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Thread: Clinical trials for PC

  1. #1
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    Clinical trials for PC

    Cancer cells express CD47 to give "don't eat me" signal to the immune system. Blocking this signal with antibodies promotes macrophage's phagocytosis. They engulf cancer cells covered with anti-CD47 antibodies.
    Normal cells minimally express CD47, so there should not be serious side effects.

    This antibody is also enhancing activity of CD8 T cells because macrophages can present neoantigens to T cells. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598283/

    One couple will give $10 million for this drug to treat their son. https://www.inspire.com/MNMKONA/jour...on-bounty-for- cd47-therapy-for-their-son-and-others/?ref=as&asat=607824618,

    There are clinical trials of antibodies to CD47 for different cancers.

    https://clinicaltrials.gov/ct2/show/NCT02216409 includes PC.
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    CAR T cells (CARTs)

    Now it's a third generation of CARTs. They are improving with each generation. For those who does not know about CARTs I will give you some ideas.

    It's a T cell from your blood that is modified in the lab. They put a small piece of antibody into the T cell receptor (TCR). Now the T cell will not look for neoantigens (because good neoantigens are rare), but go directly to the target of that piece of antibody and kill that cell. The target could be any overexpressed protein on the surface of cancer cells and not on normal cells. Example. If your cancer overexpresses PSCA on the surface of cancer cells then the CAR T cell should have an antibody to PSCA. A big army of anti-PSCA CARTs will go out checking every cell and killing every cell that has PSCA on Its surface.

    1. Prostate Stem Cell Antigen (PSCA)-Specific CAR T Cells In Subjects With Non-Resectable Pancreatic Cancer https://clinicaltrials.gov/ct2/show/NCT02744287

    2. CAR T Cell Receptor Immunotherapy Targeting Mesothelin for Patients With Metastatic Cancer https://clinicaltrials.gov/ct2/show/NCT01583686 at NIH

    3. Administering Peripheral Blood Lymphocytes Transduced With a CD70-Binding Chimeric Antigen Receptor to People With CD70 Expressing Cancers https://clinicaltrials.gov/ct2/show/NCT02830724 at NIH

    4. No need for a target. A engineered piece of DNA will produce NKR-2 receptor that is instrumental in finding the distressed (cancer) cells. NKR-2 was copied from Natural Killer cells that use this receptor to find distressed cells. Now T cells will use it to find cancer cells and kill them.
    A Dose Escalation Phase I Study to Assess the Safety and Clinical Activity of Multiple Cancer Indications (THINK) https://clinicaltrials.gov/ct2/show/NCT03018405

    5. For liver mets. CAR-T Hepatic Artery Infusions for CEA-Expressing Liver Metastases (HITM-SURE) https://clinicaltrials.gov/ct2/show/NCT02850536
    66y female, dx @43 in 1992 - DLBCL (aggressive lymphoma) CHOP x 6, rads x 20. 2007- Follicular Lymphoma (FL) grade1-2, stage 2, rads x 20. 2013 relapsed FL, grade 1-2, stage 4. R-bendamustine x 6. Finished Jan 2015. Rituxan maintenance till 2017. 11/2014 bladder cancer, surgery end of Jan 2015.

  2. #2
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    How do you know which trial is for you? It gets overwhelming and confusing.

  3. #3
    Moderator Top User ddessert's Avatar
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    PanCan.org can help with an initial search of clinical trials.

    You can whittle down a long list of trials in several ways.

    Eligibility. PanCan.org's list should take care of this, but there may be unforeseen exclusions that the trial investigators can inform you of.
    Logistics. Can you get there for all required treatments?
    Costs. What costs do the trials pick up and what is left to you?
    Trial Phase. I tend to shy away from phase 1 trials with a new drug by itself. It's the first time in humans, they're not looking for efficacy, it may not be destined for treating PanCan, and the dose can be less than therapeutic.

    After this, most are left with a more manageable list of trials, if any are left at all.

    A lot of the decision is personal. Where are you in your treatment? How much risk are you willing to take? What is your ultimate goal for a treatment?

    I took a list of the treatments to my oncologist to ask which ones would be most appropriate for me. This requires an oncologist that is up on the latest research. For instance, it might be: a) immunotherapy; b) vaccine; c) chemotherapy; d) PARP inhibitors; e) PD-L1 inhibitors; etc.

    Once I had those ranked by her, I could prepare a more specific list for my next visit. I had little luck with NCT trials numbers, but rather asked about the specific treatments. She'd attended the conferences and had more inside information that I could get.

    Another 'tip' is that trials mentioned at sites such as pancreatica.org or LetWinPC have usually passed some sort of peer review. Sites like these cannot recommend specific treatments, but treatments they mention have usually been 'vetted' by their advisory staff before being written about. But they don't have the bandwidth to write about all the promising treatments, so their omission is not necessarily a sign that the treatment is no good.
    BRCA2 3398del5
    Dec 2010 - back/abd pain
    May 2011 - Unresectable stage III, 2.5cm tumor
    Jun-Aug 2011 - Gem/Cis, 9 rounds
    Oct-Nov 2011 - Radiation+Xeloda, 25 days in 5 weeks
    Oct 2011-Sep 2012 - shrinking tumor
    Feb 2012 - National Familial Pancreatic Study
    Aug 2012 - Downgraded to stage IIA, PGP
    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
    Sep 2012-Nov 2017 - NED
    Mar 2013-present - NCT01088789
    @pancanology

 

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