may be complicated since patients are housed on immune wings, and she remains immuno-compromised after so many treatments.
“My dream position as a volunteer would be to work with BMT and cancer cell therapy patients on units like where I was…to help out in any way, but especially to sit with patients, be present with them, talk to them about my experiences, maybe demystify things, help them feel as normal as possible. It doesn't matter what, just being there and being present with them.”
February 2024 by Katie Shumake
Photo courtesy of Meryl Selig