TIL Immunotherapy at NCI

Please feel free to read, share your thoughts, your stories and connect with others!
Lee
Posts: 5293
Joined: Sun Apr 16, 2006 4:09 pm

Re: TIL Immunotherapy at NCI

Postby Lee » Fri Sep 15, 2017 7:37 pm

DAS43 wrote::D
Had my follow up at NIH today. The tumor has shrunk to 49.8% very happy and feel blessed. My next follow up will be in December.


That is so TOTALLY AWESOME!

Keep it up!!

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

pdp497
Posts: 41
Joined: Thu Jul 13, 2017 3:17 pm

Re: TIL Immunotherapy at NCI

Postby pdp497 » Fri Sep 15, 2017 8:37 pm

Sleen wrote:
pdp497 wrote:On the Clinical Trials website it seems to indicate you only need to have failed one first line treatment but I have seen in other places that you need to have failed on at least 2 treatments first, do you know what the actual criteria is? Also thanks for taking the time to respond going through this process is so difficult and being at the beginning of it it helps to have people willing to give advice and let you know about the process.


Hi pdp!
At the .gov website under "Inclusion Criteria" it says (among other things), "...All patients must be refractory to approved standard systemic therapy. Specifically : Metastatic colorectal patients must have received oxaliplatin or irinotecan."

When I was accepted onto the trial, I had previously only undergone treatment with FOLFOX.

Celine

Hi Celine,

That is how I read it as well. I will definitely be checking with NIH if the oxaliplatin stops working or the side effects get to be too much. I also wanted to say congrats on your NED status people like you willing to undergo trials like this and achieve lasting success has given me so much hope in the difficult 2 months since my diagnosis. Thank you for taking the time to respond and be a resource to others.
Dx 7/17 stage 4 inoperable colon cancer with "numerous" mets to the liver (one large 2.6cm x 2.3 the rest 1 to 1.5 cm)
MSS
KRAS
8/4 CEA 240

User avatar
DH2Sleen
Posts: 67
Joined: Thu Jan 29, 2015 10:10 am

Re: TIL Immunotherapy at NCI

Postby DH2Sleen » Mon Sep 18, 2017 8:13 am

pdp497 wrote:
Sleen wrote:"...All patients must be refractory to approved standard systemic therapy. Specifically : Metastatic colorectal patients must have received oxaliplatin or irinotecan."

When I was accepted onto the trial, I had previously only undergone treatment with FOLFOX.

Celine

Hi Celine,

That is how I read it as well. I will definitely be checking with NIH if the oxaliplatin stops working or the side effects get to be too much. I also wanted to say congrats on your NED status people like you willing to undergo trials like this and achieve lasting success has given me so much hope in the difficult 2 months since my diagnosis. Thank you for taking the time to respond and be a resource to others.

This is something of a rant; I’m sorry if anyone is offended.
That word "refractory" is a tricky one. It can be interpreted in different ways. On the most basic level, it means “been there, done that” and not presently doing it. A more strict medical interpretation would mean that you are no longer responding to the present treatment, so you need to move on to something else. Fortunately, NIH used the more lenient interpretation. But, they will not advise anyone to stop a treatment that may be holding a patient “stable”. To me, stable means that tumor cells are multiplying at the same rate that chemotherapy is killing them off. So, the patient is not winning the battle, you’re just waiting for the cancer to stumble upon a mutation that the chemo won’t kill. In the meantime, you get sicker and sicker from the chemo and the cancer, and if you get too sick, you can’t handle the trial. The nasty little secret is that they will take you if YOU decide you are done with chemo, but they won’t tell you that. They can’t tell you that. They must advise you to follow the advice of your doctors until your doctors have no more advice that can be reasonably expected to work. So jumping into this trial early would be Against Medical Advice (AMA).
I’m certainly not qualified to give anyone medical advice, and please don’t interpret what I say here as medical advice. But our experience with this trial was the result of Sleen’s personal decision to risk going AMA to find a cure, rather than following the path of “chemo for life” that conventional medicine offers. This is a hard decision and we know people who have died following this path. But we also know people who have died waiting for conventional medicine. It is a decision only you can make, and it needs to be based on your values, goals, quality of life, family situation, faith…
DW, Sleen dx 9/2013 @47yo: IIIc T4b N2b MX
09/2013 colectomy
10/2013 - 3/2014 FOLFOX
04/2014 - 6/2014 Rad to bladder
12/2014 +'ve for lung mets, MX becomes M1
03/2015 enter TIL trial @ NIH
07/01/15 Receive 148E9 cells to target K-ras G12D mutation
08/11/15 Reduction=18%, no new tumors
09/15/15 25%
10/20/15 27%; PET -> one hot met
11/24/15 30% all mets shrinking
01/26/16 46% but one suspicious met
03/24/16 46% but one growing
04/07/16 Lung lobectomy NED for the first time

boswind
Posts: 32
Joined: Fri Apr 11, 2014 12:04 pm

Re: TIL Immunotherapy at NCI

Postby boswind » Wed Oct 11, 2017 2:16 pm

Hi Celine and others who have/are participating in the clinical trial of TIL Immunotherapy:

TIL Immunotherapy is indeed break-through type of technology for cancer treatment. I believe to date NCI have enrolled many patients for the trials.

I'd like to know if there is any info you know of about the number of patients enrolled and the number of patients responded or disease is in stable condition. Furthermore, how about those patients who failed to response? are they able to return to traditional cancer treatments?

Thank you,

Boswind

BTW, I started to search for clinical trials.
01.24.2014 Male, DX @54 Rectosigmoid Cancer, MRI: T3N0M0
03.19.2014 Completed 5-week Radia+Xeloda
05.07.2014 Had surgery to remove 13cm sigmoid-colon and rectum.
02.25.2015 PET/CT/MRI scans show liver mets and L4 Spine involvement.
MSS, KRAS wild type, BRAF wild type
Mar 2015 - Aug 2015, folfox + Avastin
Aug 2015 - Jul 2017, 5FU + leucovorin + Avastin for Maintainance
Jul 2017 - Present, folfuri + Avastin
Current CEA: 5.6
Total over 50 rounds of chemo treatment received

User avatar
Sleen
Posts: 298
Joined: Tue Jan 14, 2014 7:41 am
Location: Detroit
Contact:

Re: TIL Immunotherapy at NCI

Postby Sleen » Fri Oct 13, 2017 8:42 pm

Hello Boswind,

Patients who did not respond to TIL therapy are able to return to traditional treatments. Some go on to do other clinical trials.

The number enrolled, and the number who responded are changing all the time. When I was on the protocol, my fellow told me that I was "one of 7 or 8" who were treated with targeted cells, but that was over two years ago.

If you pursue the trial, I hope you'll ask the research nurse these questions, and report back. My info is out-dated, but I know there was a breast cancer patient with an on-going response, and two CRC patients (DAS, and me). Melinda Bachini (cholangiocarcinoma) is currently stable.

Celine
my blog: Cancer Riot

NED since April 2016!
April 2016: lower left lung lobectomy. NED
8 mo. f/u: 1 of 7 tumors progressed.
6 mo. f/u PR confirmed (Jan 2016)
Jul 2015: NIH TIL trial NCT01174121 NCI/NIH Surgery Branch FAQ
Dec 2015 stage IV w/bilateral lung mets
FOLFOX + Radiation (bladder)
KRAS G12D :: MSS
dx Sep 2013 @47yo: IIIc T4b N2b MX [bladder invasion, 17/21 lymph nodes]

Married 26 yrs. kids: 21, 18, 15, 10, 8
SE Michigan home schooler, mechanical engineer, and programmer.

sdino
Posts: 43
Joined: Tue Mar 28, 2017 5:32 pm

Re: TIL Immunotherapy at NCI

Postby sdino » Wed Oct 25, 2017 12:22 pm

Any updates on fellow board members currently in this trial. We are waiting on CT Scan mid November as to whether or not we will be participating.
Caregiver for Wife 52 yrs old
DX:11/16-CC sigmoid colon 3 cm, Lung Adenocarcinoma Stg IV
Mets: 1.2 cm now 7 mm lung w/14 other nodules less than 6 mm. 7/17 growth in Mets
MSS, KRAS-mut G12D; TP53;
Completed 12 rounds Folfox/Avastin + Oxi 11/16 to 5/17
8/17 Start Xeloda + Avastin
CT Scans: 11/16; 1/17 lung mets/colon shrinkage; 5/17 colon & lung met shrinkage, 7/17 and 11/17 disease progression lungs/colon
CEA: 16 - 11/16; 4 – 12/16; 0.5 – 2/17; 0.6 - 5/17; 2.6 - 7/17; 10/17 - 1.9, 11/17 - 2.6

fighter168
Posts: 3
Joined: Tue Sep 12, 2017 1:21 pm

Rejected

Postby fighter168 » Sat Dec 09, 2017 9:49 pm

I uploaded all the CT scans and sent over the medical records. But after doctor took a look at my CT images, they think I have all my lesions in my liver, not anywhere else, they do not want to resect a sample from the liver, as it is too risky. Ideally I should have some lesions in the lung or lymph nodes. Is this true? what is your reason to be rejected?

NHMike
Posts: 673
Joined: Fri Jul 21, 2017 3:43 am

Re: Rejected

Postby NHMike » Sat Dec 09, 2017 11:05 pm

fighter168 wrote:I uploaded all the CT scans and sent over the medical records. But after doctor took a look at my CT images, they think I have all my lesions in my liver, not anywhere else, they do not want to resect a sample from the liver, as it is too risky. Ideally I should have some lesions in the lung or lymph nodes. Is this true? what is your reason to be rejected?


Was there a biopsy sample with your original CRC tumor?
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

NHMike
Posts: 673
Joined: Fri Jul 21, 2017 3:43 am

Re: TIL Immunotherapy at NCI

Postby NHMike » Sat Dec 09, 2017 11:06 pm

How do you determine that you have HLA-C*0802 or HLA-A*1101? Is there a blood test for this? Or do they get it from a tumor sample?
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

sdino
Posts: 43
Joined: Tue Mar 28, 2017 5:32 pm

Re: TIL Immunotherapy at NCI

Postby sdino » Sun Dec 10, 2017 8:31 am

My Wife's was a Blood Test for HLA
Caregiver for Wife 52 yrs old
DX:11/16-CC sigmoid colon 3 cm, Lung Adenocarcinoma Stg IV
Mets: 1.2 cm now 7 mm lung w/14 other nodules less than 6 mm. 7/17 growth in Mets
MSS, KRAS-mut G12D; TP53;
Completed 12 rounds Folfox/Avastin + Oxi 11/16 to 5/17
8/17 Start Xeloda + Avastin
CT Scans: 11/16; 1/17 lung mets/colon shrinkage; 5/17 colon & lung met shrinkage, 7/17 and 11/17 disease progression lungs/colon
CEA: 16 - 11/16; 4 – 12/16; 0.5 – 2/17; 0.6 - 5/17; 2.6 - 7/17; 10/17 - 1.9, 11/17 - 2.6

User avatar
Sleen
Posts: 298
Joined: Tue Jan 14, 2014 7:41 am
Location: Detroit
Contact:

Re: TIL Immunotherapy at NCI

Postby Sleen » Sun Dec 10, 2017 3:58 pm

NHMike wrote:How do you determine that you have HLA-C*0802 or HLA-A*1101? Is there a blood test for this? Or do they get it from a tumor sample?


Prior to my first in-person screening, NIH sent an HLA Test Kit via Fed Ex. I took it to my local hospital, and a nurse followed the instructions to draw blood, and the hospital shipped it back to NIH using materials included in the kit. At that time, they were testing to see if my HLA matched one of the NY-ESO trials (I was not a match for any of them).

HLA is only a factor in Dr. Yang's trial (They are looking for A*1101, with a KRAS mutation).
Dr. Rosenberg's trial (the one I did--see link in my sig.) can potentially work with any HLA and any mutation, providing you have at least one tumor of sufficient size, and in an easily resectable spot.

Celine
my blog: Cancer Riot

NED since April 2016!
April 2016: lower left lung lobectomy. NED
8 mo. f/u: 1 of 7 tumors progressed.
6 mo. f/u PR confirmed (Jan 2016)
Jul 2015: NIH TIL trial NCT01174121 NCI/NIH Surgery Branch FAQ
Dec 2015 stage IV w/bilateral lung mets
FOLFOX + Radiation (bladder)
KRAS G12D :: MSS
dx Sep 2013 @47yo: IIIc T4b N2b MX [bladder invasion, 17/21 lymph nodes]

Married 26 yrs. kids: 21, 18, 15, 10, 8
SE Michigan home schooler, mechanical engineer, and programmer.

User avatar
Sleen
Posts: 298
Joined: Tue Jan 14, 2014 7:41 am
Location: Detroit
Contact:

Re: Rejected

Postby Sleen » Sun Dec 10, 2017 4:30 pm

fighter168 wrote:...they do not want to resect a sample from the liver, as it is too risky.


Who told you that? I would question this statement. I know that they have resected liver tumors for the purpose of growing TIL. It is possible that your particular tumors are in a dangerous location within the liver, however. I would ask for clarification on this point before accepting a rejection. Good luck!

Celine
my blog: Cancer Riot

NED since April 2016!
April 2016: lower left lung lobectomy. NED
8 mo. f/u: 1 of 7 tumors progressed.
6 mo. f/u PR confirmed (Jan 2016)
Jul 2015: NIH TIL trial NCT01174121 NCI/NIH Surgery Branch FAQ
Dec 2015 stage IV w/bilateral lung mets
FOLFOX + Radiation (bladder)
KRAS G12D :: MSS
dx Sep 2013 @47yo: IIIc T4b N2b MX [bladder invasion, 17/21 lymph nodes]

Married 26 yrs. kids: 21, 18, 15, 10, 8
SE Michigan home schooler, mechanical engineer, and programmer.

NHMike
Posts: 673
Joined: Fri Jul 21, 2017 3:43 am

Re: TIL Immunotherapy at NCI

Postby NHMike » Sun Dec 10, 2017 4:40 pm

Sleen wrote:
NHMike wrote:How do you determine that you have HLA-C*0802 or HLA-A*1101? Is there a blood test for this? Or do they get it from a tumor sample?


Prior to my first in-person screening, NIH sent an HLA Test Kit via Fed Ex. I took it to my local hospital, and a nurse followed the instructions to draw blood, and the hospital shipped it back to NIH using materials included in the kit. At that time, they were testing to see if my HLA matched one of the NY-ESO trials (I was not a match for any of them).

HLA is only a factor in Dr. Yang's trial (They are looking for A*1101, with a KRAS mutation).
Dr. Rosenberg's trial (the one I did--see link in my sig.) can potentially work with any HLA and any mutation, providing you have at least one tumor of sufficient size, and in an easily resectable spot.

Celine


Thanks for the information. I was thinking of having the testing done but unsure of where or how to do it but I'll ask my local oncologist next week if he knows. C*0802 seems to be associated with Europe, West and South Africa while A*1101 is associated with East Asia so the latter is more likely for me. C*0501 and C*1201 also bring G12D to the cell surface but there appear to be no trials for those HLAs. This stuff is just part of the backup plan. I have a treatment plan for Stage 3B and "just" have adjuvant chemo remaining. But I want to have alternatives if I get a recurrence.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

fighter168
Posts: 3
Joined: Tue Sep 12, 2017 1:21 pm

Re: Rejected

Postby fighter168 » Mon Dec 11, 2017 12:53 am

NHMike wrote:
fighter168 wrote:I uploaded all the CT scans and sent over the medical records. But after doctor took a look at my CT images, they think I have all my lesions in my liver, not anywhere else, they do not want to resect a sample from the liver, as it is too risky. Ideally I should have some lesions in the lung or lymph nodes. Is this true? what is your reason to be rejected?


Was there a biopsy sample with your original CRC tumor?


I had surgery to remove the tumor in April. Now I got liver metastasis, multiple.

fighter168
Posts: 3
Joined: Tue Sep 12, 2017 1:21 pm

Re: Rejected

Postby fighter168 » Mon Dec 11, 2017 5:40 pm

Sleen wrote:
fighter168 wrote:...they do not want to resect a sample from the liver, as it is too risky.


Who told you that? I would question this statement. I know that they have resected liver tumors for the purpose of growing TIL. It is possible that your particular tumors are in a dangerous location within the liver, however. I would ask for clarification on this point before accepting a rejection. Good luck!

Celine


I called again today. The nurse said that there is no resection site on the liver, it is too dangerous to remove a sample within the liver.


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: Bing [Bot], cbsmith, KathyLynn, Yahoo [Bot], zephyr and 31 guests