Nautilus

This Man’s Immune System Got a Cancer-killing Update

William Ludwig was almost dead when he became Patient Number One in a radical new cancer treatment, one that’s just won the endorsement of F.D.A. advisors.Photograph by sebastianosecondi / Shutterstock

William Ludwig was a 64-year-old retired corrections officer living in Bridgeton, New Jersey, in 2010, when he received a near-hopeless cancer prognosis. The Abramson Cancer Center at the University of Pennsylvania had run out of chemotherapeutic options, and Ludwig was disqualified from most clinical trials since he had three cancers at once—leukemia, lymphoma, and squamous cell skin cancer. In a later interview, the scientist Carl June described Ludwig’s condition as “Almost dead.”

Alison Loren, an oncologist at Penn, had been taking care of Ludwig for five painful years. If chemotherapy is not effective early on, each new round brings diminishing returns, and it becomes more and more toxic, she told me. In Ludwig’s case, its toxic side-effects were outdoing any progress scaling back the battalions of cancer cells.  

The chemo was suppressing Ludwig’s immune system, since it was his immune system’s B cells, precisely the cells being targeted by the chemo treatments, that were cancerous, expanding uncontrollably in his bone marrow. An infection from an old chicken pox virus broke out in his right eye. And the cancer now appeared to be mobile, or what doctors call “motile,” riddling far-flung sites in his body. Ludwig’s skin cancer looked to Loren as if it had spread, or metastasized, from

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