nanknits
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My NSCLC has been very indolent since its accidental discovery and diagnosis 4 years ago but there has been very minor progression, a little more so in the last 12 months.
The Roche single arm MPDL3280A trial (Birch) was offered to me. (I am PD-L1 +.) I am scheduled for the 1st infusion on 9/17.
I have been reading about immunotherapy which leads me to wonder: Is my, or anyone's, indolent CA a function of one's own immune response only partly being shut down by CA cells?
If so, then I also wonder: Will introduction of a drug affecting the immune system alter a natural immune response?
Has anyone seen anything to answer my questions?
Nancy
Forums
Reply # - September 13, 2014, 05:13 PM
Hi Nancy,
Hi Nancy,
It's not really that the cancer cells "shut down" the immune system's response. Since cancer cells are not foreign to the body (in this case, they are lung cells which are mutated) the immune system does not see them as a threat, so it does nothing about them. Immunotherapy seeks to enlist the aid of the immune system to fight cancer. But it's not thought that the immune system makes a particular cancer indolent.
JimC
Forum moderator
Reply # - September 13, 2014, 06:30 PM
None of this is well studied,
None of this is well studied, but I agree with Jim that it is widely understood that the indolence of an indolent lung cancer is likely to be far more a function of the underlying biology of the cancer than a very effective suppressive effect from the immune system.
I will be very interested to learn how you do on the immune checkpoint inhibitor trial. I hope you'll report back.
Good luck.
-Dr. West
Reply # - November 12, 2014, 12:45 PM
Dr. West,
Dr. West,
As requested, here is my experience up to now, which is day 13 of the third 21-day cycle.
I have had no apparent adverse reaction so far to three infusions of the Roche drug MPDL3280A.
I also have no cancer symptoms now and have never have had before or after my lung CA diagnosis in Aug, 2010.
The first six-week scan on Oct 31 showed some progression of the two largest lesions [the target lesions for study purposes, I assume]. The increase is insignificant if only the longest diameters are compared, but comparing the sum of two diameters of each, the increase is 19%, which I think is near the limit of what could be attributable to pseudo-progression. The oncologist, however, is looking only at the longer diameters and is not concerned at this time.
If the target lesions continue to increase, the study calls for a biopsy to be analyzed by Roche, the results of which, I am told, will not be shared with me or the oncologist who is following me during the trial. Yet in that event, I will be allowed to continue in the trial if I wish. Seems to me that decision is made more difficult by not knowing what the biopsy shows.
Any comments from you will, as always, be most welcome.
Nancy
Reply # - November 12, 2014, 03:12 PM
Hi Nan, It's good to hear
Hi Nan, It's good to hear from you and that you still have no symptoms.
My non professional guess is that no matter what's found it wouldn't change standard practices for you today (if you end up having the biopsy) though the hope is the data collected from the many biopsies will show a pattern that will add to understanding and change in the future.
But let's let a pro comment.
Are you knitting or otherwise stitching lately? I've been making quilts on my home sewing machine lately and really enjoying the process. It's something I've never done before and absolutely love putting together something someone I love will cuddle in. Now that I've got the darning/quilting foot under control (just took me over a year) I want to make some babe and kids quilts for Children's Hospital here in town.
Knit one pearl too,
Janine
Reply # - November 12, 2014, 07:36 PM
Thanks for the follow up.
Thanks for the follow up.
I'm afraid there isn't really room for an opinion. If the protocol directs an approach like a biopsy and doesn't share the result, that's what is to be done. Clearly, they're trying to learn more and acknowledge that we don'the know enough yet to direct a change the treatment plan.
Good luck.
-Dr. West
Reply # - February 4, 2015, 01:23 PM
Dr. West,
Dr. West,
This, regretably, is my last report on my experience in the Genentech MPDL3280A immunotherapy trial.
On Jan 21, 2015, the oncologist following me for the trial declared that the drug was not working for me. Three scans during the six 21-day cycles showed a pattern of progression that while modest was persistent. This coupled with his judgement that I was presenting symptoms led to his decision. In retrospect, I think the symptoms were due to another episode in my 20-year history of chronic sinusitis. I said this at the time, but my view did not prevail. After a little prednisone and antibiotic, the symptoms have disappeared.
I found MPDL3280A to be easy to take. Some fatigue, a bit of itchy skin on the underside of my elbows and knees and, of more concern, an outbreak of over 30 keratoses which to my dermatologist appear to be “normal” keratoses although why such a large number should appear in a short time remains a mystery.
So, on the day the trial drug was stopped, I received Alimta on the theory that 4-cycles of Alimta and Avastin in fall, 2012, resulted in or at least helped cause 17 months of stability.
I have a few questions concerning what's next for me, but I will post them as a new topic in the New Questions area.
Janine- I am still knitting daily. More new projects one after the other. I hope you are able to keep up with your quilting.
Nancy