Any Thought On NK Cell Therapy?

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prayingforccr
Posts: 653
Joined: Sun Jun 28, 2020 4:44 pm

Any Thought On NK Cell Therapy?

Postby prayingforccr » Mon Nov 13, 2023 6:36 pm

Does anyone have any experience with it?

Is there a center recognized as “leading” and reputable to undergo this treatment?

I would be interested in pursuing this after my next til treatment.

https://jitc.bmj.com/content/10/5/e004693
11/19: colonoscopy
12/19: 6 cm s3 rectal cancer
1-3/20: 20 sessions EBRT/capecetibine/clinical trial drug m3814
7/20: 8 treatmentsFOLFOX
11/20: Primary complete response
5/21: Multiple lung nodules (3-6mm) on ct scan
10/21: mda gives me 1 year without treatment/3 years with folfiri/avastin (refused)
3/22 No growth nodules 6 months
8/22 beginning sbrt and immunotherapy
10/22 sbrt and immunotherapy failed
12/22 TIL Therapy
4/23 Lesions 40% smaller linearly/80% smaller by volume
8/23 Progression of 4 lesions

Rock_Robster
Posts: 943
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Any Thought On NK Cell Therapy?

Postby Rock_Robster » Mon Nov 13, 2023 7:39 pm

I did allogenic NK/DC Cell therapy (peripheral blood) in Japan earlier in the year, with a CEA peptide vaccine (not personalised as I couldn’t readily import tumour tissue) and a lower dose of cetuximab. Other than a pretty severe rash I didn’t notice any major immediate effects, except I was exhausted by the end of the treatment (could be the Tokyo Tiredness…). The positive change in my cell counts afterward were significant, of course. Very difficult to say if I had any clinical benefit as it was n=1 without a control, however I got Influenza A shortly after and sailed through with almost zero symptoms (they kept me in hospital as I was a chemo patient but couldn’t believe how fine I was). I had modest disease stability afterward, but no obvious regression.

They generally prefer you to combine it with something like radiotherapy (abscopal effect) or chemotherapy, as the monotherapy results aren’t super strong.

Dr Terunuma is often considered one of the emergent experts in the field, and he treats in several clinics in Tokyo (and one regionally, I think). Eg below (N2 Clinic). Lots of papers you can read too.

https://n2clinic-ginza.com/en/

https://www.researchgate.net/profile/Hiroshi-Terunuma

In Japan this is often marketed alongside other wellness and “longevity” treatments like stem cell therapies, however in my experience the vast majority of their client base is cancer patients.

One strong positive is that they have invested in their own lab capacity for cell analysis and expansion/storage. Many providers outsource their lab work (who in turn may again outsource…), which has led to some cases of quality issues in the past - even in Germany.

Like most things in life, it isn’t cheap.
Last edited by Rock_Robster on Mon Nov 13, 2023 9:42 pm, edited 2 times in total.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial - failed. Drawing board.

prayingforccr
Posts: 653
Joined: Sun Jun 28, 2020 4:44 pm

Re: Any Thought On NK Cell Therapy?

Postby prayingforccr » Mon Nov 13, 2023 8:32 pm

Thank you, Rock.

Looking into this center and would def be interested in your impressions?

https://tokyocancerclinic.jp/lang/en/tr ... nt/cell01/
11/19: colonoscopy
12/19: 6 cm s3 rectal cancer
1-3/20: 20 sessions EBRT/capecetibine/clinical trial drug m3814
7/20: 8 treatmentsFOLFOX
11/20: Primary complete response
5/21: Multiple lung nodules (3-6mm) on ct scan
10/21: mda gives me 1 year without treatment/3 years with folfiri/avastin (refused)
3/22 No growth nodules 6 months
8/22 beginning sbrt and immunotherapy
10/22 sbrt and immunotherapy failed
12/22 TIL Therapy
4/23 Lesions 40% smaller linearly/80% smaller by volume
8/23 Progression of 4 lesions

Rock_Robster
Posts: 943
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Any Thought On NK Cell Therapy?

Postby Rock_Robster » Mon Nov 13, 2023 9:39 pm

prayingforccr wrote:Thank you, Rock.

Looking into this center and would def be interested in your impressions?

https://tokyocancerclinic.jp/lang/en/tr ... nt/cell01/

I don’t know this one specifically, but broadly their setup and treatment process looks very similar to what I did. I have a contact in Japan who helps me (and others) organise treatments that I can put you in touch with for an opinion if you like? He’s not a medico, just a patient from the UK but lives in Tokyo and speaks Japanese.

One factor to consider is how well they’re set up to handle international patients (98% of Japanese hospitals don’t normally do this). Having an English language website is a very good start, and interestingly I note they say they only see international patients via a medical coordinator affiliated with their clinic (which is fine, and probably not uncommon - as long as the coordinator is also competent).

Given the time and cost involved, most clinics will arrange a consult via Zoom etc. before you commit - you could perhaps organise one with these guys, and one with Dr Terunuma, and compare their responses to your questions (Dr T speaks very good English, some other doctors may use a medical translator).
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial - failed. Drawing board.

rp1954
Posts: 1802
Joined: Mon Jun 13, 2011 1:13 am

Re: Any Thought On NK Cell Therapy?

Postby rp1954 » Mon Nov 13, 2023 10:38 pm

Rock_Robster wrote:Like most things in life, it isn’t cheap.

Door to door, over $100k ?
Tickets, Tokyo, hospital stays, various lab and procedure fees.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper to almost nothing mid 2018, mostly IV C

Rock_Robster
Posts: 943
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Any Thought On NK Cell Therapy?

Postby Rock_Robster » Mon Nov 13, 2023 10:49 pm

rp1954 wrote:
Rock_Robster wrote:Like most things in life, it isn’t cheap.

Door to door, over $100k ?
Tickets, Tokyo, hospital stays, various lab and procedure fees.

No not that bad; my whole treatment package came out at US$20-25k. Obviously if you add other treatments, it goes up (eg their PBT is very expensive, but you can always get that in the US). The good thing is they’re very transparent with costs, this covers everything except the Covid tests.

Travel costs of course are highly flexible based on your preferences, but overall you’d be looking at a minimum of about 14 nights there (4 days for apheresis* and 10 days for treatment). But there needs to be a 10 day gap in between for cell expansion - you can stay in Japan or go home and come back (which I did). Fortunately the yen is very weak at the moment so staying in Tokyo is surprisingly affordable (100/nt is quite doable for comfortable accommodation, and food is very cheap). Flights depend of course on where you’re coming from, airline and seat.

* I should add, apheresis only takes a few hours, but you have to arrive, do blood tests (incl Covid test), wait 24 hours, do the blood draw, then fly home. 3 days could be possible if you avoid a weekend. The protocol on return is basically 6 doses of NK and 2 doses of DC delivered roughly every other day over ~11 days, so I’ve allowed a day to arrive and a day before flying home. Ideally you’d apparently do 1 treatment per fortnight for about 12 weeks, but they’ve designed this protocol for international patients that can’t stay that long. If you have leftover cells (as most do), you can do further expansion and come back for more treatments without having to re-do the initial apheresis visit).
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial - failed. Drawing board.

rp1954
Posts: 1802
Joined: Mon Jun 13, 2011 1:13 am

Re: Any Thought On NK Cell Therapy?

Postby rp1954 » Tue Nov 14, 2023 5:11 am

Rock_Robster wrote: their PBT is very expensive, but you can always get that in the US).
Japan, Korea, China and Europe have done some work with He4, C12, O16 ion beams. Might be an area of review for specialized situations, with different RBE and toxicity than protons, which were not considered especially effective for CRC mets in the past. At heart, I'm a cold steel and lasers guy for CRC removals.

I get the impression (a friend) that the PBT installations in the US are an oversaturated market.
Last cancer - high energy ion work AFIK in the US, traces back to the 1970-80s with the UC Berkley accelerator, unless something recent goes beyond CAD drawings. So Asia or Europe.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper to almost nothing mid 2018, mostly IV C

prayingforccr
Posts: 653
Joined: Sun Jun 28, 2020 4:44 pm

Re: Any Thought On NK Cell Therapy

Postby prayingforccr » Tue Nov 14, 2023 10:00 am

Rock_Robster wrote:
prayingforccr wrote:Thank you, Rock.

Looking into this center and would def be interested in your impressions?

https://tokyocancerclinic.jp/lang/en/tr ... nt/cell01/

I don’t know this one specifically, but broadly their setup and treatment process looks very similar to what I did. I have a contact in Japan who helps me (and others) organise treatments that I can put you in touch with for an opinion if you like? He’s not a medico, just a patient from the UK but lives in Tokyo and speaks Japanese.

One factor to consider is how well they’re set up to handle international patients (98% of Japanese hospitals don’t normally do this). Having an English language website is a very good start, and interestingly I note they say they only see international patients via a medical coordinator affiliated with their clinic (which is fine, and probably not uncommon - as long as the coordinator is also competent).

Given the time and cost involved, most clinics will arrange a consult via Zoom etc. before you commit - you could perhaps organise one with these guys, and one with Dr Terunuma, and compare their responses to your questions (Dr T speaks very good English, some other doctors may use a medical translator).


Thank you, Rock.

I’m waiting on word from nih about possibly (probably) repeating the til therapy to deal with new mutations in march/april.

Always nice to have something to fall back on should the treatments not be effective.

I think this might be a nice mop up after I am finished in maryland and will def do some more research.

Who knows. At the rate treatments are progressing, there could be something completely new and better making the rounds in 6 months.
11/19: colonoscopy
12/19: 6 cm s3 rectal cancer
1-3/20: 20 sessions EBRT/capecetibine/clinical trial drug m3814
7/20: 8 treatmentsFOLFOX
11/20: Primary complete response
5/21: Multiple lung nodules (3-6mm) on ct scan
10/21: mda gives me 1 year without treatment/3 years with folfiri/avastin (refused)
3/22 No growth nodules 6 months
8/22 beginning sbrt and immunotherapy
10/22 sbrt and immunotherapy failed
12/22 TIL Therapy
4/23 Lesions 40% smaller linearly/80% smaller by volume
8/23 Progression of 4 lesions

Rock_Robster
Posts: 943
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Any Thought On NK Cell Therapy?

Postby Rock_Robster » Tue Nov 14, 2023 10:04 am

You’ve summarised my thoughts exactly too, pfCCR
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial - failed. Drawing board.

Rock_Robster
Posts: 943
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Any Thought On NK Cell Therapy?

Postby Rock_Robster » Tue Nov 14, 2023 10:05 am

rp1954 wrote:
Rock_Robster wrote: their PBT is very expensive, but you can always get that in the US).
Japan, Korea, China and Europe have done some work with He4, C12, O16 ion beams. Might be an area of review for specialized situations, with different RBE and toxicity than protons, which were not considered especially effective for CRC mets in the past. At heart, I'm a cold steel and lasers guy for CRC removals.

I get the impression (a friend) that the PBT installations in the US are an oversaturated market.
Last cancer - high energy ion work AFIK in the US, traces back to the 1970-80s with the UC Berkley accelerator, unless something recent goes beyond CAD drawings. So Asia or Europe.

Fascinating, thanks RP. We don’t have any PBT capability in Australia at all, so Japan would be my most convenient option anyway. (Singapore was meant to but I think that has been perennially delayed, and then got Covided).

I’m with you on the cold steel, although thankfully my tumour biology has shown itself repeatedly to be highly radiosensitive.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial - failed. Drawing board.


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