TIL Immunotherapy at NCI

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DAS43
Posts: 42
Joined: Thu Aug 18, 2016 8:10 pm

Re: TIL Immunotherapy at NCI

Postby DAS43 » Thu Dec 14, 2017 2:21 pm

:D Very good news today! The tumor in my lungs has remained the same size but is fading. The Dr thinks it may now be scar tissue left by the dead cancer cell. I will come back in 3 months for test. I am so glad that the Lord brought me here for treatment. Thank you to all of you that have kept me in prayer. I ask that you continue to pray for me and all cancer patients hoping for a miracle
11/13 total blockage DX colon cancer IV, colostomy
1/14 folfox
3/14 liver resection NED
8/14 last chemo
12/14 colostomy reversal
8/16 3mets to lungs
10/16 trial at NIH TIL
9/17 partial responder to TIL protocol

User avatar
Robino1
Posts: 300
Joined: Fri Aug 11, 2017 12:09 pm
Facebook Username: Robin.lawthers
Location: Florida

Re: TIL Immunotherapy at NCI

Postby Robino1 » Thu Dec 14, 2017 3:05 pm

Congratulations. May you continue to get good results! :D
At 54 2014 1st colonoscopy colon cancer detect
Colon resect margins clear. No chemo Stage II
2017
Distend abd, pain in intestines.
CT scan seeding & Ascites
Lap diag - cancer on the omentum
CEA 217 CEA 219
FOLFOX started 6/17
CEA 202 Not genetic
8/29/17 CT excellent melting of tumor. Ascites is gone.
12/8/17 Markedly decr ant peritoneal nodularity since 8/29/17 compat w/ marked posi respns to therapy
CEA: (2017)9/30 -109; 10/12 -99.1; 11/4 -90.7; 11/30 -70.7; 12/14 -83.4; (2018)1/4 -73.3
BRAF V600e

mariane
Posts: 585
Joined: Sun Sep 13, 2015 6:16 pm

Re: TIL Immunotherapy at NCI

Postby mariane » Thu Dec 14, 2017 8:46 pm

Congratulations!!! I am so happy for you!!!
mom of 8 years old twins, dx @ 40 with upper rectal cancer, 10+ liver mets in 6/2015, CEA 140
chemo: 8/2015 - 10/2016 - 4xFOLFIRINOX, 2xFOLFOX, 8xFOLFIRI, 10x5FU, HAI pump -12xFUDR
4 surgeries, complete pathological response
CEA<2 since 10/2015
NED since May 2016

I praise God for every day with my family!

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DH2Sleen
Posts: 69
Joined: Thu Jan 29, 2015 10:10 am

Re: TIL Immunotherapy at NCI

Postby DH2Sleen » Fri Dec 15, 2017 6:43 am

DAS43 wrote::D Very good news today! The tumor in my lungs has remained the same size but is fading. The Dr thinks it may now be scar tissue left by the dead cancer cell. I will come back in 3 months for test. I am so glad that the Lord brought me here for treatment. Thank you to all of you that have kept me in prayer. I ask that you continue to pray for me and all cancer patients hoping for a miracle

WOOHOO!!! That is the greatest news. It does take a long time for the fading tumors to go away completely, but they should keep fading. We can't see any sign of the ones we were tracking in Sleen any more; it is now 2 1/2 years since she got her cells.
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

jdepp
Posts: 487
Joined: Sun Sep 28, 2008 7:53 pm

Re: TIL Immunotherapy at NCI

Postby jdepp » Fri Dec 15, 2017 8:40 am

Great news! Happy holidays to you!
Colon dx 08 @ 41 Poorly diff. 12+ liver mets, 19/28 LN
Colon rsx /14 x Folfox-Erbitux 08-09
PVE / Liver rsx 09
Lung & LN mets 10
Folfiri, Xeloda, Avastin 10-13
Xelox, Erbitux, UFUR, TS-1, Oxi, Lonsurf 14-16
Stivarga & TIL trial 16

NHMike
Posts: 862
Joined: Fri Jul 21, 2017 3:43 am

Re: TIL Immunotherapy at NCI

Postby NHMike » Sat Dec 16, 2017 2:21 pm

For most patients, adoptive cell transfer starts with an operation at the National Cancer Institute. By removing one of your tumors, we are able to find and grow the immune cells that live there, known as tumor-infiltrating lymphocytes or TIL. We will grow and study TIL from your tumor in our labs.
...
With your permission, our referral team may request samples of your tumor to test for certain proteins of interest. For cancers expressing those proteins, patients with certain blood typing (HLA) can be treated without the need for an operation. We perform a large blood collection (called an apheresis) and genetically engineer your white blood cells to recognize those targets.


https://ccr.cancer.gov/sb-faqs

I had thought that NCI was only dealing with folks with KRAS G12D with the HLA-C*0802 or HLA-A*1101 Alleles and maybe G12V in the future. But the text above on their site implies that they will take the cases of folks outside of this relatively small group of people as well. I suspect that they are trying to find other combinations where other Alleles express tumor cells of other kinds gene mutations. If my interpretation is correct, then it should be interesting that they are looking for cures for other mutations and finding them could provide hope for many more people. I do not know if they will find other combinations but I would expect that they would.

If I'm incorrect, please let me know. If there are those in the trial that don't have KRAS G12D or don't have HLA-C*0802 and HLA-A*1101, then that would be evidence that they are working on other mutations which would be exciting.
6/23/17: ER rectal bleeding; Colonoscopy
7/13: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
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; 12/20 1.4
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 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/30: LAR, Temp Ileostomy, Path Complete Response
12/20: Started CapeOx

DAS43
Posts: 42
Joined: Thu Aug 18, 2016 8:10 pm

Re: TIL Immunotherapy at NCI

Postby DAS43 » Sat Dec 16, 2017 2:32 pm

NHMike
The great thing about this trial is it doesn't matter what your cancer mutations are. What they do is remove a cancer cell find what tumor infiltrating lymphocytes live in that tumor and they design cells that will attack that tumor type. So genetic makeup of the tumor isn't really important because they're going to engineer the cells they give back to you from the tumor that they take. It is truly individualized medicine
11/13 total blockage DX colon cancer IV, colostomy
1/14 folfox
3/14 liver resection NED
8/14 last chemo
12/14 colostomy reversal
8/16 3mets to lungs
10/16 trial at NIH TIL
9/17 partial responder to TIL protocol

NHMike
Posts: 862
Joined: Fri Jul 21, 2017 3:43 am

Re: TIL Immunotherapy at NCI

Postby NHMike » Sat Dec 16, 2017 3:07 pm

DAS43 wrote:NHMike
The great thing about this trial is it doesn't matter what your cancer mutations are. What they do is remove a cancer cell find what tumor infiltrating lymphocytes live in that tumor and they design cells that will attack that tumor type. So genetic makeup of the tumor isn't really important because they're going to engineer the cells they give back to you from the tumor that they take. It is truly individualized medicine


I'm going to have to read more about tumor infiltrating lymphocytes to see how this approach works. The main problem with KRAS, HRAS and NRAS mutations is that the mutation is inside the cell and the immune system can only target cells with structures on the cell surface. In folks with KRAS G12D and HLA-C*0802 and HLA-A*1101, the alleles bring the mutated genes to the cell surface so that the immune system can kill only those cells. So my assumption is that NCI wants to take tumor cells and see if there's an expression of gene mutations on the cell surface that can be targeted by the immune system. Would there always be a presentation of the gene mutation to the cell surface? I'd suspect not given the number of HLAs per person and the very large number of possible HLAs. But I'd love to be wrong.

Update: I did some reading of TILs and the TILs rupture the walls of tumor cells so it appears that the TILs are cells themselves. But that's my reading as someone without a biology background. I'll look around for papers on this stuff and ask my son to look them over.
6/23/17: ER rectal bleeding; Colonoscopy
7/13: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
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; 12/20 1.4
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 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/30: LAR, Temp Ileostomy, Path Complete Response
12/20: Started CapeOx

rachel2017
Posts: 32
Joined: Tue Oct 17, 2017 9:17 pm

Re: TIL Immunotherapy at NCI

Postby rachel2017 » Sun Dec 17, 2017 5:22 pm

Hey, Mike, Thanks for your explanation. Now I have better understanding about Dr Jimmy Yang’s trial. My question is my mom have KRAS mutation: Gly12Asp. What kind of mutation is it? Is this differencing from G12D? Thanks in advanced!
Rachel
DM 63. 11/16 colonoscopy (high dysplasia)
1/17 laparoscopic,6.5X4X3cm. low adenocarcinoma; 14/14 lym-; MSS. CEA 2;CT-. No chemo.
6/17 abdo pain. CEA 52. CT paracolic nodule 1.4X1.9cm
6/17 CT guided biopsy. Mucinous adenocarcinoma consistent primary tumor.
7/17 pet CT. Ascending colon 1.4X1.1cm SUV 2.4; midline scar 0.9cm SUV3.1
KRAS Gly12Asp
8/16/-9/26/17 Folfox 4 times
10/6/17 CT numorous seedings in abodominal/plvis area. close ascending 7cm; close midline scar 5.7cm.
10/16-12/15/17 Folfox/avastin

rachel2017
Posts: 32
Joined: Tue Oct 17, 2017 9:17 pm

Re: TIL Immunotherapy at NCI

Postby rachel2017 » Sun Dec 17, 2017 5:26 pm

NHMike wrote:For most patients, adoptive cell transfer starts with an operation at the National Cancer Institute. By removing one of your tumors, we are able to find and grow the immune cells that live there, known as tumor-infiltrating lymphocytes or TIL. We will grow and study TIL from your tumor in our labs.
...
With your permission, our referral team may request samples of your tumor to test for certain proteins of interest. For cancers expressing those proteins, patients with certain blood typing (HLA) can be treated without the need for an operation. We perform a large blood collection (called an apheresis) and genetically engineer your white blood cells to recognize those targets.


https://ccr.cancer.gov/sb-faqs

I had thought that NCI was only dealing with folks with KRAS G12D with the HLA-C*0802 or HLA-A*1101 Alleles and maybe G12V in the future. But the text above on their site implies that they will take the cases of folks outside of this relatively small group of people as well. I suspect that they are trying to find other combinations where other Alleles express tumor cells of other kinds gene mutations. If my interpretation is correct, then it should be interesting that they are looking for cures for other mutations and finding them could provide hope for many more people. I do not know if they will find other combinations but I would expect that they would.

If I'm incorrect, please let me know. If there are those in the trial that don't have KRAS G12D or don't have HLA-C*0802 and HLA-A*1101, then that would be evidence that they are working on other mutations which would be exciting.


Hey, Mike, Thanks for your explanation. Now I have better understanding about Dr Jimmy Yang’s trial. My question is my mom have KRAS mutation: Gly12Asp. What kind of mutation is it? Is this differencing from G12D? Thanks in advanced!
Rachel
DM 63. 11/16 colonoscopy (high dysplasia)
1/17 laparoscopic,6.5X4X3cm. low adenocarcinoma; 14/14 lym-; MSS. CEA 2;CT-. No chemo.
6/17 abdo pain. CEA 52. CT paracolic nodule 1.4X1.9cm
6/17 CT guided biopsy. Mucinous adenocarcinoma consistent primary tumor.
7/17 pet CT. Ascending colon 1.4X1.1cm SUV 2.4; midline scar 0.9cm SUV3.1
KRAS Gly12Asp
8/16/-9/26/17 Folfox 4 times
10/6/17 CT numorous seedings in abodominal/plvis area. close ascending 7cm; close midline scar 5.7cm.
10/16-12/15/17 Folfox/avastin

Lee
Posts: 5404
Joined: Sun Apr 16, 2006 4:09 pm

Re: TIL Immunotherapy at NCI

Postby Lee » Sun Dec 17, 2017 5:36 pm

DAS43 wrote::D Very good news today! The tumor in my lungs has remained the same size but is fading. The Dr thinks it may now be scar tissue left by the dead cancer cell. I will come back in 3 months for test. I am so glad that the Lord brought me here for treatment. Thank you to all of you that have kept me in prayer. I ask that you continue to pray for me and all cancer patients hoping for a miracle


That is so totally AWESOME. What a wonderful holiday gift.

To your continued success. . .

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!

veckon
Posts: 128
Joined: Thu Jul 27, 2017 7:44 am

Re: Rejected

Postby veckon » Sun Dec 17, 2017 6:13 pm

fighter168 wrote: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.


Where are you getting treatment? Might be worth a second opinion from a liver surgeon at MD Anderson or Memorial Sloan Kettering.
27 yo male
Metastatic rectal cancer diagnosed 12/16
Liver metastases and peritoneal carcinomatosis
Lynch syndrome, MSI-H
Failed liver resection 3/17
FOLFOX6 12/16 - 05/17
Keytruda 5/17 - present
@Memorial Sloan Kettering

NHMike
Posts: 862
Joined: Fri Jul 21, 2017 3:43 am

Re: TIL Immunotherapy at NCI

Postby NHMike » Sun Dec 17, 2017 7:13 pm

rachel2017 wrote:
NHMike wrote:For most patients, adoptive cell transfer starts with an operation at the National Cancer Institute. By removing one of your tumors, we are able to find and grow the immune cells that live there, known as tumor-infiltrating lymphocytes or TIL. We will grow and study TIL from your tumor in our labs.
...
With your permission, our referral team may request samples of your tumor to test for certain proteins of interest. For cancers expressing those proteins, patients with certain blood typing (HLA) can be treated without the need for an operation. We perform a large blood collection (called an apheresis) and genetically engineer your white blood cells to recognize those targets.


https://ccr.cancer.gov/sb-faqs

I had thought that NCI was only dealing with folks with KRAS G12D with the HLA-C*0802 or HLA-A*1101 Alleles and maybe G12V in the future. But the text above on their site implies that they will take the cases of folks outside of this relatively small group of people as well. I suspect that they are trying to find other combinations where other Alleles express tumor cells of other kinds gene mutations. If my interpretation is correct, then it should be interesting that they are looking for cures for other mutations and finding them could provide hope for many more people. I do not know if they will find other combinations but I would expect that they would.

If I'm incorrect, please let me know. If there are those in the trial that don't have KRAS G12D or don't have HLA-C*0802 and HLA-A*1101, then that would be evidence that they are working on other mutations which would be exciting.


Hey, Mike, Thanks for your explanation. Now I have better understanding about Dr Jimmy Yang’s trial. My question is my mom have KRAS mutation: Gly12Asp. What kind of mutation is it? Is this differencing from G12D? Thanks in advanced!
Rachel


The G12D mutation results in an amino acid substitution at position 12 in KRAS, from a glycine (G) to an aspartic acid (D).

https://www.mycancergenome.org/content/ ... r/kras/34/

So yes, G12D.

From MGH's page: https://targetedcancercare.massgeneral. ... D-(c-35G-A).aspx

Image

KRAS is a gene that provides the code for making a protein, KRAS, which is involved primarily in controlling cell division. This protein is part of the MAP kinase signaling cascade (RAS/RAF/MEK/ERK) that relays chemical signals from outside the cell to the cell's nucleus and is primarily involved in controlling cell division. KRAS is an enzyme (a GTPase) that converts a molecule called GTP into GDP. When KRAS is attached (bound) to GDP, it's in its "off" position and can't send signals to the nucleus. But when a GTP molecule arrives and binds to KRAS, KRAS is activated and sends its signal, and then it converts the GTP into GDP and returns to the "off" position.

When mutated, KRAS can act as an oncogene, causing normal cells to become cancerous. The mutations can shift the KRAS protein into the "on" position all the time. KRAS mutations are common in pancreatic, lung and colorectal cancers. These KRAS mutations are said to be somatic, because instead of coming from a parent and being present in every cell (hereditary), they are acquired during the course of a person's life and are found only in cells that become cancerous.

Tumor mutation profiling performed clinically at the MGH Cancer Center has identified KRAS mutations across a broad-spectrum of cancer types. The highest incidence of KRAS mutations have been found in pancreatic cancer (70%), colon cancer (30%), lung cancer (25%), cholangiocarcinoma (15-20%), acute myeloid leukemia (15-20%) and endometrial cancer (15-20%). Across the other major tumor types, KRAS mutations have been found in less than 10% of cases that have been tested.
6/23/17: ER rectal bleeding; Colonoscopy
7/13: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
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; 12/20 1.4
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 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/30: LAR, Temp Ileostomy, Path Complete Response
12/20: Started CapeOx

rachel2017
Posts: 32
Joined: Tue Oct 17, 2017 9:17 pm

Re: TIL Immunotherapy at NCI

Postby rachel2017 » Sun Dec 17, 2017 11:07 pm

The G12D mutation results in an amino acid substitution at position 12 in KRAS, from a glycine (G) to an aspartic acid (D).

https://www.mycancergenome.org/content/ ... r/kras/34/

So yes, G12D.

Thanks a lot! I called NCI and a lady gave me this trial contact information. I was a little bit confused why she didn't give me the information of TIL trial. I thought the TIL trial seems like more established.
DM 63. 11/16 colonoscopy (high dysplasia)
1/17 laparoscopic,6.5X4X3cm. low adenocarcinoma; 14/14 lym-; MSS. CEA 2;CT-. No chemo.
6/17 abdo pain. CEA 52. CT paracolic nodule 1.4X1.9cm
6/17 CT guided biopsy. Mucinous adenocarcinoma consistent primary tumor.
7/17 pet CT. Ascending colon 1.4X1.1cm SUV 2.4; midline scar 0.9cm SUV3.1
KRAS Gly12Asp
8/16/-9/26/17 Folfox 4 times
10/6/17 CT numorous seedings in abodominal/plvis area. close ascending 7cm; close midline scar 5.7cm.
10/16-12/15/17 Folfox/avastin

NHMike
Posts: 862
Joined: Fri Jul 21, 2017 3:43 am

Re: TIL Immunotherapy at NCI

Postby NHMike » Mon Dec 18, 2017 10:38 am

rachel2017 wrote:The G12D mutation results in an amino acid substitution at position 12 in KRAS, from a glycine (G) to an aspartic acid (D).

https://www.mycancergenome.org/content/ ... r/kras/34/

So yes, G12D.

Thanks a lot! I called NCI and a lady gave me this trial contact information. I was a little bit confused why she didn't give me the information of TIL trial. I thought the TIL trial seems like more established.


Which trial information did you get? Do you have the trial number?
6/23/17: ER rectal bleeding; Colonoscopy
7/13: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
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; 12/20 1.4
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 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/30: LAR, Temp Ileostomy, Path Complete Response
12/20: Started CapeOx


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