Opdivo-Yervoy Combo Shows Signs of Activity in CRPC Patients with Metastases

[Moespy]

Combo Immune herapy showing positive signs for MCRPC. The combo of immunotherapy drugs are what some think will be the key bigger results. Much like we have seen in HIV.

prostatecancernewstoday.com...

[Ahk1]

Very interesting article, Moespy. Thanks for posting it.

[Tall_Allen]

Very little effect and highly toxic, but it gives some clues. The "CHECKMATE 650" clinical trial of a combination of the two checkpoint inhibitor-type immunotherapies, nivolumab (Opdivo) and ipilimumab (Yervoy), there was some response (in 25% of pre-chemo men and 10% of post chemo men) from the combination, but no response from either drug alone in earlier trials. However, all of the responders (60% of the pre-chemo group and 40% of the post-chemo group) had a high mutational burden and/or showed the presence of PD-L1 in the tumors (33% of the pre-chemo group and 19% of the post chemo group). Conversely, none of the men who had low mutational burden or PD-L1 had any response to the combination therapy. Toxicity was unacceptably high. This indicates that the cancer must evolve to a high degree of genetic breakdown before such therapies become effective. Early use causes unacceptable toxicity without any survival benefit.

onclive.com/web-exclusives/...

[Kevinski65 in reply to Tall_Allen]

Any chance of crispr cas 9 being used on PCa?

[Tall_Allen in reply to Kevinski65]

There have been over 200 genes that have been implicated for prostate cancer, alone or in combination. So you can begin to see the problem in detecting and editing them. Also, they would have to discover the multi-functionality of each of them before editing them. If CRISPR will ever be used, it's a long way off.

[hrinard in reply to Tall_Allen]

I have lung cancer stage 4 since my first chemo July 2014. Had radiation on prostate cancer 2005——quiet on zoledex for 12 years——cancer scans for lungs in 2017 showed spots on right scapula and sixth rib. Since tecentriq actually worked I told doctor those spots were prostate cancer from 2005— sure enough my psa was 2.9. While finishing my tecentriq sessions the psa went up to 656. When finished went to docetaxol for six weeks——psa down to 9——became allergic to tecentriq. Phase 2 investigative trials by Bristol Meyers with opdivo combo of docetaxol prednisone. That what I’m on now one every two weeks taxotere is three so he lowered the taxotere to two wk dose. They’re doing this trial with xtandi also and they are accepting.

[hrinard in reply to hrinard]

I’m not in the trial but we’re mimic the process. I’ve only had two treatments will give scan results for this Hail Mary

[hrinard in reply to hrinard]

Zytiga didn’t work so xtandi is unlikely to do so either. BTW I’m pd 1 negative

[j-o-h-n in reply to hrinard]

Sorry to repeat myself. Besides my Pca I am also blessed with state IV Lung Melanoma. Fighting it with Keytruda and it's working.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/07/2019 5:37 PM EST

[hrinard in reply to j-o-h-n]

Had 3cm by 10cm tumor on my right lung in 2014——I should have passed years ago. Good doctor who knows how to analyze the histology of individuals. I hope I can hang on till June 28th so I can congratulate and thank him for 5 years survival.

[hrinard in reply to hrinard]

I have nsclc—-five year survival rate was 1%. I’m pd-1 negative so you must have an abundance of pd1 in order to be eligible for keytruda. Should give you enough time for the next even better treatment.

[j-o-h-n in reply to hrinard]

Well first of all when you congratulate him DO NOT buy him a carton of cigarettes, buy him two bottles of wine. One you can both finish off in his office and one for him to take home. Pre-grats to you.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/07/2019 5:56 PM EST

[hrinard in reply to j-o-h-n]

Thanks

[Magnus1964]

My research doctor told me Yervoy has caused death in about 5% of Pca patients.

[hrinard in reply to Magnus1964]

5% is not significant when dealing with this beast.

[Moespy]

I like the thought and prospects of identifying gene mutations and matching them to immune response therapies. Diferent horses for different courses may well end up being the key to future treatments.

Jim

[snoraste]

I think one major issue with the effectiveness of the new treatments is high level of expectations on response rates across all patients. It seems like everyone is looking for a cure-all or a near cure-all silver bullet. If PCa is in fact a very heterogenous disease, there's a great deal to be learned from the low number of responders as well (as was in this case to some extent). I think the medical community should dig deeper into their findings, past the mutation burden, and make the understanding of that a main priority. They have found a target group for their targeted therapy, now lets define the target.

[j-o-h-n in reply to snoraste]

If there were/was a silver bullet I would have used it long time ago on Countess Dracula...(my ex-wife)...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/07/2019 5:41 PM EST

[snoraste in reply to j-o-h-n]

never change!