Sheba News Page New 2019 31

Tamir Gilat – Human Lab Rat & Cancer Survivor

Israeli cancer research at Sheba saved his life three times

According to all the doctors’ prognoses, Tamir Gilat should not be alive right now. After he was diagnosed with cancer in 2011, he was given three months to live. Four years later, he was advised to take a farewell trip around the world. Three times, Tamir was told he had metastatic cancer, and twice he was almost pronounced dead. But each time, the odds flipped, and unbelievably, he survived.

Thanks to cutting-edge cancer research at Sheba Medical Center in Israel, Tamir was granted an opportunity to take revolutionary drugs that saved his life.

“I’m the lab rat proving that cancer research works,” said Tamir. “I figure I’m one of the only people in the world who participated in two clinical trials that yielded life-saving treatments.”

Tamir studied law in the 1980s, while simultaneously playing goalie for Maccabi Tel Aviv. Once he finished his degree, he practiced business and commercial law. In 2000, at age 40, he retired from law to work towards a graduate degree in business administration. He then plunged headfirst into a new career as an entrepreneur.

Unfortunately, Tamir experienced his first encounter with cancer shortly thereafter, when his wife, Keren, was diagnosed with breast cancer in 2003. Her condition improved for nine years, but in 2012, the cancer returned with metastases in her whole body. Keren did not respond to any treatment and her systems collapsed. She passed away in June 2017.

laboratory outside

During Keren’s heroic struggle against cancer, Tamir sensed that his health was also suffering and consulted doctors. “I felt that something wasn’t harmonious with my body,” he said. “I felt pain but they couldn’t find anything for several months. They said I had a crack in my diaphragm and suggested painkillers.”

Eventually, in February 2011, Tamir took a proactive stance and scheduled a private CT scan. “After losing eight kilograms (18 pounds) while living on Advil, I went, against doctors’ advice, and got a private CT scan,” he recalls. “I was immediately diagnosed – the night of the test – with two different cancers, in my kidney and pancreas.”

Until that point, Gilat had been healthy, but he had a family history of cancer. His father had passed away from cancer at 51 years old. Tamir’s horrendous diagnosis now put a grim perspective on his future. “One doctor told me it was a waste of time to start getting treatment, saying I only had three months to live. Go take a trip around the world, he said,” Gilat recalled.

Yet Tamir wasn’t ready to surrender to that viewpoint. He underwent testing and a difficult 10-hour long surgery to remove parts of his pancreas and other adjoining organs, including his left kidney, which was entirely cancerous. He began chemotherapy after the surgery.

“Three months later I was told the chemotherapy hadn’t worked. There were metastases in my liver, and the world of medicine really didn’t have anything to offer me. I was told I had three months to live and that there was no further treatment available.”

Pancreatic cancer, one of the more lethal types of cancer, typically leads to death within six months of detection. Only three percent of patients survive past five years, and medicine has minimal solutions. But it was then, when Tamir had hit rock bottom, that his story took an upward turn.

“After I was told my life was essentially over, my angel, Dr. Talia Golan called and told me about a clinical trial using a drug that was meant to extend the lives of women who carry the BRCA gene and have breast and ovarian cancer,” he said.

Dr. Golan, director of Sheba’s Pancreatic Cancer Center and Head of Clinical Research at Sheba Medical Center, was the lead researcher in the clinical trial. Her experimental trials give new hope for patients worldwide with pancreatic cancer. This particular study involved a drug known as a PARP inhibitor, commercially named Lynparza, which works by inhibiting the cancer cells’ ability to repair its DNA. Consequently, the cancer cells die and the disease ceases to progress.

Talia Golan

Dr. Talia Golan

The Sheba researchers wanted to test this drug on patients with metastatic pancreatic cancer who carried the BRCA gene. (In Israel, 15% of all pancreatic patients carry the BRCA gene.) Testing revealed that Tamir had the gene and therefore qualified for the trial. He was told that the objective of the research was to extend life by a few months, while also preserving an acceptable quality of life.

Throughout the trial, Tamir had to take 16 pills a day, eight at a time. It was necessary to fast for three hours before and after taking these drugs, as well as wait 12 hours between each bunch of pills.

Tamir explained, “You switch into pill-taking mode. There are also unpleasant side effects such as nausea, vomiting and diarrhea, but I lovingly kissed each pill, without which I wouldn’t be here today. The end of each month was like Judgment Day. You go to the trial coordinator and undergo tests. If they’re OK, you get the next batch of drugs for the next month. If not, you’re sent to a hospice.”

The trial lasted 13 months, but Tamir continued to receive the pills afterwards because the drug company had committed to continue supplying the drug. It was then, when the trial was officially over, that Tamir realized he was the lone survivor out of the 400 participants who had begun the trial.

rannan new

Prof. Ra’anan Berger

For four and a half years, Tamir took the pills and defied all statistics. Yet, in September 2015, his cancer resurfaced. Testing revealed that his whole body was full of metastases, including his liver, diaphragm, spleen and the remaining part of his pancreas. He stopped taking the drug and his fate seemed to be sealed – until he was approached about another new trial at Sheba.

Professor Ra’anan Berger, Head of the Oncology Institute at Sheba Medical Center and a world-renowned expert on kidney cancer, joined the team caring for Tamir. A trial involving a combination of two immunotherapeutic drugs, Ipilimumab (Yervoy) and Nivolumab (Opdivo), was about to begin. Prof. Berger and Dr. Golan decided that Tamir should first have surgery to remove the metastases and then join the new trial.

This medical decision was somewhat radical, because patients with metastases do not usually undergo operations. “I felt that if they didn’t remove most of the cancerous mass from my body, the experiment would fail,” Tamir said. “In fact, all my internal organs – save the heart and lungs – were partly or completely removed.”

After his recovery from the surgery, Tamir began taking a cocktail of the two drugs once every two weeks. Typically, patients can only receive this cocktail a maximum of four times, and most patients do not last for more than one or two doses. But once again, Tamir defied the dire predictions.

“The treatment ended in December 2015, and since then I’m only getting Nivolumab,” he said. “They told me this could only last for two years at most, but I’ve been treated with it up to now. Every two to four weeks I’m in hospital for treatment. The Nivolumab keeps my metastases under control.”

On the surface, Tamir appears to be a lively and enthusiastic person. His animated demeanor belies no hint of his improbable and tortuous medical history. He is currently dedicated to two passions – raising his and his late wife Keren’s daughters, and managing the Israel Cancer Research Fund, the foundation of which he is chairman.

During his first round of cancer, Tamir and Keren hosted an event for the Israel Cancer Research Fund in their home. This organization finances cancer research on a philanthropic basis, and Tamir was blown away by the significance of their mission.

In his words, “I’m alive thanks to research. I owe my life to cancer research, which is why I decided this was my way to give something back to society and to cancer researchers. I devote my life to spreading the message that we need to invest in cancer research. This is a social responsibility borne by all of us, since this is what will save us and our children, future generations and the human race… I’m the lab rat that proved that cancer research works. If it happened to me it could happen to anyone.”

Tamir’s exposure to cancer – his own and Keren’s – drastically changed the course of his life. He is supremely grateful to have been given the life-saving opportunity to join in Sheba’s clinical trials.