kempten
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Posts:128
Hello,
I suffer from a light case of psoriasis, chronic fatigue immune dysfunction syndrome and interstitial cystitis.
All at a very low level and I'm very functional.
Will any or all of these conditions prevent me from participating in a immunotherapy trial in the future?
I was diagnosed Dec 2015 with non small cell adenocarcinoma EGFR pos exon 19 stage IV and am still on Tarceva which appears to be still working. Started Feb 1st 2015.
Brain mets down from 9 to 3 on Tarceva.
Last 3 brain mets treated with SRS 2 days ago.
Primary still present but down to 2cm.
Thanks for any info on this subject.
Kempten
Forums
Reply # - September 25, 2015, 08:17 AM
Hi Kempten,
Hi Kempten,
It's very possible that your immune dysfunction syndrome can disqualify you from trials in immunotherapy research since they both play a roll in the immune system. Each trial has different criteria and each investigator interprets the criteria so you'd need to speak with the investigator. There is a an immunotherapy drug on the market that targets the immune system, nivolumab, so you'd not need to qualify for a trial to receive it.
Third generation egfr inhibiters are very promising as well and hopefully will be available when you need them.
It's great that you're responding so well to tarceva! I hope you're able to remain on it for a long long time.
Janine
Reply # - September 25, 2015, 02:53 PM
Hello Janine,
Hello Janine,
Thank you for responding.
I guess it would make sense to exclude someone like me with this history.
I was just wondering about the prevalence of autoimmunity in cancer. Does not cancer itself bring forth cancer syndromes at times that are also believed or even proven to be caused by certain genetic autoimmune markers? Or did I misunderstand this?????
I know the relationship between the different immune cells and us trying to fool around with them is so unbelievably complicated. It's too bad that people with autoimmune disease will lose this mode of therapy and have less options.
Thanks
Kempten
Reply # - September 25, 2015, 04:46 PM
Sorry I think I misspoke,
Sorry I think I misspoke,
I did not mean genetic markers but antigens against certain cancers????
This is all so complex that I would like to see a professional post from our faculty to talk about Cancer patients that also have autoimmune diseases, especially since autoimmune diseases seem to be on the rise.
How do we accommodate these two sometimes opposing patient needs?
Thanks ,
Kempten
Reply # - September 26, 2015, 06:04 AM
Hi Kempten,
Hi Kempten,
The issue you raise is discussed in this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2764117/
As stated therein:
"The cardinal problem with all approaches that aim to augment the host immune response to cancer is that many tumour antigens that serve as key therapeutic targets are also expressed in normal tissues. Consequently targeting melanoma antigens (which are also melanocyte differentiation antigens) by active vaccination or by adoptive transfer of TILs often results in the development of the autoimmune disease vitiligo."
Typical treatment for autoimmune disease consists of immunosuppression, which can be at odds with anti-cancer immunotherapies which seek to stimulate the response of the immune system.
The article suggests one possible solution to this problem: "Using a combination of therapeutic agents might allow for a reduction in the dose of each individual drug to levels that are not toxic."
Since lung cancer immunotherapies are fairly new, it may be a question of trying such a therapy to find out whether it exacerbates your symptoms, assuming (as Janine points out) that a particular trial does not exclude you. That might depend on whether you are currently taking immunosuppressive drugs. Trial sponsors would not want to see the efficacy of their drug reduced by such factors, which might lead to such an exclusion.
JimC
Forum moderator
Reply # - September 26, 2015, 07:15 AM
Hello Jim,
Hello Jim,
Thank you for your suggested reading.
As always,
You guys are a wonderful resource.
Kempten
Reply # - September 27, 2015, 07:11 AM
"There is a an immunotherapy
"There is a an immunotherapy drug on the market that targets the immune system, nivolumab, so you’d not need to qualify for a trial to receive it."
But it's only approved right now for squamous cell. Your insurance company would still need to approve it before you can get it if you have adeno.
Take care, Judy
Reply # - September 28, 2015, 02:38 AM
Thanks Judy,
Thanks Judy,
I will bring up the subject with my onc on my next visit, but initially at the very start of me being diagnosed,
he appeared skeptical that I would have success with this mode of therapy.
Kempten