In November of 2014, Phil Kauffman went to his primary care doctor with what he thought was a broken rib. The doctor advised him to let it heal on its own—a standard approach for such maladies.
Phil, a retired engineering consultant who lives near San Diego, California, with his wife (their two daughters are grown), went home and waited for his rib to heal, but the pain stuck around for months.
In March of 2015 his doctor ordered an X-ray, but instead of a broken rib, it revealed suspicious spots in Phil’s lung. A CT scan found five lesions characteristic of lung cancer. His rib pain was caused by pleural effusion (liquid) in his right lung, which was extracted, and an examination of that liquid confirmed a diagnosis of stage IV non-small cell lung cancer (NSCLC).
Phil remembers that during the first week after his diagnosis he was paralyzed with fear. His brother in law, a physician, helped him snap out of it, assuring him that his treatment options guaranteed a survival period of at least a few years or maybe more, and that cancer research was progressing at such a fast rate that the prospect of extending his lifetime beyond a couple of years was good. Continue reading…
“Seasonal influenza vaccination resulted in increased risk of immune-related adverse events (AEs) in lung cancer patients treated with PD-1/PD-L1 checkpoint inhibitors in a small study. However, the risks of the flu itself may still outweigh the risks associated with vaccination.
” ‘Use of immune checkpoint inhibitors is now standard clinical practice for many oncology patients, and these same patients—particularly those with lung cancer—also face increased risk for complications from influenza,’ said Sacha Rothschild, MD, PhD, of University Hospital Basel in Switzerland, in a press release. ‘Although routine influenza vaccination has long been recommended for cancer patients, there are concerns that it might trigger an exaggerated immune response in this subgroup receiving checkpoint inhibitors.’ ”
“The FDA granted fast track designation to pelareorep for the treatment of metastatic breast cancer, according to the drug’s manufacturer.
“Pelareorep (Reolysin, Oncolytics Biotech) is an immuno-oncology viral-agent designed to induce selective tumor lysis, and promote an inflamed tumor phenotype through innate and adaptive immune responses, according to a company-issued press release.
“An open-label, randomized phase 2 study evaluated the addition of IV pelareorep to paclitaxel for patients with advanced or metastatic breast cancer.”
“White blood cell counts can predict whether or not lung cancer patients will benefit from immunotherapy, according to research presented at the European Lung Cancer Conference (ELCC).
” ‘Immune checkpoint inhibitors such as nivolumab and pembrolizumab significantly improve overall survival in some – but not all – patients with non-small cell lung cancer (NSCLC),’ said lead author Dr Marcello Tiseo, Coordinator of DMT Thoracic Oncology, University Hospital of Parma, Italy. ‘Researchers are looking for a predictive biomarker to select patients that will benefit from this treatment to avoid unnecessary toxicity and a waste of resources in patients who will not respond.’ ”
“Some advanced lung cancer patients benefit from immunotherapy even after the disease has progressed as evaluated by standard criteria, according to research presented at the European Lung Cancer Conference (ELCC). The findings pave the way for certain patients to continue treatment if the disease is not progressing according to new, more specific, criteria.
“The Response Evaluation Criteria in Solid Tumours (RECIST) evaluates changes in tumour size and identifies whether patients are responding to treatment or progressing. An enlarging tumour on a CT scan signals that patients are progressing, and treatment is changed to best supportive care or a different drug. Immune-related RECIST was developed to account for the fact that tumours enlarge temporarily in patients taking immunotherapy.”
“Glioblastoma is the most common brain tumor in humans and also one of the most difficult cancers to treat; patients with this type of cancer only survive about one year from time of diagnosis. Researchers at Baylor College of Medicine, Texas Children’s Cancer Center, and the Center for Cell and Gene Therapy at Baylor, Texas Children’s Hospital and Houston Methodist are investigating a new treatment option using modified T cells with anti-tumor properties with the goal of improving outcomes for patients with glioblastoma.
Their research focuses on engineered T cells that target the protein HER 2 expressed in low levels in glioblastoma cells. Results of a Phase 1 study published in the current issue of JAMA Oncology established the safety of these HER 2-specific, chimeric antigen receptor modified T cells (CAR T cells) when infused in to patients in increasing doses and, importantly, results also showed a clinical benefit to patients.”
“Immunotherapy agents, both as monotherapy and in combination, are emerging in the pipeline of non–small cell lung cancer (NSCLC) and could end up competing as frontline treatment for patients, explains Sukhmani Padda, MD.
“For example, the PD-1 inhibitor pembrolizumab (Keytruda) is the sole immunotherapy agent approved in the first-line setting for patients with NSCLC; however, many other immunotherapy agents and combination regimens are in development that are aimed at this line of therapy.”
“Cytomegalovirus (CMV)-targeted vaccination plus high-dose chemotherapy with temozolomide can lead to long-term progression-free survival (PFS) and overall survival (OS) in patients with newly diagnosed glioblastoma (GBM), according to a new study published in Clinical Care Research.
“Despite surgical resection, high-dose radiation, and chemotherapy with temozolomide, GBM patients typically survive a median of 15 months. CMV proteins are expressed in more than 90% of GBM. ‘Recent evidence has also demonstrated that CMV-specific T-cell immunity can be generated to recognize and effectively kill autologous GBM tumor cells expressing endogenous levels of the immunodominant pp65 antigen, providing compelling support for the development of CMV-directed immunotherapy for the treatment of GBM,’ stated the researchers, led by Kristen A. Batich, MD, PhD, a researcher in the departments of neurosurgery and pathology at Duke University Medical Center in Durham, North Carolina.”
“Combination treatment with an intratumoral injection of Coxsackievirus A21 (CVA21) and the cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor ipilimumab has demonstrated durable response with minimal toxicity among patients with advanced melanoma, according to data (abstract CT114) presented at the American Association for Cancer Research (AACR) Annual Meeting 2017, held April 1–5 in Washington, DC.
“Response to the combination occurred even among several patients whose melanoma had progressed despite prior treatment with an immune checkpoint inhibitor.”