Are you currently (or have you been) in a Clinical Trial?
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Kathy/Wereon...wow...I didn't realize that...thats pretty neat! That was my bad thinking you were ER+ HER2- I looked to fast at your signature and didn't see the ER- .
I just prayed for you to find the right treatment to eradicate your cancer.
I'm one year out since diagnosis and no treatment has worked more than 3 months for me... so I "get it".
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So sorry to hear that, Kathy!!
Is it the policy now for most trials that having previously had Keytruda does not rule out future trials with immunotherapy? because respond or not you are surely getting a survival advantage from having had immunotherapy twice now...
TTK is a kinase that is critical for DNA repair, and is often very active in chemoresistant cancers. Inhibiting this kinase in mice makes cancers sensitive to radiation and immunotherapy. Given that you were just treated with immunotherapy, this sounds like an excellent choice to follow up with this drug! The properties of blocking mitosis and introducing genome instability seem very similar to CDK12 inhibitors.
Here is a good paper on TTK inhibitor: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC53733...
Aggressive cancers with active beta-catenin (Wnt signaling) are five times more sensitive to this drug https://mct.aacrjournals.org/content/molcanther/16...
The drug is also indicated to work on ER-positive cancers that have become resistant to Ibrance or Verzenio: https://www.pharmacytimes.com/conferences/san-anto...
Good Luck with the trial- Clearly, you have a terrific team guiding you!
PS Some backup options could be trials with the CDK2,4,6 inhibitor, the ATR inhibitor Berzosertib, or the ADC sacituzumab govitecan...
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Thank you Nicole and Curious, curious to answer your question about futures immunotherapy. No it doesnt mean I cant have more immunotherapy in future. He wanted a trial that had a different type of injection with immunotherapy but they wouldnt approve using the same tumour I just used.
I will keep posting if I enter the trial
As of tonight my brain mri showed either radiation damage or progression. We will have to rescan in a few weeks to confirm either and that will determine my next steps.
Thank you again for info Curious and the prayers Nicole.
Kathy
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Dear Weareonthecusp, I am sorry Keytruda failed... what are your PD-L1 levels, have you had them tested? What about Atezolizumab (probably with chemo) or Sacitizumab Govitecan - can you have access to these drugs? Saulius
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Hi Saulius, I was very happy to see your wife is still Ned. I have never had my PD-l1 tested. Most immunotherapy drugs here in Canada are only given thru trials. I guess it wasnt needed for the trials I was in. The other drugs you mentioned are not available here I dont think but will ask. Not sure why the font went dark but was not on purpose. Lol
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Weareonthecusp - I'm on atezolizumab (+ ipatasertib/placebo) through a trial & it's one of the ones for PD-L1 positive tumors.. It's avail in Canada but BC is not paying for it yet so it's either a trial or compassionate access. Not sure where Ontario is at with it.
I'm getting it through a trial but my MO was putting in paperwork for compassionate access from Roche and seemed reasonably confident that it would have been accepted so maybe that's something to explore.0 -
Thanks Moth, I will be speaking with my MO tomorrow by phone. He is a specialist in Tnbc and I trust him completely. Until we find out what the brain is doing in next couple weeks I will be on hold unfortunately. I am hoping to at least start xeloda during radiation but am not sure if that's an option until I talk to him. If radiation is indicated again, I would have to wait for 3 clear scans again before entering another trial. I will also ask about compassionate use of anything he feels I could benifit from. I know I have asked about the tecentriq with taxal and I did not qualify.
Thank you for keeping me in your thought
Kathy
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Dear Weareonthecusp, thank you so much for best wishes. Please check these drugs. I know one woman here in LT who is mtnbc and progressed constantly throughout 3 years but had pd-l1 tested (25% which is huge) and now for the first time after more than 40 chemos she has very good response to Atezolizumab+Abraxane... Sacitizumab-Govitecan is even newer horse in the race... Saulius
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How come I have it on my Foundation 1 that I have the PDL1 gene but I do not see a %???
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Nicole,
I would call Foundation One and see if they can pull this info for you -- I had to call them once regarding my report and they were great.
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So No chemo today (ill explain in liver thread)
My F1 report says this: Tumor-Infiltrating Immune Cell (IC) Score (%) 10.
It looks like my percentage is 10? I guess that's not good as far as responding to Tecentriq in the future right?
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Nicole,
You don't know that without a new genomic report, either through tissue or blood biopsy. Fingers crossed that that number has changed.
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here is Hope Rugo summarizing/updating Piqray and some other stuff, including oral taxanes, which sound horrible (you have to take 10-12 capsules?!) but at least have less neuropathy; and about a third of people make it 200 days? depressing how little progress has been announced in the medical community for MBC this year, although the basic research plows on
https://www.onclive.com/view/pi3k-inhibitors-and-o...
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Thank you for that article, Cure-ious. I have bookmarked it as both alpelisib and a taxane (again) may be future treatments for me.
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Dear Nicole, 10 % is really good... I guess they talk about TILs there. In this case you'd be a good candidate for TIL therapy. Tecentriq is PD-L1 directed, so PD-L1 % is important. Tecentriq works well for > 1 %. Saulius
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Oh wow really Saulius?? I am glad about that!!! She said we will go to Abraxane and Tecentriq next so...that could be the one if Eruibiln fails...
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chaos with my trial - just got off the phone with MO and Roche is unblinding the study, but not terminating it as of this moment but who knows how long? Since I'm responding well to treatment both MO and I agreed we just keep going on as we are but it's all topsy turvy as access for Tecentriq is tricky in BC.
Apparently all this is due to (presumably negative) results from another trial being released.
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MOTH- hope you get things worked out. That’s a little scary/frustrating. Glad you are responding.
So with my recent mixed scans I am starting the process to get into the CDK 2/4/6 trial in Nashville. NCT03519178 According to the trial nurse they have open slots. We will see if they take me. It has to be my next step if I want to go that route because it is limited to 1-2 chemos. I will let you all know if I make it in and if I choose to do it.
I am also looking at 2 Neuroendocrine trials. I need to see if they will accept me If try other trial drugs first.
I was hoping for no progression and a rest from research.
Dee
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Dee I looked at that trial and even emailed with them right before I started the Halavan
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Has anyone tried the AKT kinase inhibitor, Ipatasertib? It is being tested on both TNBC and ER-positive MBC, and is in one of the arms of the Morpheous trial where it is being tested with immunotherapy for secondline or later following I/F.
It has been getting some good press for the TNBC tests- it sounds like they are looking to see if there is an activity difference between wild-type or mutant PIK3CA (the latter at least should be responders)
https://www.onclive.com/view/ipatasertib-survival-results-continue-to-impress-in-tnbc
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Good news out today, published in CELL!!!
A protein called TREM2 is expressed in macrophages that infiltrate solid tumors and protect them from T cells that want to get in there and kill them off. If you get rid of the TREM2 gene in mice, the macrophages no longer target the tumor, and they die off from the immune system, especially when they threw in a checkpoint inhibitor (PD1 antibody like Keytruda). Huge effect. There is an antibody to TREM2 protein that also gives the same result, and the antibody is already in clinical trials for a different reason, so they will be able to go quickly to clinical testing. These TREM2 expressing macrophages were found in 200 cancer types, and were associated previously with shorter overall survival.
https://www.cell.com/cell/fulltext/S0092-8674(20)30878-3
https://medicine.wustl.edu/news/immunotherapy-resi...
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Cure-ious,
This is indeed very interesting. I read the WUSTL report that you posted. Wondering when they will go to clinical trials.
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Cure-ious, I was in Roche's ipatasertib trial but my cohort was unblinded and the trial is partly on hold after the impassion trial results in atezo+taxol showed no improvement. I was in pdl1 positive group. I think the pdl1 neg group is still continuing the trial but I'm not sure. My MO called me last Friday and details were still unclear.
Anyway, turns out I was getting placebo anyway
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BevJen, I am confused about the antibody, because the ones they are trying for alzheimers stimulate the receptor whereas the one we would want need to inhibit (an easier feat)- they say they still need to test human antibodies in the mouse model but then will be ready for a clinical trial, which is more explicit than most papers get about trials, and indicates they are serious
Moth- dang those placebos!! I hope the AKT inhibitors work well, and are better than Piqray in terms of SEs
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Cure-ious,
Thanks for posting. I’m very hopeful that there will be something more effective than just chemo for TBNC. I’m just trying to hang in there until there is something that will actually work
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Curious the first link didn't work for me??
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I have been NEAD for 4.5 years with no treatment of my cancer. My trial was in 2016
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Thank you
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barbigwire, that's awesome! Congratulations.
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Barbigwire,
Again, its so exciting to have you join us!! I think you had a cytokine storm in response to Halaven-Keytruda, and had to fight off sepsis? Are there others you know who have had similarly remarkable responses to immunotherapy?
We have had a couple of women on this site with durable responses in a trial that combines immunotherapy with EP4, which is a next-generation NSAID anti-inflammatory, however their cancers did return so not yet a cure. It's still great because any response usually is accompanied by an increase in overall survival, but still- we're all hoping for an even better outcome
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