Emma Dimery was just 23 when she received a devastating diagnosis of colon cancer after experiencing abdominal pain and abnormal blood work. A colonoscopy revealed a "softball-sized" tumor and another "golf ball-sized" one. Now 35, the Minnesota resident has defied medical expectations by achieving complete remission from stage 4 colon cancer through an experimental gene-editing therapy that her oncologist describes as "the next frontier of immunotherapy."
After exhausting all standard treatment options over a 12-year battle with the disease, Dimery enrolled in a clinical trial at the University of Minnesota that would ultimately save her life.
Novel Mechanism Targets Cancer's Immune Evasion
The groundbreaking trial, led by medical oncologist and scientist Dr. Emil Lou, employed CRISPR-Cas9 gene editing technology to modify immune cells in a fundamentally different way from existing immunotherapies.
"Some of the targets inside the cell are preventing the immune system from activating against the cancer," explained Dr. Lou. "It's kind of like a shield that protects the cancer cell from the body's immune system."
Unlike conventional immunotherapies that target cell surface markers, this approach focused on intracellular mechanisms. The treatment involved extracting immune cells from participants, genetically modifying them in the laboratory using CRISPR-Cas9 technology—which Dr. Lou described as "genetic scissors"—and then reinfusing them back into patients.
"They trained the cells to be able to fight my cancer specifically when they were reintroduced into my body," Dimery noted.
Unprecedented Clinical Response
The results were remarkable. After just one infusion of the engineered cells, Dimery was pronounced cancer-free—an outcome that Dr. Lou described as "almost unheard-of" for advanced colorectal cancer.
"We term this in oncology as a 'clinical complete response,' which is something that you see in 10% or less of all patients," Dr. Lou said. "And it's less than 10% for stage 4 colorectal cancers."
The vast majority of advanced colorectal cancers are considered incurable, with available treatments being palliative rather than curative. Among the 12 patients who participated in the study, Dimery demonstrated by far the most dramatic response.
"What we saw in Emma was a magnificent and unprecedented level of response, going from a metastatic stage for an otherwise incurable cancer... where now we don't see any cancer," Dr. Lou stated.
Two years after treatment, Dimery remains cancer-free. "The trial worked almost immediately—and I've had no evidence of disease since," she reported. "All of my scans have just been coming back better and better."
Rising Incidence in Young Adults
Dimery's case highlights a troubling trend in colorectal cancer epidemiology. Studies show that in 2023, one in 10 colorectal cancer diagnoses were considered early-onset, affecting patients under 50 years of age. The American College of Surgeons predicts that early-onset cases will double by 2030.
Dr. Lou expressed concern about this shift in patient demographics. "I'm seeing something in the last five or six years that I really did not see earlier in my career—teenagers, people in their 20s, 30s and 40s," he shared. "Just last week, I saw someone in their early 40s with widely metastatic stage 4 colorectal cancer."
What's particularly alarming, according to Dr. Lou, is that approximately half of colorectal cancer cases are diagnosed at stage 4, often because symptoms are absent or misinterpreted.
Screening and Genetic Testing
In response to the rising incidence in younger populations, the American Cancer Society changed its colorectal screening recommendation from age 50 to age 45 in 2018, with other medical organizations following suit in subsequent years.
"Colorectal cancer remains one of the few cancers for which we have validated screening tools," Dr. Lou emphasized. These include blood-based tests, stool-based tests, and colonoscopies.
Dimery also highlighted the importance of genetic testing to determine eligibility for clinical trials. "That can tell you a lot about your individual type of cancer," she said. "Luckily for me, I had just the right kind of cancer for this treatment."
Future Directions
Dimery's case was presented at the American Association for Cancer Research (AACR) Annual Meeting in Chicago, generating significant interest in the scientific community.
While the treatment process was challenging with some difficult side effects, Dimery credits her support system with helping her through. "You just get through it and try to focus on the good," she said. "And I had a lot of good around me. I had a really amazing support team."
Dr. Lou and his team are now working to understand why Dimery responded so exceptionally well to the treatment. "Emma is exceptional in many ways, but what we learned from her case, we hope to replicate and decipher how we can achieve this on a more consistent basis across the board for more patients like her," he said.
Though hesitant to use the term "cure," Dimery acknowledged that the trial has transformed her outlook. "Until now, the best I could hope for was remission to the point of no evidence of disease... and had to accept that it could rear its head again at any point, even if they can't detect it on a scan," she reflected.
For Dimery, raising awareness about early-onset colon cancer is crucial. "The more people who are aware, the better. I think it's really important to not panic, but to stay informed and connected to the community."
