TIL

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Butt
Posts: 33
Joined: Mon Mar 11, 2019 10:48 pm

TIL

Postby Butt » Fri Feb 21, 2020 11:37 pm

Only 1 percent of colon cancer patients is eligible for TIL. Info received from an MD Anderson TIL expert.

Claudine
Posts: 301
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: TIL

Postby Claudine » Sat Feb 22, 2020 11:44 am

What 1%? Did you receive information on specific requirements (mutations, etc)? TIL is something I’m keeping in the back of my mind in case we need to look beyond the usual approaches.
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT radiation 04/18, SBRT 02/19
Resection small intestine 05/18 (no cancer found - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin since 03/19
6.7 cm left adrenal mass 03/19, 3.67 cm 12/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 7.6
Scan 03/19: Multiple small lung nodules up to 5mm
Scan 12/19: 2 calcified granulomas, one 1mm stable nodule

Butt
Posts: 33
Joined: Mon Mar 11, 2019 10:48 pm

Re: TIL

Postby Butt » Sat Feb 22, 2020 1:13 pm

It was my plan B. MD Anderson showed me a report where they screened about 2400 colon cancer patients and only about 28 or so were qualified. First, need to have HLA in a blood, second a very specific rear mutation.

sdino
Posts: 77
Joined: Tue Mar 28, 2017 5:32 pm

Re: TIL

Postby sdino » Mon Feb 24, 2020 10:41 am

TIL Trial NCT01174121 at NIH/NCI is NOT mutation or HLA Specific... The team searches for TILs that you already have in your tumor and that are “reactive” to your tumor mutations – So it doesn’t matter what mutations or HLA you have. Just that you have reactive TILs that they can grow by the billions. Remember, Clinical trial is a "Trial" the goal is to discover and see what can work and discover new mutations that may work against solid tumors .
Caregiver for Wife 54 yrs old
DX:11/16-CC sigmoid colon
Lung Mets: Bilateral ranging 4mm-4.0cm
MSS, KRAS-G12D; TP53
Xeloda+Avastin 11/2016 to 2/2019
iTCR TIL Trial NCT03412877 4/19 to 7/19 Off trial, - Sept. 2019 TIL trial NCT01174121
CT Scans: 1/2020 lung met shrinkage 36%, Liver & Brain met shrinkage 90%
CEA:16-11/16; 5.1-9/18; 63.6-8/19; 1.2.9-1/20

User avatar
DH2Sleen
Posts: 81
Joined: Thu Jan 29, 2015 10:10 am

Re: TIL

Postby DH2Sleen » Thu Mar 05, 2020 6:54 am

Butt wrote:Only 1 percent of colon cancer patients is eligible for TIL. Info received from an MD Anderson TIL expert.

The trial that Anderson is doing is specific to one HLA/mutation combination, but that does not mean it is the only combination that can benefit; it is just the only one they are working on. As sdino said, NIH is working with whatever the patient has. If your body has TIL that are reactive to the driver mutations in your cancer, then they may be able to clone them to wipe your cancer out.
Sleen is now four years cancer free from the infamous "undruggable" mutation. No human had ever been cured of KRas G12D driven metastatic cancer before her, and a doctor told her she had a 2% chance of even getting into the trial. That "expert" was wrong.
It doesn't work for everyone, and we know many patients who have tried it and didn't survive. But if you want a chance to wipe out all of the cancer cells, TIL could work for some people
DW, Sleen dx 9/2013 @47yo: IIIc T4b N2b MX
9/2013 colectomy
10/2013 - 3/2014 FOLFOX
4/2014 - 6/2014 Rad to bladder
12/2014 +'ve for lung mets, MX becomes M1
3/2015 enter TIL trial @ NIH
7/1/15 Receive 148E9 cells to target K-ras G12D mutation
8/11/15 Reduction=18%, no new tumors
9/15/15 25%
10/20/15 27%; PET -> one hot met
11/24/15 30% all mets shrinking
1/26/16 46% but one suspicious met
3/24/16 46% but one growing
4/7/16 Lung lobectomy NED for the first time
3/3/20 Still NED "cured"

sdino
Posts: 77
Joined: Tue Mar 28, 2017 5:32 pm

Re: TIL

Postby sdino » Thu Mar 05, 2020 12:30 pm

MIXED BAG RESULTS Update 3/2/2020 Tumor Infiltrating Lymphocytes (TILs) Clinical Immunology Trial at NIH NCT01174121 :

24 week follow-up - 2 Liver lesions are Gone. Brain Met (3 mm) left side is gone. Targeted lung mets have shrunk by 36%. According to Cancer RECIST 1.1 this is considered by NIH as an “Unofficial” Partial Response (PR). **With a caveat** A New 7.8 mm right side brain lesion has appeared in the last 6 weeks.

The Old Battle-Axe Grandma Lung Tumor has FINALLY showed shrinkage for the 1st time ever. Kim’s Team is very-very excited that the TIL cells are currently seeking and destroying the lung mets. Partial Response in Stage IV cancer is a huge deal.

We met with our Immuno Team, the Radiologic Oncologist and a Brain Neurosurgeon to discuss the numerous possible remedies. The Plan moving forward was discussed in great length with everything taken into consideration. We are All in agreement (along with Kim), that we will take a very aggressive approach on this new brain lesion and have it removed completely by brain surgery. Surgery will be 3 to 4 hours in length with a week stay at NIH and a several week recovery at home. Surgery will be scheduled next Friday 3/13/20 at NIH.

Also as DH2Sleen says, NIH is TIL trial is mutational driven with no specific mutations except they need to be reactive to your tumor.
Caregiver for Wife 54 yrs old
DX:11/16-CC sigmoid colon
Lung Mets: Bilateral ranging 4mm-4.0cm
MSS, KRAS-G12D; TP53
Xeloda+Avastin 11/2016 to 2/2019
iTCR TIL Trial NCT03412877 4/19 to 7/19 Off trial, - Sept. 2019 TIL trial NCT01174121
CT Scans: 1/2020 lung met shrinkage 36%, Liver & Brain met shrinkage 90%
CEA:16-11/16; 5.1-9/18; 63.6-8/19; 1.2.9-1/20

Brearmstrong
Posts: 93
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: TIL

Postby Brearmstrong » Thu Mar 05, 2020 8:00 pm

[quote][/Sleen is now four years cancer free from the infamous "undruggable" mutation. No human had ever been cured of KRas G12D driven metastatic cancer before her, and a doctor told her she had a 2% chance of even getting into the trial. That "expert" was.

So, not to interrupt this topic but just having a bit of a panic attack here. Do you mean no one with stage IV KRASG12D has ever been able to beat it long term even if surgery got them to NED? I know my risk of recurrence is high but NO ONE???
48 F Jan 17 2 sons
tumor appendix/colon
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery <.05
KRAS G12D MSS
FOLFOX Apr-sep 17
Clean CT Jul 2017 lung 4mm, clean CT oct 17, CEA 3.4, nov 17 8.1. May 18 2.3,1.0,1.3, 1.3, 1.0, 2.3, 2.2, 2.1,2.2,1.6,1.4,1.5
Oct 2017 clean CT
Nov 17 PET para aortic nodes Stage IV
Folfori w/avastin Dec 17 CEA 7.1
May 18- surgery to remove nodes- 5 positive xeloda continues
Aug 18-CT NED Clear CT's Nov 18, Feb 19, May 19, Aug 19,Nov19

Rock_Robster
Posts: 474
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: TIL

Postby Rock_Robster » Thu Mar 05, 2020 8:20 pm

Brearmstrong wrote:
[/Sleen is now four years cancer free from the infamous "undruggable" mutation. No human had ever been cured of KRas G12D driven metastatic cancer before her, and a doctor told her she had a 2% chance of even getting into the trial. That "expert" was.

So, not to interrupt this topic but just having a bit of a panic attack here. Do you mean no one with stage IV KRASG12D has ever been able to beat it long term even if surgery got them to NED? I know my risk of recurrence is high but NO ONE???

I don’t want to put words in DH2Sleen’s mouth, but I believe “undruggable” generally refers to the fact that we do not have a targeted therapy specifically for this mutation. I personally know one G12D patient who is currently NED; she has had recurrences in the past but her last chemo was in 2016. Another was diagnosed over 10 years ago and has been NED several times since then (the longest lasting 5 years).

Cheers
Rob
Male 38; Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0, Mar-20=2.2
11/18- FOLFOX x6
3/19- Liver resection
5/19- 25 x pelvic VMAT radiation; complete metabolic response
07/19- ULAR (robot), temp ileo, 1/27 LN
08/19- Missed a liver spot
08-11/19- FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19- Liver resection #2
02/20- Ileostomy reversed
03/20- PET & MRI = NED!

Brearmstrong
Posts: 93
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: TIL

Postby Brearmstrong » Thu Mar 05, 2020 8:31 pm

Thank you Rob. I get myself worked up quite easily at times and then spiral into pouring through studies that just keep telling me the same thing=poor prognosis. It’s just so disheartening and I then bring myself back reading success stories but never see them with KRASG12D people which upsets me even more. Vicious cycle :roll:
48 F Jan 17 2 sons
tumor appendix/colon
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery <.05
KRAS G12D MSS
FOLFOX Apr-sep 17
Clean CT Jul 2017 lung 4mm, clean CT oct 17, CEA 3.4, nov 17 8.1. May 18 2.3,1.0,1.3, 1.3, 1.0, 2.3, 2.2, 2.1,2.2,1.6,1.4,1.5
Oct 2017 clean CT
Nov 17 PET para aortic nodes Stage IV
Folfori w/avastin Dec 17 CEA 7.1
May 18- surgery to remove nodes- 5 positive xeloda continues
Aug 18-CT NED Clear CT's Nov 18, Feb 19, May 19, Aug 19,Nov19

Rock_Robster
Posts: 474
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: TIL

Postby Rock_Robster » Thu Mar 05, 2020 9:06 pm

Brearmstrong wrote:Thank you Rob. I get myself worked up quite easily at times and then spiral into pouring through studies that just keep telling me the same thing=poor prognosis. It’s just so disheartening and I then bring myself back reading success stories but never see them with KRASG12D people which upsets me even more. Vicious cycle :roll:

I understand - I go through the exact same process. I also go back and forth on the details of my diagnosis trying to work out of my prognosis is good or not, for example...

Stage 4 = bad. Resectable = good. NRAS = bad. G13R = good? Oligometastatic = good. EMVI = bad. Complete metabolic response = good. LVI = bad. Mod diff = good. Tricky margins = bad. Good chemo response = good. 1/27 lymph nodes = good. ECOG 0 = good.

Net result? No idea!! So I’ve given up trying to work it out
:)

At least it does remind me that there aren’t only negative factors though.
Male 38; Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0, Mar-20=2.2
11/18- FOLFOX x6
3/19- Liver resection
5/19- 25 x pelvic VMAT radiation; complete metabolic response
07/19- ULAR (robot), temp ileo, 1/27 LN
08/19- Missed a liver spot
08-11/19- FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19- Liver resection #2
02/20- Ileostomy reversed
03/20- PET & MRI = NED!

Butt
Posts: 33
Joined: Mon Mar 11, 2019 10:48 pm

Re: TIL

Postby Butt » Mon Mar 16, 2020 6:59 pm

Ok. I received this info from an MD Anderson doc who supervises their TIL trail. I asked specifically if there are any other places in the US that do this trail without HLA or that specific mutation and the answer was No. Now, I looked on this trail and my understanding that 2 groups are closed. Not sure what it means. No desirable results or the group was full. Do we know about other TILs that do not require HLA. If so, the numbers will help.

sdino
Posts: 77
Joined: Tue Mar 28, 2017 5:32 pm

Re: TIL

Postby sdino » Wed Mar 18, 2020 11:36 am

Both these Trials are at National Institute of Health in Bethesda, MD. They do not care what type of HLA you have or Mutations as long as your cells react. You must be MSS.
My Wife failed the NCT03412877 trial.
Then they did the TIL trial NCT01174121 on her with good response so far.

iTCR's Trial NCT03412877 Administration of Autologous T-Cells Genetically Engineered to Express T-Cell Receptors Reactive Against Mutated Neoantigens in People With Metastatic Cancer.
AND TIL trial NCT01174121 Immunotherapy Using Tumor Infiltrating Lymphocytes for Patients With Metastatic Cancer.
Caregiver for Wife 54 yrs old
DX:11/16-CC sigmoid colon
Lung Mets: Bilateral ranging 4mm-4.0cm
MSS, KRAS-G12D; TP53
Xeloda+Avastin 11/2016 to 2/2019
iTCR TIL Trial NCT03412877 4/19 to 7/19 Off trial, - Sept. 2019 TIL trial NCT01174121
CT Scans: 1/2020 lung met shrinkage 36%, Liver & Brain met shrinkage 90%
CEA:16-11/16; 5.1-9/18; 63.6-8/19; 1.2.9-1/20


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