Any Thought On NK Cell Therapy?

[Rock_Robster]

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.

[Rock_Robster]

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).

[rp1954]

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

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

[Rock_Robster]

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).

[rp1954]

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.

[Rock_Robster]

You’ve summarised my thoughts exactly too, pfCCR

[Rock_Robster]

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.