To his first words "mom" and "dad", Harry just added "to live", to say goodbye. If the 10 month old boy smiles all the time, it may be because he feels how much he was expected by his parents. And what Lucie, her mother, had to face before giving her life last August. Four years ago, the 31-year-old woman developed cancer that she did not even suspect existed. A so-called “gestational” tumor, which lodged in her uterus instead of what she thought was her first pregnancy. A rare disease that resisted chemotherapy, but not new immunotherapy, which the lawyer then received. The results of this unprecedented clinical trial, in which she participated in Lyon, were unveiled this Friday at the Chicago Cancer Congress (Asco). They are better than promising, with over 50% cure.
Right after their marriage in June 2016, Lucie and Olivier started a baby project. From the fall, all the signals are green: the pregnancy test is positive, Lucie is nauseated, an already rounded stomach and the blood test is categorical - her beta-HCG hormone level, witnessing the arrival of a little being, is very high. In fact, it is too much.
"Madame, it's not a baby, it's a tumor"
“A few days later, my kidneys were so bad that I went to the emergency room. When the gynecologist on duty gave me an ultrasound, he said to me: but madam, this is not a baby, it is a tumor. "Lucie remembers each word, these and the following: curettage of the uterus, tumors in the wall, chemotherapy ..." There, you say to yourself: but how did we get there when we just wanted a child ? Fertilization did not create a baby, but cancer. Thinking about it is surreal, ”she says.
Lucie was 27 years old, a career that had just started and an illness that resisted treatment. “I was lucky that this clinical trial started. It was either that, or another chemotherapy that I had been warned of, the side effects were very serious and the toxicity was such that I had to stay hospitalized every other week. "
For several months, the young woman who lives in the Paris region will go to Lyon to receive her immunotherapy. Physically, the horse riding enthusiast stays in shape but her morale falters: "I didn't even want to ride a horse anymore," she recalls. Before, I had confidence in life, I thought that it was enough to trace its path and there, I focused on: why me, why that? And then, with a small dose of "magic thoughts" and a strong dose of science, his HCG level finally drops. The disease goes away. Lucie is back in the saddle.
"I understood that this time he was a real baby"
"The other issue, of course, was whether fertility would be preserved," says Benoît You, the professor who conducted the study. The answer came a year later. “I was asked to wait until this time before trying to get pregnant again. During the first ultrasound, I did not want to look at the screen. I was staring at my husband's eyes to see how he reacted. I understood from his gaze, that this time he was a real baby! So, of course, when asked how Harry is, the qualifiers rain down: "perfect", "player", "laughing".
This birth also shows that it is a priori possible to have a normal pregnancy after this new curative treatment by immunotherapy. A first. "So it's possible!" she says. I healed and I had Harry! All the women who pass by there, must know it: yes, one can have the baby whom one wanted so much! "
The hope of immunotherapy
Fifteen women participated in the Benoît You study. This medical oncologist at the Hospices Civils de Lyon (HCL), a specialist in women's tumors, was tired of biting his brakes. New therapies were developing everywhere and he still had to be content for resistant tumors with "old super-toxic chemos, with very hard side effects", he breathes. This is how he came up with the idea of looking for an immunotherapy, already used for certain skin cancers (Avelumab).
The fifteen patients all presented a very rare disease called "gestational trophoblastic". "It is a tumor that occurs in the uterus and grows in the cells of the placenta during pregnancy." Clearly, it is a fertilization that is not going well, ”decrypts Professor You. For the most part, it is a mild form, also known as “molar pregnancy”, without an embryo or with one, but which cannot survive. But for 200 others, like Lucie, it can have a malignant form, with a high risk of metastases.
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In this case, chemotherapy is offered, then a second - much more restrictive - if the first is not effective. It was in place of this second that immunotherapy was tested. Not only, after 29 months, more than 50% of the patients are cured, but "what makes me, I think, the happiest is that a third could have escaped the most toxic treatment thanks to the immuno", s enthuses the doctor.
Icing on the cake, the example of Lucie, a former patient who became a mother, shows that the new treatment would not be incompatible with pregnancy. Benoit You will continue his trials, in particular by administering the product as a first intention. “What we are seeing for the moment is reassuring and brings hope. "
Good to know: these trophoblastic diseases require special care. The Reference Center, directed by François Golfier, is located at the Lyon University Hospital.
