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Immunotherapy drugs for breast cancer

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  • aterry
    aterry Member Posts: 142
    edited June 2018
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    I've just read all of the updates. You all write such interesting posts. I haven't followed ASCO closely; I guess I should catch up on that. Zaraovka, what is TILs? Did I miss that in an earlier post? It's not on the list of abbreviations. Thanks.

  • KPW3
    KPW3 Member Posts: 127
    edited June 2018
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    I'm on a Pd-1 and am wondering what is thought about taking ibuprofen with pd-1? Or supplements, I normally take cucurmin, melatonin, vit D3, multi vit, and Claritin.


    MO says it's fine, but am concerned....

  • zarovka
    zarovka Member Posts: 2,959
    edited June 2018
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    aterry - TILs are tumor infiltrating lymphocytes. These are white blood cells found in tumors.

    The immune response to cancer has (at least) two important steps. First the immune system has to recognize the cancer as foreign, second the immune system has to launch an attack.

    TILs are important because they indicate the immune system has identified the cancer as foreign. TILs enter the tumor ready to multiply and take out the tumor but the tumor shuts down the immune response through immune suppression. The presence of TILs suggests that an agent that suppresses immune suppression in the tumor microenvironment like PDL-1 might work. And, in fact, such agents are more successful in patients whose tumors have TILs.

    KPW3 - this forum is mostly about discussing research. You will get a better response from a forum that discusses PDL-1 inhibitors, regardless of cancer type. PDL-1 inhibition is still not common for MBC. I am not on a PDL-1 inhibitor, but I can share my general strategy for thinking through the supplement interaction problem. I ask myself what is the drug trying to do and what is the supplement trying to do. PDL-1 is trying to enhance an immune response, which can promote inflammation, curcumin reduces inflammation. I think you may be working at cross purposes with that particular combination. Cannabis, for example is a powerful anti-inflammatory and I've seen smart people suggest it should not be combined with immunotherapy.

    This is NOT a direct answer to your question. I am just supporting your intuition/concern.

    Generally, when I start a new regime and I am not sure I understand what the interactions are, I stop all supplements but the multi-vitamin and let the standard of care drug do it's thing for a while. It helps me to understand how the Standard of Care treatment "feels"/works on its own. At some point I feel comfortable adding things back... I think that the fact that you are concerned indicates you might want to pull back supplements. Often there is no data driven, researched answers to these questions but going by your intuition should not be underestimated ...

    >Z<

  • blainejennifer
    blainejennifer Member Posts: 441
    edited July 2018
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    Just spoke to Sarah Ramirez at the NIH about trial eligibility for the same trial that "cured" Judy Perkins. Of note - they have been slammed with trial enquiries because of the publicity. Also, only three patients, out of the entire cohort, have achieved remission. Just Judy, one colorectal patient, and one bile duct cancer patient. While that's great, the numbers are still not in our favor.

    Also, if you are thinking about this trial, and I am, you should have a resectable tumor that is easy to get to, because they need to harvest cells from the tumor. Ms. Ramirez seemed to favor lung nodules (well, she talked about them a lot). And, it is four months from cell harvest to t-cell infusion, so you will need to line up a conventional treatment for the interim period. They need a 4 week washout before infusion, but I don't know too many of us that could go for four months without treatment.

    Jennifer

  • Kidmanliang
    Kidmanliang Member Posts: 72
    edited July 2018
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    thanks Jennifer. We also contacted them, since they have been slammed, they don’t even accept international patients. We already started looking into other clinical trials, I really hope that a real cure will be invented soon.

  • moderators
    moderators Posts: 7,966
    edited July 2018
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    We just opened a new forum on Immunotherapy, so are moving this over!

  • nurseruthie
    nurseruthie Member Posts: 2
    edited August 2018
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    My 35 year old daughter, who was recently diagnosed with TNBC Stage IIB, is involved in the second tier of a drug trail using Abraxane and Durvalumab (a monoclonal antibody) as her initial neoadjuvant chemotherapy. Has anyone heard anything about this monoclonal antibody?

  • Kidmanliang
    Kidmanliang Member Posts: 72
    edited August 2018
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    hi nurseruthie, Durvalumab seems to be a PD1 immunotherapy drug. I’m not familiar with it, but I hope someone else will give you some info soon

  • funthing42
    funthing42 Member Posts: 236
    edited October 2018
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    Hi

    Just wondering what to expect next.

    They told me immunotherapy is not for me only triple neg breast ca. Than gave some 5% effective statistic statement. Told me I didn't have 30 days to figure out trials etc.

    They are ready to give chemo again. Abraxane?

    No Biopsy of the liver just juice me.

    I want to survive. I feel like they are looking in a book and throwing their hands up figuring it might work with no analysis.

    Ibrance and fasoldex gave me 2 years remission.

    Tumors shrunk to nothing markers normal.

    I still do lupron also.

    Last week I was told my markers went up.

    Hx below I don't have time to figure out whats going to work.

    Liver 3 large 1 small

    4cm largest

    x 6/1/2009, IDC, <1cm, Grade 2, ER+/PR+, HER2-

    Hormonal Therapy 6/5/2009 Arimidex (anastrozole)

    Surgery 6/5/2009 Lumpectomy: RightRadiation Therapy 8/1/2009 Whole-breast: BreastHormonal Therapy 11/1/2009 Arimidex (anastrozole)

    Dx 11/1/2013, IDC, 1cm, Stage IA, Grade 2, ER+/PR-, HER2+

    Surgery 1/1/2014 Mastectomy: Right; Prophylactic mastectomy: Left

    Targeted Therapy 2/1/2014 Herceptin (trastuzumab)

    Chemotherapy ,Carboplatin (Paraplatin), Taxotere (docetaxel)

    Dx 10/1/2014, IDC, <1cm, ER+/PR-, HER2-Hormonal Therapy 11/1/2014 Aromasin (exemestane)

    Skin mets Sept 2015

    3/2016, IDC, Right, ER+, HER2-Metastatic treatmentTypeExternalSiteChest wall radiation was finished . Pet scan then revealed left lymph node involvement. Her2- estrogen + progesterone-

    Ibrance and fasoldex 2yrs

    It shrunk to nothing markers normal no Ca.

    But now on

    10.10.18 markers up

    Liver mets

  • KPW3
    KPW3 Member Posts: 127
    edited October 2018
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    funthing42, How are your liver enzymes? My liver met changed to triple negative (primary ER+,) and they would not have known if they hadn't done a biopsy. I think I would really push for a biopsy, unless your liver enzymes are high. Have you gotten a second opinion? I always get a second opinion when my treatment changes and have gotten a third.

    My 2 cents......

    Here is a clinical trial for what I think you are asking.....

    Atezolizumab and Cobimetinib or Idasanutlin in Participants With Stage IV or Unresectable Recurrent Estrogen Receptor Positive Breast Cancer

    https://clinicaltrials.gov/ct2/show/NCT03566485


    I think there may be others with keytruda, these are the clinical trial #s.

    NCTT01772004 and NCT02054806


  • funthing42
    funthing42 Member Posts: 236
    edited October 2018
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    Thank you for caring. It is crazy how much work is on the patient. Lol.

    I'm exhausted. With out all of us here on this forum, I would have been one flew over the cuckoo nest.

    My enzymes are great. I look at my urine for change every chance I get. Lol not brown yet.

  • Kidmanliang
    Kidmanliang Member Posts: 72
    edited November 2018
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    funthing42, have you noticed this thread yet? Y90 seems to work for liver mets


    https://community.breastcancer.org/forum/8/topics/832767?page=17#idx_481

  • funthing42
    funthing42 Member Posts: 236
    edited November 2018
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    Hi

    Thank you Im looking into the y90.

    I start xeloda this week.Smile

  • Kattysmith
    Kattysmith Member Posts: 688
    edited November 2018
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    I'm being vetted for a Phase 1 Immunotherapy clinical trial at MDA that will combine Optivo (Nivolumab) with a new targeted therapy known only by its initials so far. I am not triple-neg, but I do have two mutations in my liver mets, so that may be why they are considering me for this trial. I've been playing message tag with the head of the study. My baseline biopsy will be Tuesday, then I should know if I'll be moving forward with this trial in two weeks!

    I've sailed through two courses of IV chemo without severe side-effects, but I must admit, the list of possible side-effects for both of these drugs is DAUNTING.

  • funthing42
    funthing42 Member Posts: 236
    edited November 2018
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    I called MD Anderson as a back up. I normally shy away from trials. I'm ready now to keep the option open.

    Good luck. Your brave and encouraging. :)

  • Falconer
    Falconer Member Posts: 801
    edited January 2019
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    Could Immunotherapy Offer a Cure for Cancer?

    https://nyti.ms/2REQxRu?smid=nytcore-ios-share

    In The NY Times today. A book review

  • soic
    soic Member Posts: 3
    edited October 2019
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    Hi All

  • soic
    soic Member Posts: 3
    edited October 2019
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    hi

  • soic
    soic Member Posts: 3
    edited October 2019
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    Hi

  • [Deleted User]
    [Deleted User] Member Posts: 760
    edited November 2020
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    Kattysmith

    That’s great that MDACC found you a trial. (I had to find my own trial and bring it to them) are you pdl1 positive?
    What mutations do you have? FYI- my sister has been on opdivo Single agent for more than 5 years for lung cancer. She has had many of the side effects but nothing real bad -she is a walking miracle!!! She keeps her grandbabies occasionally, rides her horse, takes care of her big German shepherd and gets along pretty well most days with only a partial lung!!!

    Best wishes

    Dee

  • [Deleted User]
    [Deleted User] Member Posts: 760
    edited November 2020
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    Do you have the SF3B1 mutation?

    Check out this clinical trial for immunotherapy at John Hopkins. https://clinicaltrials.gov/ct2/show/NCT04447651#contactlocation

    Dee

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