› Forums › General Melanoma Community › IL-2 or TIL Study at NIH?
- This topic has 24 replies, 6 voices, and was last updated 12 years, 9 months ago by
MariaH.
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- July 21, 2011 at 11:45 am
Dave and I have been in contact with NIH regarding their clinical trial with TIL, chemo, irradiation, and IL-2. They are asking that once we get the results of Dave's pretesting for IL-2 at Roswell, we forward them to them. They said they can remove part of Dave's tumor prior to doing IL-2 treatment at Roswell and start growing the TIL cells if IL-2 fails. Since the IL-2 protocol takes up to 8 weeks, this to me sounded like a good back up plan. However, now I am wondering – should Dave do the IL-2 first and wait to see if it works or should he look into going
Dave and I have been in contact with NIH regarding their clinical trial with TIL, chemo, irradiation, and IL-2. They are asking that once we get the results of Dave's pretesting for IL-2 at Roswell, we forward them to them. They said they can remove part of Dave's tumor prior to doing IL-2 treatment at Roswell and start growing the TIL cells if IL-2 fails. Since the IL-2 protocol takes up to 8 weeks, this to me sounded like a good back up plan. However, now I am wondering – should Dave do the IL-2 first and wait to see if it works or should he look into going to NIH and start his treatment there (IF he is accepted by them)?
I guess having options is better than having none, but it really is so difficult to decide. Any thoughts/opinions would be greatly appreciated.
Maria & Dave
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- July 21, 2011 at 12:22 pm
How much time would it be to get accepted at NIH, surgery, then recovery before he could do IL2? Depending on his personel history that has to be considered. If passing the tests allow him to begin at Roswell the treatment could start immediately. You will know in month if he is responding. Would NIH accept a tumor that has just gone through IL2? How dificult would the surgery be to get the cells?
This would give you a backup plan if IL2 doesn't work. However I would be concerned if it would put the IL2 off 6 -8 weeks and was a difficult surgery. Whatever choice Dave makes he can only look forward.
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- July 21, 2011 at 12:22 pm
How much time would it be to get accepted at NIH, surgery, then recovery before he could do IL2? Depending on his personel history that has to be considered. If passing the tests allow him to begin at Roswell the treatment could start immediately. You will know in month if he is responding. Would NIH accept a tumor that has just gone through IL2? How dificult would the surgery be to get the cells?
This would give you a backup plan if IL2 doesn't work. However I would be concerned if it would put the IL2 off 6 -8 weeks and was a difficult surgery. Whatever choice Dave makes he can only look forward.
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- July 21, 2011 at 1:07 pm
Has Dave's oncologist made any suggestions regarding treatment options? I think that it is
really difficult to predict how someone will respond to IL-2, and how long that response
will last. One could possibly try IL-2, and then follow it with Yervoy.The TIL treatment at the National Institutes of Health has tremendous potential, and it
has the best chance of giving the patient a durable remission. However, there are no
guarantees that any current treatment will do this as there is a lot of research still to
be done.Best wishes
Frank from Australia
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- July 21, 2011 at 6:47 pm
Actually Frank, his current plan is to try IL-2 first then IPI if he doesn't respond (as recommended by his onc and surgeon). However, after researching clinical trials and hearing from others, I think that doing the TIL route may be his second choice – or maybe even his first.
I wish we knew which one he would respond to….
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- July 21, 2011 at 6:47 pm
Actually Frank, his current plan is to try IL-2 first then IPI if he doesn't respond (as recommended by his onc and surgeon). However, after researching clinical trials and hearing from others, I think that doing the TIL route may be his second choice – or maybe even his first.
I wish we knew which one he would respond to….
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- July 21, 2011 at 1:07 pm
Has Dave's oncologist made any suggestions regarding treatment options? I think that it is
really difficult to predict how someone will respond to IL-2, and how long that response
will last. One could possibly try IL-2, and then follow it with Yervoy.The TIL treatment at the National Institutes of Health has tremendous potential, and it
has the best chance of giving the patient a durable remission. However, there are no
guarantees that any current treatment will do this as there is a lot of research still to
be done.Best wishes
Frank from Australia
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- July 21, 2011 at 2:51 pm
Maria and Dave,
If it was me , Based on Rosenburg's response rate, I would opt to do the TIL therapy first.
Here is my reasoning:
1) Tregs are in high levels in stage 1 and IV ( surppress the immune response
2) IL-2 can be a growth factor for CD4+/Tcells along with Tregs (Not Good)
L-2 treatment during the expansion phase was detrimental to the survival of rapidly dividing effector T cells. In contrast, IL-2 therapy was highly beneficial during the death phase, resulting in increased proliferation and survival of Tumor-specific T cells. IL-2 treatment also increased proliferation of resting memory T cells in the host that controlled the disease. Tumor-specific T cells in chronically infected Host also responds to IL-2 resulting in decreased tumor burden. Thus, timing of IL-2 administration and differentiation status of the T cell are critical parameters in designing IL-2 therapies (Blattman et al., 2003).
This means the timing of IL-2 during growth phase is crucial in Dave's therapy.
Prior Chemo/IL-2 to the TIL only produced a 16 % complete response
Prior IL-2 to the TIL only produced a 18 % complete response
No prior therapy to the TIL produced a 40 % complete response
Prior Chemotherapy to the TIL only produced a 18 % complete response
IL-2 therapy by itself had a 3-6 % complete response
Did you ever do Ipi / Yervoy?
Jimmy B
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- July 21, 2011 at 2:51 pm
Maria and Dave,
If it was me , Based on Rosenburg's response rate, I would opt to do the TIL therapy first.
Here is my reasoning:
1) Tregs are in high levels in stage 1 and IV ( surppress the immune response
2) IL-2 can be a growth factor for CD4+/Tcells along with Tregs (Not Good)
L-2 treatment during the expansion phase was detrimental to the survival of rapidly dividing effector T cells. In contrast, IL-2 therapy was highly beneficial during the death phase, resulting in increased proliferation and survival of Tumor-specific T cells. IL-2 treatment also increased proliferation of resting memory T cells in the host that controlled the disease. Tumor-specific T cells in chronically infected Host also responds to IL-2 resulting in decreased tumor burden. Thus, timing of IL-2 administration and differentiation status of the T cell are critical parameters in designing IL-2 therapies (Blattman et al., 2003).
This means the timing of IL-2 during growth phase is crucial in Dave's therapy.
Prior Chemo/IL-2 to the TIL only produced a 16 % complete response
Prior IL-2 to the TIL only produced a 18 % complete response
No prior therapy to the TIL produced a 40 % complete response
Prior Chemotherapy to the TIL only produced a 18 % complete response
IL-2 therapy by itself had a 3-6 % complete response
Did you ever do Ipi / Yervoy?
Jimmy B
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- July 21, 2011 at 6:56 pm
Thanks for the numbers Jim. He has not done anything yet – he is doing his PET and Brain MRI today, nuclear stress on Monday, doctor visit on Wednesday, then start IL-2 on 8/1 (pending there are no brain mets and his heart is good). I'm not convinced on IPI's success rate yet as a complete response regimen alone, especially given the side effects they told him about. He's not looking for 6+ months, he's looking for a complete response. Mind you, he'll take stability – but if he's going to play the game, he wants to swing for a homerun and hope for a base hit – not the other way around.
Guess we will wait for the test results and call NIH when we get them. His oncologist was in favor of Dave looking at clinical trials, but I don't know how he will feel about Dave having surgery and holding up IL-2.
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- July 21, 2011 at 7:17 pm
Maria,
When I had tumors in my lungs, I opted not to have surgery because of the delay in starting therapy. I am also diabetic, which slow down the healing process.
I widh you all the best
And what every you decide, never look back. The complete response is over the next hill.
You just have to get there.
Jimmy B
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- July 21, 2011 at 7:17 pm
Maria,
When I had tumors in my lungs, I opted not to have surgery because of the delay in starting therapy. I am also diabetic, which slow down the healing process.
I widh you all the best
And what every you decide, never look back. The complete response is over the next hill.
You just have to get there.
Jimmy B
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- July 21, 2011 at 6:56 pm
Thanks for the numbers Jim. He has not done anything yet – he is doing his PET and Brain MRI today, nuclear stress on Monday, doctor visit on Wednesday, then start IL-2 on 8/1 (pending there are no brain mets and his heart is good). I'm not convinced on IPI's success rate yet as a complete response regimen alone, especially given the side effects they told him about. He's not looking for 6+ months, he's looking for a complete response. Mind you, he'll take stability – but if he's going to play the game, he wants to swing for a homerun and hope for a base hit – not the other way around.
Guess we will wait for the test results and call NIH when we get them. His oncologist was in favor of Dave looking at clinical trials, but I don't know how he will feel about Dave having surgery and holding up IL-2.
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- July 21, 2011 at 3:47 pm
Hi Maria, I am presently trying to qualify for the TIL at NIH http://www.clinicaltrials.gov/ct2/show/NCT01319565?term=11-c-0123&rank=1
They have removed two masses from my left groin. I can't say enough about the high quality of care and knowledge there, absolutely excellent. If you note, the above trial does also include IL-2..I believe it is 12 bags. But IL-2 by itself has pretty good total response. I did ipi but IL-2 was not available in Quebec so I didn't have to hesitate about the TIL…Best wishes in making your decision, Val
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- July 21, 2011 at 3:47 pm
Hi Maria, I am presently trying to qualify for the TIL at NIH http://www.clinicaltrials.gov/ct2/show/NCT01319565?term=11-c-0123&rank=1
They have removed two masses from my left groin. I can't say enough about the high quality of care and knowledge there, absolutely excellent. If you note, the above trial does also include IL-2..I believe it is 12 bags. But IL-2 by itself has pretty good total response. I did ipi but IL-2 was not available in Quebec so I didn't have to hesitate about the TIL…Best wishes in making your decision, Val
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- July 21, 2011 at 6:59 pm
Actually Val, the whole reason I contacted NIH was because of a post you had earlier. Could you let me know what your screening process has consisted of and how long it has taken? It may be a deciding factor for Dave.
I really hope you are accepted and it works for you… you are such an inspiration!!
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- July 21, 2011 at 6:59 pm
Actually Val, the whole reason I contacted NIH was because of a post you had earlier. Could you let me know what your screening process has consisted of and how long it has taken? It may be a deciding factor for Dave.
I really hope you are accepted and it works for you… you are such an inspiration!!
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- July 23, 2011 at 4:00 pm
If considering NIH, perhaps read my story….
Look up on google…. Warren Galinat
Then click on ‘white brows’
It’s my NIH journeyBest of luck to you. Warren G
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- July 25, 2011 at 1:47 am
Actually Val, your "thank you" to Warren is what had me look up his story and look into this trial. If it wasn't for the MPIP board, I would have never brought this up to Dave's oncologist. I will be forever grateful for both of your posts to this board – THANK YOU!!
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- July 25, 2011 at 1:47 am
Actually Val, your "thank you" to Warren is what had me look up his story and look into this trial. If it wasn't for the MPIP board, I would have never brought this up to Dave's oncologist. I will be forever grateful for both of your posts to this board – THANK YOU!!
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