- Kristina Donatelli was diagnosed with advanced kidney cancer in early 2015.
- After researching her options for care, she decided to see MSK surgeon Paul Russo.
- Dr. Russo removed the tumor and connected her with Robert Motzer, an MSK medical oncologist who has been researching kidney cancer for more than 30 years.
- Dr. Motzer started Kristina on a clinical trial of two immunotherapy medications that completely wiped out her cancer.
- Kristina has been cancer free ever since.
The pain in Kristina Donatelli’s abdomen was so severe that she was doubled over even as she lay in bed one night in January 2015.
Kristina, a marketing manager from Bethlehem, Pennsylvania, drove herself to an urgent care center the next morning. The provider sent her to the emergency room.
“I thought they were going to say, ‘You have a slight bowel obstruction,’ ” says Kristina, now 46. “I was at the hospital by myself and I called my husband saying, ‘I think everything’s fine, but please come and wait with me.’ ”
“I was in shock,” the mother of two recalls.
Making a Plan
Kristina was admitted to the hospital for more tests. She was relieved to learn that the cancer hadn’t spread to her brain or bones. Surgeons there were ready to operate on her kidney, but Kristina needed a moment to catch her breath.
“I was just so confused,” she says. “My sister is very good at researching medical information, and I told her to find the best place in the country for me. I was willing to fly or go anywhere.”
The searches led Kristina and her family to Paul Russo, a surgeon specializing in kidney cancer at Memorial Sloan Kettering. She told the doctors treating her that that’s where she wanted to go. Within hours, a member of MSK’s Patient Access Service called Kristina to set up her first appointment. From the very beginning, Kristina felt well taken care of.
“The woman I spoke with was just phenomenal,” she remembers. “At MSK, everybody does everything to make sure you don’t have any questions or any worries. From logistics to housing, she had everything settled.”
Meeting Her Team
Exactly one week after her trip to the emergency room, Kristina and her family came to MSK to meet Dr. Russo. As they reviewed her scans, Kristina was stunned to learn that her tumor weighed ten pounds and had been growing for 14 years.
Dr. Russo explained that he works in tandem with Robert Motzer, a medical oncologist who specializes in kidney cancer. She would first undergo surgery with Dr. Russo to remove the massive kidney tumor and surrounding lymph nodes, some of which were also cancerous. Then, she would meet Dr. Motzer to determine their next steps.
Kristina underwent surgery in February, recovered for a week in New York, and then went home. A few weeks later, she came back to meet Dr. Motzer, who felt compassion for his patient.
“She was such a young, functional person to be faced with a serious medical diagnosis,” he recalls.
Dr. Motzer told Kristina and her family about a clinical trial he was leading that she might be able to participate in. It compared the standard of treatment, sunitinib, with a combination of the immunotherapy medications nivolumab and ipilimumab. Both of the latter drugs are part of a group of medicines called checkpoint inhibitors, which release the brakes on the immune system to full-throttle attack cancer.
“Some of the most exciting progress we are making in cancer treatment is around these checkpoint inhibitors,” says Dr. Motzer, who has been leading kidney cancer studies at MSK for 30 years. “The combination of ipilimumab and nivolumab was developed at MSK for melanoma by Jedd Wolchok. When we applied it to an early kidney cancer study, we saw promising results.”
In April 2018, the Food and Drug Administration agreed and approved the combination of ipilimumab and nivolumab for the treatment of people with poor- and intermediate-risk advanced renal cell carcinoma.
Kristina was eager to receive this novel course of treatment.
“We hoped and prayed and enjoyed Easter, and on Monday we got the call that we had been accepted to the trial,” she says. “I felt blessed to have options.”
More Good News
In April 2015, Kristina began treatment. She received a combination of ipilimumab and nivolumab through an IV every three weeks for three months. The treatment caused her to develop joint pain and a hyperactive thyroid. When she starting having shortness of breath, doctors at MSK saw that the cancer had caused one lung to collapse. Kristina was admitted to Memorial Hospital over Mother’s Day weekend but went home that Monday. Shortly thereafter, she went back to work.
“I just needed ‘normal’ back,” she says. “Everybody thinks that when they’re diagnosed they’re going to do all these crazy things. That was not me. I just wanted normalcy.”
Kristina began a flexible work schedule that allowed her to come into New York City every other Thursday for treatment. She had recently taken on a new role at her job and wanted to devote her time and energy to it.
During a business trip that July, Kristina was at a diner with a colleague when her phone rang. She had just undergone her first imaging scan to check for signs of the cancer since starting the trial, so she knew to expect the call. But she wasn’t expecting what she heard.
“My nurse, Patty Fischer, said I had no evidence of disease,” Kristina says. “I said, ‘Are you kidding?’ My coworker and I just sat there crying.”
The Power of Support
That winter, after several more clear scans, Kristina started feeling anxious and sad. Even though her cancer was gone, she was worried it would come back. She was also having memory problems. She began seeing a psychologist in MSK’s Counseling Center, and within one month of working together, Kristina started to feel better.
“Just finally talking to him and getting everything off my chest helped,” she says. “I still think about it, but I don’t have that intense worry anymore.”
Kristina comes to New York City once every two weeks for a maintenance dose of medicine, but she’s been disease free ever since that CT scan in July 2015. Dr. Motzer and his team are now looking for ways to predict which patients will respond better to sunitinib and which will respond better to the combination of medicines Kristina had.
“Kristina had a complete remission and she’s been doing well all this time,” Dr. Motzer says. “It’s a positive outcome.”
Kristina counts her family, friends, and faith as what helped her through the hardest parts.
“I did a lot of praying. The word in my family became ‘trust,’ ” she says. “First, trust in God, then in your medical team, and then in the process. Also, my sister-in-law told me to accept the tremendous outpouring of help I was receiving. When it snowed, neighbors shoveled our driveway. Teachers took our kids to school. My parents went to every appointment and my in-laws watched the kids without hesitation. We wouldn’t have been able to get through it without them.”
She also remained confident in her team at MSK and asked her support network to rally around her.
“I asked for success stories because I needed to see something positive,” she recalls.
Now, Kristina herself is the success story.