Immunotherapy (general) - Interesting NY Times Article.

[pjoshea13]

From today's Times [1].

First, the back story:

"Dr. Douglas Levine, director of gynecologic oncology at New York University Langone Medical Center, specializes in {hypercalcemic small cell ovarian cancer, a rare disease}. A few years ago, he discovered that the cancer was driven by a single gene mutation."

Immunotherapy works best when there are many mutations. With few mutations (& this includes PCa) "experts believe that the tumor cells just do not look threatening enough to the body to spur a response."

With only one mutation, immunotherapy should not have worked for the four cured women Levine found via an online group.

...

Cutting to the chase:

"Dr. Drew Pardoll, who directs the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins" & "Dr. Padmanee Sharma of M.D. Anderson" are planning new clinical trials that treat the immune system, rather than the cancer type.

"Dr. Sharma’s study, funded by the Parker Institute, is getting ready to enroll patients. The researchers will look at pathology slides of patients’ tumors to see if white blood cells are worming their way into the cancers. If so, the patients will get an immunotherapy drug to help activate their white blood cells to attack the tumor.

"If there are few white blood cells in the tumor tissue, patients will get a combination of two immunotherapy drugs to help move more white blood cells into the tumor and help them attack.

“The trial is written for all comers,” Dr. Sharma said."

"At Johns Hopkins, Dr. Pardoll and his colleagues are planning a similar trial. They will be looking for tumors — it does not matter what type — that have a protein, PD-L1, on the surface that repels the immune system. Any patient whose tumor fits that description will get an immunotherapy drug."

-Patrick

[1] nytimes.com/2018/02/19/heal...

[gusgold]

Patrick,

Your protocol of 3 months T and 3 months PC-SPES has been successful in preventing CR PCa....I am trying to duplicate your results with Xtandi...3 months on and 3 months off....how low is your PSA on 3 months PC-SPES and how high on 3 months T

Gus

[pjoshea13 in reply to gusgold]

Gus,

I'm not using PC-SPES.

PSA gets down to about 1 & up to ~15.

I'm thinking of increasing the frequency - switching to monthly.

-Patrick

[dave100 in reply to pjoshea13]

I plan a similar BAT "exercise" and wonder if the 28-day cycle might better be a 56-day one to allow more time to get back down to castrate level allowing for a more dramatic transition range. However, if this therapy depends more heavily on time in high T state to allow for phenotype changes toward greater differentiation and less aggressive state then monthly cycles make more sense. Haven't started the 3-shot intro yet as I'm still waiting for the bicalutamide to wash out of my system. Any thoughts??

[gusgold in reply to pjoshea13]

can you tell us what you are using to lower your PSA

[pjoshea13 in reply to gusgold]

Gus,

It's been off the market for some years. Many men who used it have managed to switch to low-dose DES (~1mg).

-Patrick

[gusgold in reply to pjoshea13]

Pat,

any idea where to obtain low dose DES

[pjoshea13 in reply to gusgold]

Gus,

My urologist offered to write a prescription if/when I wanted to use it. A nearby compounding pharmacy would make it up.

High-dose DES was used for PCa from ~1940-85. Eli Lilly stopped making it in 1997.

-Patrick

[podsart in reply to gusgold]

Gus

Interesting your using Xtandi In bi-modal approach, what dose Xtandi are u using and what was your PSA when u started this method?

Do u know what PC-SPES means?

[periclesBC]

Wiki info page on PD-1: en.wikipedia.org/wiki/Progr...

[paulofaus]

Excellent article Patrick, thanks.