Are you currently (or have you been) in a Clinical Trial?
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Update No. 2:
Its frustrating that I cannot find the paper the press release mentions, but provides no link- how can Duke have such a lame press office?
Anyway, here is an abstract they presented at a meeting in 2024:
Despite encouraging early phase clinical trials, decades of research have yet to yield effective cancer vaccine immunotherapies. To determine potential markers for success, we performed a follow-up study of a HER2-pulsed dendritic cell cancer vaccine Phase I trial performed in advanced HER2+ cancer patients. Surprisingly, we found that all treated patients were alive at over 18 years post-treatment. These patients still possessed significant HER2-specific memory T cell responses, typified by CD27 expression. The expansion of HER2-specific CD27+ memory T cells was also observed in patients from a separate clinical trial, who received a HER2-expressing viral vaccine. To validate these clinical responses, we vaccinated human CD27 transgenic mice with a HER2 viral vector again observing HER2-specific CD27+ memory T cells, suggesting the significance of this axis in eliciting and maintaining effective vaccine-specific memory T cell responses. We hypothesized that CD27 expression was not just a marker of memory T cells, but represented a critical activation pathway during memory formation. To determine the potential impact of CD27 agonism in vaccination, we combined HER2 vaccination with an anti-CD27 agonist antibody (Varlilumab). The combination treatment elicited a robust increase in HER2-specific CD4+ memory T cell responses that was maintained for at least 300 days post-vaccination. Using therapeutic HER2 vaccination in combination with anti-CD27 of HER2+ tumor bearing mice, we show significantly increased anti-tumor efficacy and further enhancement in combination with PD1 inhibition. The anti-tumor response was triggered by anti-CD27 antibody during the vaccine priming phase, which enhanced HER2-specific CD4+ T cells. Critically, we found that HER2 specific CD4+ T cell responses allowed for anti-tumor responses that persisted after CD8+ T cell depletion, indicating a direct role for antigen-specific CD4+ T cells independent of CD8+ T cells. Collectively, our results support a central role for antigen-specific CD27+ CD4+ T cells in cancer vaccination. These data support the addition of CD27 agonism to improve the therapeutic index of cancer vaccines and potentially enhance responses to immune checkpoint blockade in refractory cancers.
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cureious - my last scan (mid October) showed some ascites and bigger lesions. So my break was over, but it was a nice 7 months while it lasted. My oncologist was "pleased" that it seems to be just regrowth in the old lesions, nothing new. I've gone back on Enhertu, now every 4 weeks. Still tired, and really tired the week of infusion, but otherwise okay. And of course, I'm hoping that everything responds again. Plan is to scan Januaryish. All weird and new territory.
I saw that news about Duke - one thing that no one points out is that those first patients were Stage 2, 3 and 4 ("advanced" was used just because of positive nodes) and NED. I'm wondering whether their 20 year survival could really be just within expectation of treatment with herceptin? But this is outside my paygrade!
https://pubmed.ncbi.nlm.nih.gov/17822557/
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NewGardener, It is so amazing you are 15 years out and able to take a seven month break!!! It's such a remarkable response, and that includes 14 months on that trial before starting the Enhertu! You, and JensGotThis, who's at ten years-plus just on endocrine therapy, and I know several others here also +/- ten years out. Its so inspiring.
Anyway, all that aside, we need some new great treatments. SABCS2025 is just around the corner, maybe they will have something.
I was just reading that some of the next-generation SERDs (camizestrant, imlunestrant, and giredestrant), have are better inhibitors than elacestrant (which has worked well for me), so I wonder if some combination therapy with these would benefit you? I had been interested in Kat6A, but now see that it doesn't really work for cancers with PIK3CA mutations. However, if the cancer retains significant levels of PIK3CA, gedatolisib is an inhibitor that hits both PIK3CA and mTOR, and is working its way through phase 3 trials right now. Also RLY-2608, which works only on mutant PIK3CA, is in phase 3, tho it has just started. I see that you got 1.5 years from Inavolisib with fulvestrant (!), and you've been on other things since then, so maybe hitting the same pathway again with Gedatolisib or even Capivasertib in combination with Elascestrant or one of the other oral SERDs would be worth trying (if the cancer has retained endocrine sensitivity)?
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Dear cureious… my Sandra got a dendritic cell vaccine. First she was given weeks to live, then THP+dc vaccine, 8 doses+CIK infusion, 5 doses (both autologous, matured with HER2+ cancer cells). And now look… she's NED for past 5 years, and almost 8.5 years out with absolutely deadly diagnosis: just before treatment 9 cm tumor with many lymph nodes involved, liver full of mets and doctors saying "we cannot take the risk to give you THP, as it can kill you - if you want it, you have to sign it on your own risk". Exceptional responder and survivor? Or all treatments simply did their work?
Saulius
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Hi Saulius,
Wow, wow, wow!!! I had no idea her situation before treatment was so dire…Your wife sounds so much like these other survivor- I haven't seen their paper so no idea how the dendritic vaccine might have resulted in the formation of these robust immune CD8+ CD27+ memory cells, but surely her therapy did the same, and how great is it they are all alive twenty years hence…
I have been reading how histotripsy, a newer technique where liver mets are broken apart by a lasered ultrasound, can lead to a broader immune stimulation and abscopal effect (where immune cells act throughout the body, not just the targeted met), than radiation or chemo, because it leaves more of the cancer neoantigens intact and acts like a personalized cancer vaccine, providing snippets of the weirdo cancer proteins specific to your cancer (each cancer has different distinct neoantigen proteins). And because the ultrasound used in histotripsy leaves the werido proteins more intact, the stimulation of the immune system they get with histotripsy is better than what is seen with radiation or chemo.
It is remarkable that someone can go from death's door to just fine, amazing
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Such an incredible story. So happy for you and your wife.
Just tagging you here so you can see cure-ious' comment above concerning histotripsy.
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Dear all, thanks for best wishes. Yes, my wife's situation was absolutely desperate… Cannot even remember these days well, probably my brain blocks these crazy moments: could not sleep, was running NCI corridors with 2.5 year old baby in my hands who was crying for mommy, hiding for some minutes to cry, then wiping off tears and going out to fight again. Our doctors were amazing and broke not one protocol to bring my wife back to life. Ehh, my heart always breaks when I hear C stories… no one, no one will really understand what these people go through until you face it yourself. Biggest respect to all these fighters, biggest respect to these forums and you all who gave me hope, courage and knowledge. Hugs,
Saulius
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Whoa, happy to hear this about minoxidil! I just went on it end of October - I had complained to my dermatologist about my thin thin flyaway hair and said I was afraid of growing a beard on minoxidil- so she gave me a script for Finasteride. I didn’t take it until I went to my oncology appt and the doc said NO NO and wrote me a script for oral minoxidil, plus I am doing 5% foam every night. It’s only week 5 but I feel like I see a difference and some baby hairs growing in front.
I am just being careful about getting the foam residue from my hands to my face and on my pillowcase, so far no facial hair is sprouting. I use an eyebrow brush or a toothbrush to get it into the scalp, since I do have some hair
The derm had also given me ketoconazole shampoo which helps some women with hair thinning and flaky scalp. This may be making my actual existing hair look better, too. Although it is very drying, I use Nioxin conditioner after and I see my hair looking fulller and feeling very soft.
I have high blood pressure already so I am not worried about the blood pressure lowering qualities of minox, if anything it may help. And now a possible cancer benefit, well this is some excellent news!!!!
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Hi Saulius,
Hope is always in such short supply, can you tell us more of what her trial was? She was treated in Bethesda? And what were the details of the vaccine regimen, and how long did it take before she noted her improvement?
I can't imagine running around with a toddler and trying to hope against hope- and baby is now like 10? Amazing!!!
Just tell more of your story so we can fantasize a bit longer… Is the trial still going on (surely not) or there must be other trials continuing this approach?
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