Calling ALL Colorectal CANUCKS !

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Achilles Torn
Posts: 141
Joined: Fri Dec 16, 2016 2:41 pm

Re: Calling ALL Colorectal CANUCKS !

Postby Achilles Torn » Fri Feb 03, 2017 4:06 pm

If you pursue this I'd be interested to hear how it goes. I'm dealing with the BCCA here in BC and it's been varied regarding treatment quality. I had to push hard for everything at first (for the PET scan which revealed stage 4, meeting with Onc in a reasonable time and getting chemo moved up from 8-9 weeks post surgery to 4 weeks). All of which may be vital to my care and would never have happened without a significant amount effort which was draining emotionally.

My treatment has started and I've met 4 different docs so far some good and one terrible..... But overall I have little confidence in the agency to push as aggressively as I need to maximize my life.

If you think things should be moved up or treatment changes then campaign HARD for it. I actually found citing published science can help. You can make things happen by being polite and unrelenting !

that being said I think I will be ending up at least seeking one second opinion on treatments
Diagnosed as 40 yo Male. BC Canada. Sigmoid Colectomy Dec. 2016
Pathology T3N2bM1 19 of 24 Nodes Positive + tumour deposits
PET scan - Para-Aortic and Iliac Lymph node spread. Stage VI.
Moderately differentiated. MSS. KRAS/BRAF Wild.
Mutations: TP53, ERBB4, MLL3, PDCD1LG2, PRKDC, SMAD3
FOLFOX + Bevacizumab Commenced Jan 9/2017 PET Scan July 2017 - on maintenance 5FU/Bev every 2 weeks.
Progression after Covid19 induced break June 2020. Resume Maintenance chemo of Capecitabine and Bev

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Nature of Things episode : Cracking Cancer

Postby CRguy » Mon Feb 13, 2017 5:16 pm

Just wanted to let folks know about an upcoming Nature of Things.
The trailer linked below shows another patient cured of Stage IV BC by the POG program
Cracking Cancer
Thursday, February 23, 2017 at 8 PM on CBC-TV

Cracking Cancer Press Release

google search links

Clinical trial aims to crack cancer code using genome sequencing Audio podcast on CBC One "The Current"
with the Project cofounder Dr. Janessa Laskin
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

User avatar
Maia
Posts: 2443
Joined: Fri Aug 24, 2012 8:00 am

Re: Calling ALL Colorectal CANUCKS !

Postby Maia » Tue Feb 14, 2017 4:57 pm

Dear Canadians,

there are several great immunotherapy trials ongoing in Canada (you can put "Canada" in the search box of the Clinical trial Finder for MSS-CRC in my signature, curated by Tom (our DK37 fellow, on this forum). BUTT I wanted to point out three that are "only in Canada" and specially important. (Two of them are not on the curated spreadsheet/ app).

****************
Clinical trial, for LIVER mCRC
#NCT02864485
*Only Toronto, Canada.
*LIVE DONOR LIVER TRANSPLANTATION for the treatment of unresectable colorectal cancer liver metastases

A radical treatment, which has as antecedent the Oslo trial.

"This study will offer live donor liver transplantation (LDLT) to select patients with unresectable metastases that are 1) limited to the liver and 2) stable (non-progressing) on standard chemotherapy. Potential participants will be evaluated for liver transplant suitability and must also have a willing, healthy living donor come forward for evaluation."
https://clinicaltrials.gov/ct2/show/NCT02864485

***********
MG1 Maraba/MAGE-A3, With and Without Adenovirus Vaccine, With Transgenic MAGE-A3 Insertion in Patients With Incurable MAGE-A3-Expressing Solid Tumours (I214)
https://clinicaltrials.gov/ct2/show/NCT02285816
#NCT02285816

The Phase I admits CRC, supposedly, if the tumour test positive for what they are looking for.

Contacts
Contact: Janet Dancey 6135336430 jdancey@ctg.queensu.ca

Locations
Canada, British Columbia
BCCA - Vancouver Cancer Centre Recruiting
Vancouver, British Columbia, Canada, V5Z 4E6
Contact: Daniel John Renouf 604 877-6000

Canada, Ontario
Juravinski Cancer Centre at Hamilton Health Sciences Recruiting
Hamilton, Ontario, Canada, L8V 5C2
Contact: Sebastien Hotte 905 387-9495

Ottawa Hospital Research Institute Recruiting
Ottawa, Ontario, Canada, K1H 8L6
Contact: Derek Jonker 613 737-7700

University Health Network Recruiting
Toronto, Ontario, Canada, M5G 2M9
Contact: Albiruni R A Razak 416 946-4501

Sponsors and Collaborators

Canadian Cancer Trials Group
Ottawa Hospital Research Institute

*******************

Study of TBI-1301 (NY-ESO-1 Specific TCR Gene Transduced Autologous T Lymphocytes) in Patients With Solid Tumors
#NCT02869217
https://clinicaltrials.gov/ct2/show/NCT02869217

Only in TO, Princess Margaret Hospital

*Similar* to the TIL trial at NHI (our Sleen / Celine trial :) )

One needs to check if tumour qualifies.

Histologically or cytologically confirmed metastatic or recurrent unresectable solid tumor.
HLA-A*02:01 or HLA-A*02:06 positive.
Tumor NY-ESO-1 expression by immunohistochemistry.
No anti-cancer chemotherapy, radiation therapy or immunotherapy within 2 weeks of PBMC harvest.
If approved and funded standard therapy is available, subjects must have failed, be intolerant to, be ineligible for, or have refused treatment.
Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as >10 mm with CT scan, MRI, or calipers by clinical exam. See Section 11 for the evaluation of measurable disease. Patients must have radiographic evidence of disease progression following the most recent line of treatment. Areas of previous radiation may not serve as measurable disease unless there is evidence of progression post radiation.
ECOG Performance Status 0 or 1.

"The target populations for this phase I study with TBI-1301 are patients with advanced solid tumors. Patients' tumors will be required to express NY-ESO-1, which include but is not limited to ovarian cancer, synovial sarcoma, esophageal cancer and malignant melanoma. Patients must be positive for HLA-A*02:01 or HLA-A*02:06 and the patient's tumor tissue must be positive for NY-ESO-1 antigen expression. The study will take the subject's T cells, which are a natural type of immune cell in the blood, and send them to a laboratory to be modified. The changed T cells used in this study will be the subject's own T cells that have been genetically changed with the aim of attacking and destroying cancer cells.

The manufacturing of T cells takes about 1 month to complete. The T cells will be given back to the subject through an intravenous infusion.
The purpose of this study is to test the safety of genetically changed T cells and find out what effects, if any, they have in subjects with advanced solid tumors."

Contacts
Marcus Butler, MD 416-946-4521 marcus.butler@uhn.ca..

Locations
Canada, Ontario
Princess Margaret Cancer Centre Recruiting
Toronto, Ontario, Canada, M5G 2M9
Contact: Marcus Butler, M.D. 416-946-4521 marcus.butler@uhn.ca..
Principal Investigator: Marcus Butler, M.D.

Achilles Torn
Posts: 141
Joined: Fri Dec 16, 2016 2:41 pm

Re: Calling ALL Colorectal CANUCKS !

Postby Achilles Torn » Tue Feb 14, 2017 6:25 pm

Maia,

This is awesome. Thanks so much for this info and for all you do.

You are an amazing person!

Cheers
AT
Diagnosed as 40 yo Male. BC Canada. Sigmoid Colectomy Dec. 2016
Pathology T3N2bM1 19 of 24 Nodes Positive + tumour deposits
PET scan - Para-Aortic and Iliac Lymph node spread. Stage VI.
Moderately differentiated. MSS. KRAS/BRAF Wild.
Mutations: TP53, ERBB4, MLL3, PDCD1LG2, PRKDC, SMAD3
FOLFOX + Bevacizumab Commenced Jan 9/2017 PET Scan July 2017 - on maintenance 5FU/Bev every 2 weeks.
Progression after Covid19 induced break June 2020. Resume Maintenance chemo of Capecitabine and Bev

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: Calling ALL Colorectal CANUCKS !

Postby CRguy » Tue Feb 14, 2017 6:51 pm

Yes AT ... Maia is a keeper !!!! :mrgreen:
and a very dear friend here

( You know she once asked me to marry her :shock: )
Since today IS Valentine's Day I will let her know I shoulda' said yes ... BUTT my wife likely would not have approved :oops:
:mrgreen: :mrgreen: :mrgreen:

luvya' Maia ! ... Yes you ARE truly amazing.

Cheers and Harmony to all on the Journey
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

User avatar
Maia
Posts: 2443
Joined: Fri Aug 24, 2012 8:00 am

Re: Calling ALL Colorectal CANUCKS !

Postby Maia » Tue Feb 14, 2017 8:07 pm

CRguy wrote:( You know she once asked me to marry her :shock: )

Yeah, my heart was broken... :P So, rejected, I continued here, 5,600 miles/ 9,000 kilometers away, with my husband of 20 years... :wink:

AT, I came to this forum in 2012 trying to help a friend of mine, Faith, who lived in Toronto (I live in Argentina, I'm Argentinian). We were friends since many years before that, but we never met in person until that moment. She was an artist. She was a patient at the Princess Margaret. Some months after she was diagnosed with unresectable lung mets, during 2012, I did flight to TO (my first and only time on a plane, out of my country); she invited other friends (12 women!) from around the world, and me. I spent 10 days with her and the friends at her cottage north TO, and later I spent two days in TO at her home, with her and her husband. Unforgettable and extremely funny experience :) I liked Canada so much. If I had the choice, I would choose it over any other country I can think of.
She got a brain met on December 2012 but kept going with reasonable quality of life, during other two years. We kept in contact, on email, after a couple of months before she passed away, on March 2015. I emailed with so many Canadian docs, over those years (just there in my previous post, I see two: Derek Jonker and Sebastian Hotte).
Later, on this forum, I developed quite a friendship with Marc, a doctor who lived in Sudbury, who chose to treat his Stage IV on his own, with a modern version of the first successful immunotherapy from beginning of the XXth century --Coley's toxin. We never even Skyped but he's one of the best friends I ever had. We kept in touch until the day he died. (BTW, he was a wonderful writer, you might enjoy his blog https://marcdu4.wordpress.com/2012/09/1 ... e-a-mouse/ ).
((Edited to add: and my dear Carmen Belcredi, who also lived in TO, and passed away being too young!))
So, that is my long way to say I have a soft spot for Canadians!
Last edited by Maia on Tue Feb 14, 2017 9:32 pm, edited 2 times in total.

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CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: Calling ALL Colorectal CANUCKS !

Postby CRguy » Tue Feb 14, 2017 8:22 pm

So, that is my long way to say I have a soft spot for Canadians!

.... AND why she even puts up with ME ! :mrgreen:

Yes Maia you were an incredible friend and resource for Faith
and yes ... I remember that day when you told us she had passed
and I recall all the posts and PMs with Marc while he was with us
and the support you gave him when he returned "home"

This IS always an incredible Journey
BUTT .... only because of the people we meet along the way

Harmony
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

NeVadasMitis
Posts: 20
Joined: Thu Feb 02, 2017 3:34 pm

Re: Calling ALL Colorectal CANUCKS !

Postby NeVadasMitis » Wed Feb 15, 2017 11:19 am

Thank you, Maia, and CRguy, and everyone on the forum who shares information and therefore HOPE! It means so much.

In the meantime, if anyone hears anything about clinical trials for patients who have had liver mets resected (preferably in Canada, or northeastern USA) I'm all ears! :)

I found one that is being conducted by Sloan that involves HAI therapy and IV chemo with or without panitumumab, but I'm confused because the status on the website says "recruiting," but the completion date is March 2017....and it was recently updated...so how can that be? https://clinicaltrials.gov/ct2/show/record/NCT01312857
DD dx Dec.2012, age 57, Stage I CRC
2013/01 complicated resection
2016 summer/fall CEA slowing rising...(2.1, 2.8, 3.1)
2016/12 scan shows "something" on RL of liver; fna biopsy ordered
2017/01 confirmed 1 met to liver (1.5x2 cm); Stage IVa; cea 3.1
2017/02 5mm node on lung
2017/03 liver resection
2017/05 wedge resection of lung node
2017/09 CEA rising....5.6, 8.9...
2017/12 pet confirms cancer is back in hepatic lymph node

User avatar
Maia
Posts: 2443
Joined: Fri Aug 24, 2012 8:00 am

Re: Calling ALL Colorectal CANUCKS !

Postby Maia » Wed Feb 15, 2017 2:58 pm

NeVadasMitis wrote: clinical trials for patients who have had liver mets resected (preferably in Canada, or northeastern USA) I'm all ears! :)


Do you mean that they did go ahead with the resection, so your dad has a NED liver now, and the only remaining evidence of disease is the lung met?
Do you know his MS status (MSS or MSI)?

I'm confused because the status on the website says "recruiting," but the completion date is March 2017....and it was recently updated...so how can that be? https://clinicaltrials.gov/ct2/show/record/NCT01312857

It's just an Estimated Primary Completion Date, the trial will be recruting during a while still.

But the inclusion criteria stats that " no clinical or radiographic evidence of extrahepatic disease". So just keep in mind that your dad would need ablation of the lung nodule, and clean scans, before being eligible for that trial. Where is he treated, what are they planning for the lung nodule?

NeVadasMitis
Posts: 20
Joined: Thu Feb 02, 2017 3:34 pm

Re: Calling ALL Colorectal CANUCKS !

Postby NeVadasMitis » Wed Feb 15, 2017 5:09 pm

Hi Maia,

His surgery is this week, so hopefully he will have a NED liver very soon!

As for the lung thingy, it is only 5mm so they say they can't even biopsy it yet. I guess technically they don't "know" it's a met, but if it looks like a duck, and quacks like a duck....

Once the surgery is over, they will be talking about possible adjuvant chemo, so I guess that could impact the lung approach too?

No idea of MSI, MSS status yet. Is that something we'd have to ask to be tested for, or is it part of a "normal" workup?

Treatment is in Ottawa.

Thanks so much.

Sarah
DD dx Dec.2012, age 57, Stage I CRC
2013/01 complicated resection
2016 summer/fall CEA slowing rising...(2.1, 2.8, 3.1)
2016/12 scan shows "something" on RL of liver; fna biopsy ordered
2017/01 confirmed 1 met to liver (1.5x2 cm); Stage IVa; cea 3.1
2017/02 5mm node on lung
2017/03 liver resection
2017/05 wedge resection of lung node
2017/09 CEA rising....5.6, 8.9...
2017/12 pet confirms cancer is back in hepatic lymph node

User avatar
Maia
Posts: 2443
Joined: Fri Aug 24, 2012 8:00 am

Re: Calling ALL Colorectal CANUCKS !

Postby Maia » Wed Feb 15, 2017 5:54 pm

Hi, Sarah!
NeVadasMitis wrote:No idea of MSI, MSS status yet. Is that something we'd have to ask to be tested for, or is it part of a "normal" workup?

It should be. Maybe it's already in the report (like "no mistmatch deletions detected", or something like that). But if it's not, a simple call or email to the doc might give you the answer. MSS/ MSI s important to determine if he would get more benefit from an immunotherapy than from chemotherapy, as systemic treatment.
If you are in Ottawa, in the eventuality your dad need to explore immunotherapy, or other clinical trial, you have there one of the best --Dr Derek Jonker at the Ottawa Hospital Research Institute ( 613 737-7700 ). Remember that if you need guidance : )
The lung thingy is indeed tiny, that's good!

NeVadasMitis
Posts: 20
Joined: Thu Feb 02, 2017 3:34 pm

Re: Calling ALL Colorectal CANUCKS !

Postby NeVadasMitis » Thu Feb 16, 2017 3:03 pm

Dr. Jonker is my dad's oncologist :) . I heard he was good - nice to have that confirmed!
DD dx Dec.2012, age 57, Stage I CRC
2013/01 complicated resection
2016 summer/fall CEA slowing rising...(2.1, 2.8, 3.1)
2016/12 scan shows "something" on RL of liver; fna biopsy ordered
2017/01 confirmed 1 met to liver (1.5x2 cm); Stage IVa; cea 3.1
2017/02 5mm node on lung
2017/03 liver resection
2017/05 wedge resection of lung node
2017/09 CEA rising....5.6, 8.9...
2017/12 pet confirms cancer is back in hepatic lymph node

Steph20021
Posts: 553
Joined: Sat Dec 27, 2014 4:58 pm
Location: Ontario, Canada

Re: Calling ALL Colorectal CANUCKS !

Postby Steph20021 » Thu Feb 16, 2017 10:19 pm

Maia wrote:Dear Canadians,

there are several great immunotherapy trials ongoing in Canada (you can put "Canada" in the search box of the Clinical trial Finder for MSS-CRC in my signature, curated by Tom (our DK37 fellow, on this forum). BUTT I wanted to point out three that are "only in Canada" and specially important. (Two of them are not on the curated spreadsheet/ app).

****************
Clinical trial, for LIVER mCRC
#NCT02864485
*Only Toronto, Canada.
*LIVE DONOR LIVER TRANSPLANTATION for the treatment of unresectable colorectal cancer liver metastases

A radical treatment, which has as antecedent the Oslo trial.

"This study will offer live donor liver transplantation (LDLT) to select patients with unresectable metastases that are 1) limited to the liver and 2) stable (non-progressing) on standard chemotherapy. Potential participants will be evaluated for liver transplant suitability and must also have a willing, healthy living donor come forward for evaluation."
https://clinicaltrials.gov/ct2/show/NCT02864485

***********
MG1 Maraba/MAGE-A3, With and Without Adenovirus Vaccine, With Transgenic MAGE-A3 Insertion in Patients With Incurable MAGE-A3-Expressing Solid Tumours (I214)
https://clinicaltrials.gov/ct2/show/NCT02285816
#NCT02285816

The Phase I admits CRC, supposedly, if the tumour test positive for what they are looking for.

Contacts
Contact: Janet Dancey 6135336430 jdancey@ctg.queensu.ca

Locations
Canada, British Columbia
BCCA - Vancouver Cancer Centre Recruiting
Vancouver, British Columbia, Canada, V5Z 4E6
Contact: Daniel John Renouf 604 877-6000

Canada, Ontario
Juravinski Cancer Centre at Hamilton Health Sciences Recruiting
Hamilton, Ontario, Canada, L8V 5C2
Contact: Sebastien Hotte 905 387-9495

Ottawa Hospital Research Institute Recruiting
Ottawa, Ontario, Canada, K1H 8L6
Contact: Derek Jonker 613 737-7700

University Health Network Recruiting
Toronto, Ontario, Canada, M5G 2M9
Contact: Albiruni R A Razak 416 946-4501

Sponsors and Collaborators

Canadian Cancer Trials Group
Ottawa Hospital Research Institute

*******************

Study of TBI-1301 (NY-ESO-1 Specific TCR Gene Transduced Autologous T Lymphocytes) in Patients With Solid Tumors
#NCT02869217
https://clinicaltrials.gov/ct2/show/NCT02869217

Only in TO, Princess Margaret Hospital

*Similar* to the TIL trial at NHI (our Sleen / Celine trial :) )

One needs to check if tumour qualifies.

Histologically or cytologically confirmed metastatic or recurrent unresectable solid tumor.
HLA-A*02:01 or HLA-A*02:06 positive.
Tumor NY-ESO-1 expression by immunohistochemistry.
No anti-cancer chemotherapy, radiation therapy or immunotherapy within 2 weeks of PBMC harvest.
If approved and funded standard therapy is available, subjects must have failed, be intolerant to, be ineligible for, or have refused treatment.
Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as >10 mm with CT scan, MRI, or calipers by clinical exam. See Section 11 for the evaluation of measurable disease. Patients must have radiographic evidence of disease progression following the most recent line of treatment. Areas of previous radiation may not serve as measurable disease unless there is evidence of progression post radiation.
ECOG Performance Status 0 or 1.

"The target populations for this phase I study with TBI-1301 are patients with advanced solid tumors. Patients' tumors will be required to express NY-ESO-1, which include but is not limited to ovarian cancer, synovial sarcoma, esophageal cancer and malignant melanoma. Patients must be positive for HLA-A*02:01 or HLA-A*02:06 and the patient's tumor tissue must be positive for NY-ESO-1 antigen expression. The study will take the subject's T cells, which are a natural type of immune cell in the blood, and send them to a laboratory to be modified. The changed T cells used in this study will be the subject's own T cells that have been genetically changed with the aim of attacking and destroying cancer cells.

The manufacturing of T cells takes about 1 month to complete. The T cells will be given back to the subject through an intravenous infusion.
The purpose of this study is to test the safety of genetically changed T cells and find out what effects, if any, they have in subjects with advanced solid tumors."

Contacts
Marcus Butler, MD 416-946-4521 marcus.butler@uhn.ca....

Locations
Canada, Ontario
Princess Margaret Cancer Centre Recruiting
Toronto, Ontario, Canada, M5G 2M9
Contact: Marcus Butler, M.D. 416-946-4521 marcus.butler@uhn.ca....
Principal Investigator: Marcus Butler, M.D.

This is so awesome Maia, thank you!the only thing keeping me from trying a trial right now is I'm told once I get off folfiri I won't be able to go back on, and it's keeping me stable but for an abdo wall met.
DX 1/31/14 @ 33- SPS-T4a(invades visceral peri), N2a(6/106 LN), M1a(ovary) (Stage 4a) MSS; BRAF V600E
2/1/14-subtotal col, lost R ovary, temp ileo
3/14-9/14- folfox; sepsis
11/14-CT/PET: L ovary met, pelvic met, (?)ghost liver met(?)
12/14-folfiri -13 rds kept me stable from 3/15-6/15
8/15-HIPEC, NED
09/15- cea 0.9
05/16- recurrence in abdo wall and lymph nodes
01/17- pulmonary embolism
02/17- 1 wk radiation to abdo wall
08/16- on folfiri
01/18-folfox
11/18- Beacon trial-encorafenib & cetuximab

User avatar
Maia
Posts: 2443
Joined: Fri Aug 24, 2012 8:00 am

Re: Calling ALL Colorectal CANUCKS !

Postby Maia » Fri Feb 17, 2017 4:23 am

Steph20021 wrote: I'm told once I get off folfiri I won't be able to go back on, and it's keeping me stable but for an abdo wall met.


Why would be that? Because the healthcare system won't cover it, as per Canadian guidelines? Because, scientifically, there is no reason. In fact, I see in a FB group for MSS-CRC-clinical-trials-only that people revisit Folfiri often, after being in one, or two, immuno trials, when they need it. Their oncs propose that. And some go back to it after being "failed it" (not just because they stopped to get into a trial).
(Just copying a message from yesterday: "Atezo/cobi did not work for me and with my infection my lungs Ct has got worse. Back on folfiri and looking for another trial.")

And you have trials that *include* Folfiri in the combo (just an example: https://clinicaltrials.gov/ct2/show/NCT02024607. BBI608 is not an immunotherapy but a cancer stem cell inhibitor, a pill.
Also, there are MSS patients that are getting Keytruda or Opdivo from the manufacturer, per recommendation of their oncs. One that I know, it 's getting it in combination with Folfiri (onc recomendation too). But this is in USA.

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Reminder of program showing tomorrow

Postby CRguy » Wed Feb 22, 2017 4:38 pm

Just bumping this up as a reminder for the upcoming show tomorrow night.
I have set my PVR !
Details in this prior post of mine which now includes an audio podcast with one of the doctors.

viewtopic.php?f=1&t=32353&start=270#p452003
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far


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