Developments in the Continued Search for a Prostate Cancer Vaccine...

[NPfisherman]

Greetings FPC members,

As some of you know, I believe that the development of a vaccine or vaccines is crucial to developing a cure for PCa and certainly for achieving longer remissions. Activation of our immune system is the key. We have seen the development of Provenge which has proven useful for some and less so for others. The APCEDEN vaccine is being given in India and a gentleman on another forum had fantastic results with use of it over several years ( see posts by Fuzzman77 in Advanced Prostate Cancer ). So where are we at today in finding a vaccine?? I will try and cover recent developments as well as clinical trials that are ongoing.

In a meeting this year of the American Association of Cancer Research, a case presentation of using a combination of cryosurgical tumor lysis followed by intratumoral immunotherapy resulted in a durable response for both MHSPC and MCRPC patients. See below:

abstractsonline.com/pp8/#!/...

Next, a vaccine comprised of human antibodies fused with tumour-specific protein intended to target the cancer as well as activating the memory of the tumour cells.

sciencedaily.com/releases/2...

The science article for the heavy hitters:

onlinelibrary.wiley.com/doi...

Third, some vaccine clinical trials in progress:

cancer.gov/about-cancer/tre...

cancer.gov/about-cancer/tre...

cancer.gov/about-cancer/tre...

cancer.gov/about-cancer/tre...

cancer.gov/about-cancer/tre...

cancer.gov/about-cancer/tre...

cancer.gov/about-cancer/tre...

There are more that I am aware of in process by companies such as Advaxis with 2 vaccine candidates--ADXS PSA- see below:

advaxis.com/psa-associated-...

and ADXS 504 starting Phase 1:

prostatecancernewstoday.com...

The Science is Coming, so let us have... HOPE !!!

Don Pescado

DISCLAIMER: I can not guarantee that I have covered all vaccines in development or on trial as the list goes beyond this I am sure...

[cujoe]

Good Stuff, Don Sherlock Pescado. Nice to see you back in the fray. Hope all is well with you and yours. Keep the science coming, Amigo. I'll read through the links tomorrow and see if I have anything to add. Be Safe & Stay Well - K9

[NPfisherman in reply to cujoe]

The developments progress and what we are seeing bodes well for vaccines...Will we see some combo of vaccines even as initial treatments. The hunt continues...

DP

[hansjd]

Thank you for this Fish. Pleased to see you posting again. Your contributions are always worth reading. Cheers

[NPfisherman in reply to hansjd]

Appreciate the comment... Have been busy with a number of things and took a break...Take care, amigo....All the best.....

Fish

[marnieg46]

Thank you Dave.

It's encouraging to read about developments apart from the normal SOC treatments. Gives hope. I'll sift through what I can understand easily and then check in with you to translate what's beyond me.

Fabulous to see your contribution and I agree with hansjd .... your posts are always worth reading. I always like the way your posts commence with a simple overview that captures the essence of the topic. Marnie.

[NPfisherman in reply to marnieg46]

Thank you, my friend across the ocean.... I do try... read through and send me a message... some of this stuff is a bit heavy but exciting.... one of the problems is that Killer T cells get "exhausted" after so long and they are working on that issue...

Dave

[tom67inMA]

It's good to see your optimistic posts about new treatments again. Do you have any news on the neuroendocrine front? Good news has been quite thin in that area unfortunately.

[NPfisherman in reply to tom67inMA]

I have not heard that SBRT works any less effectively for neuroendocrine and I believe you had a liver lesion. It is something to consider as well as the looking at developments in SCLC. One of the things that is being discovered is that drugs that work on a particular defect in one cancer will work on the same defect in another cancer. For example, PARP inhibitors for BRCA 1/2 in breast and prostate cancers. I would be looking at the small cell developments in lung cancer. Hang tough, Tom... Stay in motion ...Best of luck....

Fish

[tom67inMA in reply to NPfisherman]

Both my MO and RO have said they're basing my treatment on SCLC. I did have liver lesions, but they responded completely to chemotherapy. The radiation is targeted at the main tumor in my bladder, which shrank significantly during chemo. Apparently I have no detectable prostate cancer left in my prostate. This might have a very happy ending.

I have a friend with SCLC, our treatments have been extremely similar. I got two more cycles of chemo, he got two more zaps of radiation.

I'm torn about how much research to do right now. Probably going to wait a bit and just heal and live. Can't imagine having more treatment right now. I'm on ongoing Atezolizumab infusions and hoping I'll be in the 10% pr so who get a fantastic response.

[cujoe in reply to tom67inMA]

Along with the fisherman, I, too, hope you are in the 10% fantastic responders.

Brothers in arms are we all. Keep da faith & Be Well - K9

[NPfisherman]

Hoping you get that response...Best of luck...

Don Pescado

[jdm3]

I wonder if there will be any benefit to the cancer community from all the money, effort, and brainpower chasing the COVID vaccine. I would like to think cancer researchers can learn a lot from some of those studies about immunity, T cells, mRNA, re-purposed drugs, etc...

[NPfisherman in reply to jdm3]

Exactly right. I suspect so and we will see as the science is evolving so fast. it is why I am hopeful just from looking how far researchers have come with PCa in the last 10 years, but yet....people die... Each person's cancer is different and this is why finding a common treatment that can be pulled off the shelf like a vaccine is so important. I hope we see it in our lifetimes.

DP

[cujoe in reply to jdm3]

Actually, we are seeing significant existing medical knowledge flowing in the opposite direction, with COVID trails using existing drugs that influence the immune system and cellular components, like ACE2, that are active in COVID infections.

boston.cbslocal.com/2020/05...

bgr.com/2020/05/08/coronavi...

Being off treatment for both of my cancers, I find it a bit ironic that the frontline treatments for each seem to be protective against some aspect of COVID. Maybe some true clouds with silver linings for those of you on treatment. For the time being, I'm still willing to face the loss of some possible protective benefits and remain off treatment for the near/distant future.

News today of progress in three different COVID vax trials. Miles yet to go, but some evidence that the efforts will eventual produce an effective vaccine. Science needs to keep coming for that, too. Stay Safe - K9

[Fuzzman77 in reply to jdm3]

Of course I am a believer in cancer vaccines since it appears I was cured from stage 4 kidney cancer to the bone from TVAX T-cell vaccines 25 years ago this spring. And even though I did have to add Lupron four months ago to the APCEDEN vaccines and Keytruda to get my PSA to go from .03 to <.01 the combo is working for now. I was still NED last fall after having appx 30 tumors before. I also had 11 mRNA vaccines for prostate cancer in 2018. It still came back but did keep me stable. They are out of Baylor from Dr. William K Decker and Dr. Konduri. I had to have them done in India but they were in collaboration with the lab in India. From what they told me I was the first person to be given mRNA vaccines of any kind. I too believe vaccines in conjunction with something else helps some people. I am at almost four years now and although the vaccines did not sure me they have helped keep me stable. My onco here added Keytruda in July, 2018, and Lupron 4 months ago. Will stop everything in the fall and hope I can get a couple of good years off treatment. I know I am a one off as far as what has been done to me, but so far, so good. Dx’d 8/2014 with PSA of 212, and Gleason 9 with lymph node mets up to my neck. By March, 2017 mets were in the bones up to my cheekbone confirmed by PSMA PET scan in Delhi. It’s been a long road and if and when it come back I will most likely try Lu177 in Delhi if I am PSA avid.

[NPfisherman in reply to Fuzzman77]

You have had a great run on the APCEDEN vaccine and combos. It is what I have been preaching....combos that attack different targets can get this under control in spite of bad starts. Another guy I know started off with a PSA over 500, but took Cabazitaxel and carboplatin chemo, followed quickly by Zytiga, prednisone, and lupron and got control for years....hit it hard early is crucial...

Fish

[Fuzzman77 in reply to NPfisherman]

I was very end stage when I went to Delhi out of desperation. Truth be told, I was ready and OK with it but my kids were only 11 and 9 at the time so I got on a plane and just got lucky. The immunologist that made my APCEDEN vaccines said that doing a combo should give better results. My immunologist that gave me TVAX told me if it was him he’d look for a true autologous vaccine using my own tumor for the antigen, not like Provenge since it uses just cell lines. He also told me to try to do Keytruda which I was able to start 16 months after my first vaccine. Absolutely no question the combo made my health much better, so much so I tore both of my calves I felt so much better. One took about a month to heal. My kids are now 15 & 13 this week. Now I want to see them both graduate high school. Mine was and I imagine still is aggressive and that I still have some CTC’s somewhere. The great thing is I am tolerating Lupron much better this time around. It truly almost killed me the first time. I have now taken it a total of 19 months over 6 1/2 years so I can always stay on it I suppose. My onco here thinks I might be OK for awhile when I run out of vaccines and will then hit about 55 infusions of Keytruda. It will also make 71 vaccines altogether. And about three years of Zytiga and Xtandi. The Zytiga only helped for six weeks but when added to the vaccines before Keytruda it worked again. Weird. It does show combos may be the answer at least for me. After TVAX for kidney cancer I feel like I have been an experiment my entire life. I know I need to be grateful but I sometimes don’t like feeling like a walking experiment but the alternative is pretty ugly.

[NPfisherman in reply to Fuzzman77]

Taking these drugs is a challenge physically and mentally, but buying the time is the key... I think you run another 5 years and the new drug and treatment discoveries that happened during that time, will buy you 5 more... For me, the "brain fog" is what I hate most...

Fish

[Fuzzman77]

When I say the cancer came back there it was because my PSA went up to .22. It went from <.01 to .02, .05, .08, .13, .22 taken three weeks apart. When it takes off it takes off unfortunately. My onco here keeps a good eye on me. He has been a great onco and some of that I think is he has a degree in cancer research too. He was on it when the FDA approved Keytruda for any solid tumor that is MSI High or has certain mutations. Just hoping for the best since like I imagine most of us here I am mentally shot from all the treatment.

[NPfisherman in reply to Fuzzman77]

.22 is low...Many wish they could get there....You are lucky to be followed by a solid professional that knows how to treat PCa....Too many are seeing Urologists that start people on Lupron only with castrate resistance soon to follow...

Indeed, this disease has a physical and mental toll with it...But keep your chin up....As I like to say, "You think treating prostate cancer changed in the last 5 years ?? Well, just wait for the next 5 years and you will see real change !!!!" I do think we are at the beginning of some real change...

Fish

[Fuzzman77 in reply to NPfisherman]

You are right. I used to wish I could get to .22. I am lucky the vaccines and Keytruda got me stable for two years all the while all the doctors thinking I should have it removed. They were right because I felt better right away and had lots of tumor tissue to make lots of vaccines that sit in my basement on liquid nitrogen. I’m not so sure they shouldn’t remove the prostate in a trial of men that somehow get stable for a year or whatever they agree on. I mean I felt a lot better not fighting the primary anymore. Moderna has been working on cancer with mRNA vaccines for some time before they developed their COVID vaccine. The immunologist that consulted on my case and was instrumental in me trying mRNA vacccines for prostate cancer has been working on mRNA cancer vaccines for years at Baylor along with the the rest of his team. They finally have FDA approval for what I did for pancreatic and glioblastoma cancer uses the same mRNA vaccines I did using the patients tumor for the vaccines. They put mice and a couple of dogs in remission from metastatic pancreatic cancer with the vaccines. If they do a trial for prostate I will be sure to let everyone know since I am I touch with them periodically. They will be doing it soon in Cancún but it won’t be cheap unfortunately. DCImmunotherapy.con has licensed the treatment I did along with some others. There’s a lot of cutting edge technology in the pipeline for sure.

[NPfisherman in reply to Fuzzman77]

I am waiting for some one to be able to collect adequate number of CTC's and develop a vaccine from those cells. For now, I watch the science. I am waiting to see if ADXS-504 will be offered to MHSPC patients and might consider doing that trial...My MO at Cleveland Clinic feels that it is better to do no trials now and not "rock the boat" when it comes to treatment, since I have done well......Just happy to still be doing well and "in the game of Life"...

Do keep us posted...there are many who would love to do a vaccine trial....especially for MHSPC...

Fish

[Fuzzman77 in reply to NPfisherman]

I absolutely will if they do a trial for prostate. I went to Cleveland for a second opinion. Because I went there I was the first guy here that my onco gave both Lupron and docetaxal right after dx due to the ASCO report showing a 15 month longer survival or about that. I really liked Dr Grivas at Cleveland but I know he left. Dr. Noble, a urologist at Cleveland removed my kidney cancer tumor in 1996 at KU Med in Kansas City, and helped get me in the TVAX trial for kidney cancer as the 2nd patient. They ended up doing 39, and were trying to show that cancer vaccines work best when given immediately after healing from the surgery. My kidney tumor was 5.1 pounds and they told me they were 99.99++++ sure it was all over but the scans just weren’t showing it yet. This was in the days before PET scans.

[NPfisherman in reply to Fuzzman77]

It pays to go where your MO is a PCa Specialist, and not an Onc Generalist....ie: Heme/Onc... keep us posted...I have thought I would do APCEDEN for a metastatic recurrence... impressed by your results...Best of luck...

Fish

[Fuzzman77 in reply to NPfisherman]

That would be nice if they could do that with CTC’s. Who knows, maybe they are just enough different than the original cells is why they go undetected? As far as APCEDEN they have posters there to try to do it before recurrence. Of course you’d need enough tumor to biopsy. I had 58 individual prostate biopsies over three times to make three dozen vaccines. Plus the 12 at diagnosis for 70 total. Not having a prostate anymore means I couldn’t do it again unless I end up with another tumor that is accessible. I will go another route if that happens anyway. Like you say, I’ve had a nice run.

[NPfisherman in reply to Fuzzman77]

I could not do APCEDEN currently because my prostate came out in 2017 and they want you to have a current tumor, not one that hasn't changed in years... I had SBRT to one met in 2018 post recurrence... I am looking into doing the Lisanti protocol for CTC's when I get vaccinated...the IV Vitamin C is the issue... The APCEDEN has served you well from your initial situation...like the commercial says, "You've come a long way, baby....to get where you got to today !!"

Fish

[Fuzzman77 in reply to Fuzzman77]

You are so correct NPFisherman. There’s a bunch of Nee stuff just since I had my first vacccine back in March, 2017. I like the vaccines the best because there’s zero side effects except they made me feel better. I looked like a ghost when I took the first one.

[NPfisherman in reply to Fuzzman77]

In my 3 years, we have seen new scans, nanoparticle treatments, stereotactic radiation and radiopharmaceuticals, new drugs like apalutamide, darolutamide, PARP inhibitors, and Orgovyx... and new drugs coming through Phase 2 like ARV-110, VERU-111, ZEN 3694, etc... it is happening fast...sadly, not fast enough for some...

Fish