I’m not sure if these have been mentioned before. I noticed 2 new recently opened PD-1 inhibitor immunotherapy combination clinical trials that either accept all types of CRC or are specifically intended for MSS-CRC (note I said MSS!).
As I have mentioned before, scientists hope that PD-1/PD-L1 inhibitors can become a backbone therapy for many cancers (including CRC) in the future with additional drugs added to them as a combination cocktail, to hopefully make them active against MSS-CRC (and also to hopefully improve response rate and/or durability of response in MSI-CRC).
Also, I wanted to note that as a strategic choice, many combination trials with PD-1/PD-L1 inhibitors EXCLUDE patients who have previously taken them – so choosing to sign up for a PD-1/PD-L1 inhibitor trial should “strategically” not be taken lightly – you might be precluded from some future PD-1/PD-L1 combination trials if future trials are needed. These trials are all highly experimental, since the “tricks” needed to get PD-1/PD-L1 activity in MSS-CRC have not been proven yet in clinical trials, although there are indications various combination therapies could work based upon pre-clinical animal models.
Here are the 2 trials:
1.) NCT02512172. New Phase 1. Johns Hopkins. Combination of: Two epigenetic modifying drugs + anti-PD1 MK-3475 (pembrolizumab). Intended to try to make MSS-CRC tumors more easily seen by the immune system. https://clinicaltrials.gov/ct2/show/NCT ... 15&rank=14
2.) NCT02526017. New Phase 1. So far in San Antonio, they want to accrue hundreds of patients so I believe will be expanding to multiple sites. Combination of anti-CSF1R antibody + anti-PD1 Nivolumab. Intended to try to make CRC tumors less immunosuppressive. https://clinicaltrials.gov/ct2/show/NCT ... 15&rank=40
6/4/2012 Dx Stage 3C CRC @ 40 yo. MSS, KRAS-WT, BRAF-WT, p53-mut
8/13 Enlarged lymphs - Stable
10/14 Stage IV. Lung & Lymph mets. 5-FU+bev
11/15 FOLFIRI + bev
11/16 Signs of FOLFIRI resistance (Lymph mets)
1/17 Palliative radiation for resistant mets
2/17 FOLFIRI + bev + Maraviroc (off-label)
3/17 FOLFIRI + Erbitux + Maraviroc (off-label)MSS-CRC Clinical Trial Finder: http://trialfinder.fightcrc.org/2016 Colondar 2.0 ModelDK37 Science Posts List