For Bryan Mazza, the journey of a cancer patient back to restoring power and his life began not with a stride, but with a single, agonizing step. A utility lineman for Pacific Gas & Electric, Mazza’s professional life is defined by physical endurance—hiking through the foothills of El Dorado, snowshoeing to remote poles, and climbing high into the air to keep the lights on for his community. But in August 2023, the strength he relied on began to fail him.
What started as persistent back pain was initially dismissed as a strained muscle or perhaps gallstones. However, a sudden escalation in symptoms led to an emergency room visit at Marshall in Placerville, where a CT scan revealed a harrowing reality: multiple masses on his kidneys and nodules on his lungs. The diagnosis was stage four diffuse large B-cell lymphoma (DLBCL), an aggressive form of non-Hodgkin lymphoma that develops from blood cells and spreads rapidly.
Facing a high-risk prognosis, Mazza became a pivotal participant in a new clinical trial at the UC Davis Comprehensive Cancer Center. Under the care of Dr. Joseph Tuscano, Mazza underwent a sophisticated, targeted treatment sequence designed for patients who are at a high risk of relapse. Today, the 39-year-old father of three is not only back on the job but has pushed his physical recovery to an elite level, completing a 50-mile ultra marathon.
The Descent into Diagnosis
The onset of DLBCL can be deceptive, often mimicking less severe ailments. For Mazza, the pain intensified after large meals or during sleep. Despite initial suggestions of kidney cysts during an ultrasound, the rapid progression of the disease forced a more urgent intervention. Mazza recalls the moment he realized the gravity of the situation, noting that he could see the diagnosis on his doctor’s face before a word was spoken.
“My only thought was how I was going to tell my wife and kids,” Mazza said.
The urgency of the situation required specialized expertise. Mazza’s wife, Jessica, researched National Cancer Institute-designated cancer centers to find the most advanced care available in Northern California. This search led them to Dr. Joseph Tuscano at UC Davis, a recognized expert in blood cancers. Because the cancer was spreading quickly, Tuscano contacted Mazza the same evening the referral arrived, proposing a clinical trial that offered a more aggressive, targeted approach than standard therapies.
A Strategic “One-Two Punch” of Therapy
High-risk DLBCL is notoriously difficult to treat, and many patients relapse even after conventional chemotherapy. To combat this, Dr. Tuscano implemented a “one-two punch” strategy: using targeted immunotherapy to weaken the cancer before applying the full strength of chemotherapy to eliminate remaining cells.
The first phase involved two specific targeted drugs: loncastuximab tesirine and rituximab. These agents are designed to seek out and attach to specific proteins on the surface of lymphoma cells, allowing the medication to destroy the cancer while sparing healthy surrounding tissue.
- Loncastuximab tesirine: Targets the CD19 protein to deliver a cancer-killing drug directly into the cell.
- Rituximab: Targets the CD20 protein, signaling the patient’s own immune system to recognize and remove the lymphoma cells.
Once the immunotherapy had primed the system, Mazza began a personalized chemotherapy regimen known as DA-EPOCH-R. This intensive protocol required him to stay at the UC Davis Medical Center for five days every three weeks across six treatment cycles. Tuscano noted that “one size doesn’t fit all in cancer treatment,” and adjusted the dosages based on Mazza’s specific response to the drugs.
To ease the burden of the aggressive treatment, Mazza utilized a coordinated care model. While the primary treatment occurred in Sacramento, he received frequent blood tests and port dressing changes closer to home at Marshall’s Cancer Center in Cameron Park, reducing his travel time from an hour to 15 minutes.
From Remission to the Ultra Marathon
By April 2024, Mazza reached remission. However, the victory came with a physical toll; the chemotherapy had stripped him of his hair and significant muscle mass. For a man whose livelihood depended on climbing power poles, the road back to strength was a necessity.
Mazza began his recovery with modest goals: walking a half-mile, then a mile, then jogging. This incremental progress evolved into a series of athletic milestones that mirrored his internal battle with cancer. He first completed a 5K run, followed by a 13.1-mile half marathon in Apple Hill. He later tackled the American River 25-mile Endurance Run, crossing the finish line with his wife and three children cheering him on.
The culmination of this recovery was the completion of a 50-mile ultra marathon this year, a feat that served as a definitive reclamation of his health and identity.
The Impact of Clinical Research on Lymphoma
Mazza’s recovery highlights a broader shift in how hematologists approach aggressive blood cancers. By combining immunotherapy with chemotherapy, clinicians hope to provide long-lasting remission for patients who previously had limited options.
| Treatment Phase | Primary Goal | Method |
|---|---|---|
| Phase 1: Immunotherapy | Targeted Destruction | CD19/CD20 Protein Targeting |
| Phase 2: Chemotherapy | Total Eradication | Personalized DA-EPOCH-R |
| Phase 3: Recovery | Functional Restoration | Graduated Physical Training |
“Every advancement starts with research,” Tuscano said. “Our goal is simple: Give patients a better chance at long‑lasting remission.”
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Patients should consult with a qualified healthcare provider regarding cancer treatments and clinical trial eligibility.
As the clinical trial continues, UC Davis Health remains focused on gathering data to refine the sequence of these targeted therapies. The next phase of research will involve monitoring long-term remission rates among participants to determine if this “one-two punch” approach can become a new standard of care for high-risk DLBCL patients.
We invite readers to share their experiences with clinical trials or recovery journeys in the comments below.
