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We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Tue Nov 28, 2017 11:42 am
by boswind
Before Thanksgiving day, I posted a topic about MGD007. After reading some info I found it might not be as effective as I originally thought.
The other medicine CEA-TCB (RO6958688; RG7802) by Roche in phase 1 clinical trial is based on the same principle as MGD007:
MGD007 lets T-cells targets cancer cells with gpA33 x CD3 antigen while CEA-TCB lets T-cells targets cancer cells with CEA CD3 TCB.

Below is Roche's reports of phase 1 regarding drug's efficacy and side-effects, published in May 2017.
https://www.roche.com/investors/updates ... -05-18.htm
Our forum member Julie YW got the treatment of this drug in a phase 1 clinicial trial at MSCCC. The outcome was mixed.

The makers of both drugs will present detailed results in Jun 2018 in ASCO in Chicago.

In summary, while many patients including me are eager to participate in clinical trials of these two drugs, but now I do not feel excited after reading a lot of info.

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Tue Nov 28, 2017 12:08 pm
by NHMike
A reason to be more optimistic:

We identified a polyclonal CD8+ T-cell response against mutant KRAS G12D in tumor-infiltrating lymphocytes obtained from a patient with metastatic colorectal cancer. We observed objective regression of all seven lung metastases after the infusion of approximately 1.11×1011 HLA-C*08:02–restricted tumor-infiltrating lymphocytes that were composed of four different T-cell clonotypes that specifically targeted KRAS G12D. However, one of these lesions had progressed on evaluation 9 months after therapy. The lesion was resected and found to have lost the chromosome 6 haplotype encoding the HLA-C*08:02 class I major histocompatibility complex (MHC) molecule. The loss of expression of this molecule provided a direct mechanism of tumor immune evasion. Thus, the infusion of CD8+ cells targeting mutant KRAS mediated effective antitumor immunotherapy against a cancer that expressed mutant KRAS G12D and HLA-C*08:02.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178827/

This caught my eye because it's my mutation and knowing that this has helped people already and that they are refining it is hopeful. If they can do this with G12D, then I would hope that they could do it with all of the KRAS mutations. And maybe NRAS and BRAF. It's going to take a lot of work and a decent amount of time but I think that you have a lot of researchers trying to get Immunotherapy to work.

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Tue Nov 28, 2017 4:45 pm
by jortego128
I think the results you posted above are for the TIL (tumor infiltrating lymphocytes) therapy and specifically for our own member Sleen, who made national news because of it. She had shrinkage/obliteration of all tumors except one in her lung, which was resected.

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Tue Nov 28, 2017 5:47 pm
by NHMike
jortego128 wrote:I think the results you posted above are for the TIL (tumor infiltrating lymphocytes) therapy and specifically for our own member Sleen, who made national news because of it. She had shrinkage/obliteration of all tumors except one in her lung, which was resected.


I'm not familiar with Sleen but I'm glad to see that it's worked out really well for her. It's a strange case for sure in the the NIH did a study of their approach on only one patient and it worked out really well. I'm hoping that they got the biopsy on that tumor that they removed so that they can nail those tumor cells the next time. Do you have a link to her story?

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Tue Nov 28, 2017 6:12 pm
by CRguy
Sleen info :
https://cancerriot.blogspot.ca/ is her blog with a beautiful tribute to Tom (DK37)
and her CClub profile can be found here

DH2Sleen is her hubby who also has contributed a lot to this forum.

Cheers
CR

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Tue Nov 28, 2017 9:43 pm
by NHMike
CRguy wrote:Sleen info :
https://cancerriot.blogspot.ca/ is her blog with a beautiful tribute to Tom (DK37)
and her CClub profile can be found here

DH2Sleen is her hubby who also has contributed a lot to this forum.

Cheers
CR


That's a fascinating blog and she provided a great description of the conditions required for the cure. My son explained the HLAs (his manager alluded to these in an email to me but I didn't know what an HLA was). My son told me that the problem with KRAS mutations is that the mutation is inside the cell and that there isn't a way for Immunotherapy approaches because they can't see inside the cell. The HLAs allow that but it looks like there are lots of these things and that each person only has a few so the question is: which HLAs match up with being able to identify KRAS (and NRAS and HRAS) mutations to the cell surface? We know that the particular HLA in this case aligns with KRAS G12D. When we do Genomic Tumor testing, we should have a test: if you have KRAS G12D and the right HLA, then this particular solution should work. At any rate, is looks like a healthy channel for research.

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Wed Nov 29, 2017 9:20 am
by DH2Sleen
NHMike wrote:
CRguy wrote:Sleen info :
https://cancerriot.blogspot.ca/ is her blog with a beautiful tribute to Tom (DK37)
and her CClub profile can be found here

DH2Sleen is her hubby who also has contributed a lot to this forum.

Cheers
CR


That's a fascinating blog and she provided a great description of the conditions required for the cure. My son explained the HLAs (his manager alluded to these in an email to me but I didn't know what an HLA was). My son told me that the problem with KRAS mutations is that the mutation is inside the cell and that there isn't a way for Immunotherapy approaches because they can't see inside the cell. The HLAs allow that but it looks like there are lots of these things and that each person only has a few so the question is: which HLAs match up with being able to identify KRAS (and NRAS and HRAS) mutations to the cell surface? We know that the particular HLA in this case aligns with KRAS G12D. When we do Genomic Tumor testing, we should have a test: if you have KRAS G12D and the right HLA, then this particular solution should work. At any rate, is looks like a healthy channel for research.


Thanks for the mention CRguy. We have been trying to get back to "normal" life lately, so we haven't been posting as much. Tom's passing was pretty hard on both of us.
HLA is the key to activation of a normal immune system in response to an abnormality in cells in the body, and there are hundreds of HLAs. But each person has six distinct HLAs in their "self" cells. The HLA-C*08:02 that they found in Sleen, which presented the mutation to the immune system as a "foreign" presence, is one of the HLAs that are known to be able to present the mutation Kras G12D. That particular HLA is present in about 11% of the population of European decent, and higher for some other ethnic groups. They have also proven that Kras G12D is presented by HLA-A*11:01 (a more common HLA) and they have an active trial for that combination ongoing at NIH now. And HLA-A*11:01 has also been proven to present Kras G12V, but that has not reached the trial stage yet.
The strategy for targeting a known mutation/HLA combination is called Engineered T-cell Adoptive Cell Therapy (ACT). With hundreds of HLAs and thousands of mutations, you can imagine the complexity of creating Engineered T-cell ACT for every combination. But at least progress is being made, and more trail participants means that more effective combinations will be found. I hope that everyone who reads this will plan to apply for a trial at NIH.

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Wed Nov 29, 2017 7:44 pm
by NHMike
DH2Sleen wrote:
NHMike wrote:
CRguy wrote:Sleen info :
https://cancerriot.blogspot.ca/ is her blog with a beautiful tribute to Tom (DK37)
and her CClub profile can be found here

DH2Sleen is her hubby who also has contributed a lot to this forum.

Cheers
CR


That's a fascinating blog and she provided a great description of the conditions required for the cure. My son explained the HLAs (his manager alluded to these in an email to me but I didn't know what an HLA was). My son told me that the problem with KRAS mutations is that the mutation is inside the cell and that there isn't a way for Immunotherapy approaches because they can't see inside the cell. The HLAs allow that but it looks like there are lots of these things and that each person only has a few so the question is: which HLAs match up with being able to identify KRAS (and NRAS and HRAS) mutations to the cell surface? We know that the particular HLA in this case aligns with KRAS G12D. When we do Genomic Tumor testing, we should have a test: if you have KRAS G12D and the right HLA, then this particular solution should work. At any rate, is looks like a healthy channel for research.


Thanks for the mention CRguy. We have been trying to get back to "normal" life lately, so we haven't been posting as much. Tom's passing was pretty hard on both of us.
HLA is the key to activation of a normal immune system in response to an abnormality in cells in the body, and there are hundreds of HLAs. But each person has six distinct HLAs in their "self" cells. The HLA-C*08:02 that they found in Sleen, which presented the mutation to the immune system as a "foreign" presence, is one of the HLAs that are known to be able to present the mutation Kras G12D. That particular HLA is present in about 11% of the population of European decent, and higher for some other ethnic groups. They have also proven that Kras G12D is presented by HLA-A*11:01 (a more common HLA) and they have an active trial for that combination ongoing at NIH now. And HLA-A*11:01 has also been proven to present Kras G12V, but that has not reached the trial stage yet.
The strategy for targeting a known mutation/HLA combination is called Engineered T-cell Adoptive Cell Therapy (ACT). With hundreds of HLAs and thousands of mutations, you can imagine the complexity of creating Engineered T-cell ACT for every combination. But at least progress is being made, and more trail participants means that more effective combinations will be found. I hope that everyone who reads this will plan to apply for a trial at NIH.


Here's a paper on it for the curious:

http://www.nejm.org/doi/pdf/10.1056/NEJMc1616637

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Sat Dec 02, 2017 10:46 pm
by NHMike
DH2Sleen wrote:
Thanks for the mention CRguy. We have been trying to get back to "normal" life lately, so we haven't been posting as much. Tom's passing was pretty hard on both of us.
HLA is the key to activation of a normal immune system in response to an abnormality in cells in the body, and there are hundreds of HLAs. But each person has six distinct HLAs in their "self" cells. The HLA-C*08:02 that they found in Sleen, which presented the mutation to the immune system as a "foreign" presence, is one of the HLAs that are known to be able to present the mutation Kras G12D. That particular HLA is present in about 11% of the population of European decent, and higher for some other ethnic groups. They have also proven that Kras G12D is presented by HLA-A*11:01 (a more common HLA) and they have an active trial for that combination ongoing at NIH now. And HLA-A*11:01 has also been proven to present Kras G12V, but that has not reached the trial stage yet.
The strategy for targeting a known mutation/HLA combination is called Engineered T-cell Adoptive Cell Therapy (ACT). With hundreds of HLAs and thousands of mutations, you can imagine the complexity of creating Engineered T-cell ACT for every combination. But at least progress is being made, and more trail participants means that more effective combinations will be found. I hope that everyone who reads this will plan to apply for a trial at NIH.


There's a nice HLA-A*1101 frequency table by ethnic group and location at https://en.wikipedia.org/wiki/HLA-A11

It looks like it's most common in East Asia.

I looked for something similar for HLA-C*0801 and didn't find anything. There are small studies of various regions but I couldn't find something that's rolled up.

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Sat Dec 02, 2017 11:18 pm
by NHMike
I found a paper with percentages by racial group for the United States at http://www.academia.edu/24748549/Analys ... opulations

HLA-A*1101:
African-Americans 2.3%
Caucasions 7%
Hispanics 5.8%
Native Americans 2.7%
Asians 23%

HLA-C*0802
African-Americans 3.2%
Caucasions 3.8%
Hispanics 5.1%
Native Americans 1.9%
Asians 0.1%

Re: We may have a mile to go to see effective immunotherapies to occur for those with MSS

Posted: Sun Dec 03, 2017 11:12 pm
by rp1954
In the meantime, a lot of people are missing important immunotherapy opportunities that they've had since day 1, and those that they have even while waiting for a good trial.

Some generic drugs and supplements have easy companion tests that should help (y)our choices and doses. Other materials will probably be best guided by serial blood panels and markers. The problem we have here is that we are too hesitant, hoping a few small changes will do heavy lifting, when success beyond what's commercially offered (e.g. -oxi, -iri, BEV, CET ) takes several well aimed steps, but without the incredible side effects and high costs.

We do these things because they are cheaper, more effective and mostly more convenient than "standard" or someone's experiment, on us.

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Mon Dec 04, 2017 2:10 am
by Stewsbetty
boswind wrote:Before Thanksgiving day, I posted a topic about MGD007. After reading some info I found it might not be as effective as I originally thought.
The other medicine CEA-TCB (RO6958688; RG7802) by Roche in phase 1 clinical trial is based on the same principle as MGD007:
MGD007 lets T-cells targets cancer cells with gpA33 x CD3 antigen while CEA-TCB lets T-cells targets cancer cells with CEA CD3 TCB.

Below is Roche's reports of phase 1 regarding drug's efficacy and side-effects, published in May 2017.
https://www.roche.com/investors/updates ... -05-18.htm
Our forum member Julie YW got the treatment of this drug in a phase 1 clinicial trial at MSCCC. The outcome was mixed.

The makers of both drugs will present detailed results in Jun 2018 in ASCO in Chicago.

In summary, while many patients including me are eager to participate in clinical trials of these two drugs, but now I do not feel excited after reading a lot of info.


I didn’t read the whole report but I wanted to encourage you a bit. I read several study reports on immunotherapy for MSI high (which I am) and the numbers weren’t always the most encouraging but if you do respond (which I have ) it is the most amazing thing in the world. So don’t necessarily write off a trial because there aren’t high percentages of Complete or partial response. For many even stable disease sounds like a win.

Beth

Re: We may have a mile to go to see effective immunothrarpies to occur for those with MSS

Posted: Wed Dec 06, 2017 12:45 pm
by NHMike
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