› Forums › General Melanoma Community › Is Jim Breitfeller around?
- This topic has 39 replies, 6 voices, and was last updated 10 years, 10 months ago by Maureen038.
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- February 8, 2014 at 7:50 pm
Good question. The best that I can tell from his blog is that the last post he wrote was last year.
http://melanomamissionary.blogspot.com/ There is alot of info on his blog.
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- February 9, 2014 at 8:19 am
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- February 9, 2014 at 8:19 am
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- February 10, 2014 at 2:25 pm
Thanks for posting his twitter! That's very helpful. Thanks for all you do for melanoma research Jim!!!
Maureen
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- February 10, 2014 at 2:25 pm
Thanks for posting his twitter! That's very helpful. Thanks for all you do for melanoma research Jim!!!
Maureen
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- February 10, 2014 at 2:25 pm
Thanks for posting his twitter! That's very helpful. Thanks for all you do for melanoma research Jim!!!
Maureen
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- February 9, 2014 at 8:19 am
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- February 8, 2014 at 7:50 pm
Good question. The best that I can tell from his blog is that the last post he wrote was last year.
http://melanomamissionary.blogspot.com/ There is alot of info on his blog.
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- February 8, 2014 at 7:50 pm
Good question. The best that I can tell from his blog is that the last post he wrote was last year.
http://melanomamissionary.blogspot.com/ There is alot of info on his blog.
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- February 9, 2014 at 4:33 pm
Yes, I am here in the background.
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- February 9, 2014 at 4:33 pm
Yes, I am here in the background.
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- February 9, 2014 at 5:59 pm
Hi, Jim-
Thanks for checking in. I am delighted that you are still here sharing your knowledge and experience with us. If you don't mind, I do have a question for you.
Partly as a result of your publications and persistent efforts, we are beginning to see a resurgence of IL-2 used in combination with checkpoint inhibitors like ipi and anti-PD1. The hope is that IL-2 will enhance and extend the benefits of the checkpoint inhibitors resulting is long-term NED or even permanent cures.
My concern is that in some of your prior posts here, you have described what I call a "window of opportunity" for IL-2. You seem to think that it is important that the IL-2 be administered 50-60 days after the first ipi infusion. Is this still your recommendation? How important is the timing? In other words, if a patient completes the whole course of ipi or anti-PD1 (12-16 weeks) and then gets IL-2, will they still benefit from the IL-2? Are there any publications or clinical trials investigating the timing for combining checkpoint inhibitors with IL-2 administration?
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- February 9, 2014 at 5:59 pm
Hi, Jim-
Thanks for checking in. I am delighted that you are still here sharing your knowledge and experience with us. If you don't mind, I do have a question for you.
Partly as a result of your publications and persistent efforts, we are beginning to see a resurgence of IL-2 used in combination with checkpoint inhibitors like ipi and anti-PD1. The hope is that IL-2 will enhance and extend the benefits of the checkpoint inhibitors resulting is long-term NED or even permanent cures.
My concern is that in some of your prior posts here, you have described what I call a "window of opportunity" for IL-2. You seem to think that it is important that the IL-2 be administered 50-60 days after the first ipi infusion. Is this still your recommendation? How important is the timing? In other words, if a patient completes the whole course of ipi or anti-PD1 (12-16 weeks) and then gets IL-2, will they still benefit from the IL-2? Are there any publications or clinical trials investigating the timing for combining checkpoint inhibitors with IL-2 administration?
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- February 9, 2014 at 8:26 pm
Your question about timing is a very good one. My theory is based on activation of the T-cells (CD-4 and CD8). CD-4 is the helper T-cell and CD-8 is known as the cytotoxic T-cell. These T-cells grow and propagate at different growth patterns. In the literature, CD4 cells growth in vivo takes about 33 days. Where as the CD-8 T-cells take about 49 days to reach its maximum propagation. Now the amount of time may differ from patient to patient base on microenvironment of the cells. This means there can be a lot of different cytokines present or made by these cells that can hinder, delay or help propagate these cells.
Also, once the T-cells are activated, within 3 -6 days the receptors CTLA-4, PD-1 and others upregulate from within the and surface to the outer layer of the T-cells. These receptors will then bind to other proteins that complete the signaling to shut down the T-cell activation. This our body’s way of making sure our T-cells don’t over react to the immune response. That is why the anti-bodies of the receptors (yervoy and Anti-PD-1) are called checkpoint modulators.
Now to get back to the timing. IL-2, Think of it as growth factor/fertilizer for your cells. If IL-2 is dosed to early in the growth process, the suppressive Tregs will grow faster than the CD4 helper T-cells and can shut down the immune response.
If IL-2 is added late in growth (50 days or longer) it has been shown that CD-8 T-cells (Cytotoxic T-cells) seem to flourish. When supplied exogenously, IL-2 increases the magnitude of cytolytic activity generated. (Baker et al., 1978)
L-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).
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- February 9, 2014 at 8:26 pm
Your question about timing is a very good one. My theory is based on activation of the T-cells (CD-4 and CD8). CD-4 is the helper T-cell and CD-8 is known as the cytotoxic T-cell. These T-cells grow and propagate at different growth patterns. In the literature, CD4 cells growth in vivo takes about 33 days. Where as the CD-8 T-cells take about 49 days to reach its maximum propagation. Now the amount of time may differ from patient to patient base on microenvironment of the cells. This means there can be a lot of different cytokines present or made by these cells that can hinder, delay or help propagate these cells.
Also, once the T-cells are activated, within 3 -6 days the receptors CTLA-4, PD-1 and others upregulate from within the and surface to the outer layer of the T-cells. These receptors will then bind to other proteins that complete the signaling to shut down the T-cell activation. This our body’s way of making sure our T-cells don’t over react to the immune response. That is why the anti-bodies of the receptors (yervoy and Anti-PD-1) are called checkpoint modulators.
Now to get back to the timing. IL-2, Think of it as growth factor/fertilizer for your cells. If IL-2 is dosed to early in the growth process, the suppressive Tregs will grow faster than the CD4 helper T-cells and can shut down the immune response.
If IL-2 is added late in growth (50 days or longer) it has been shown that CD-8 T-cells (Cytotoxic T-cells) seem to flourish. When supplied exogenously, IL-2 increases the magnitude of cytolytic activity generated. (Baker et al., 1978)
L-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).
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- February 9, 2014 at 8:26 pm
Your question about timing is a very good one. My theory is based on activation of the T-cells (CD-4 and CD8). CD-4 is the helper T-cell and CD-8 is known as the cytotoxic T-cell. These T-cells grow and propagate at different growth patterns. In the literature, CD4 cells growth in vivo takes about 33 days. Where as the CD-8 T-cells take about 49 days to reach its maximum propagation. Now the amount of time may differ from patient to patient base on microenvironment of the cells. This means there can be a lot of different cytokines present or made by these cells that can hinder, delay or help propagate these cells.
Also, once the T-cells are activated, within 3 -6 days the receptors CTLA-4, PD-1 and others upregulate from within the and surface to the outer layer of the T-cells. These receptors will then bind to other proteins that complete the signaling to shut down the T-cell activation. This our body’s way of making sure our T-cells don’t over react to the immune response. That is why the anti-bodies of the receptors (yervoy and Anti-PD-1) are called checkpoint modulators.
Now to get back to the timing. IL-2, Think of it as growth factor/fertilizer for your cells. If IL-2 is dosed to early in the growth process, the suppressive Tregs will grow faster than the CD4 helper T-cells and can shut down the immune response.
If IL-2 is added late in growth (50 days or longer) it has been shown that CD-8 T-cells (Cytotoxic T-cells) seem to flourish. When supplied exogenously, IL-2 increases the magnitude of cytolytic activity generated. (Baker et al., 1978)
L-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).
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- February 9, 2014 at 8:32 pm
Publications or clinical trials investigating the timing for combining checkpoint inhibitors with IL-2 administration are very scarce due to the fact that Big Pharma wants to use their drugs as a mono-therapy. It is a lot easier to get FDA approval mono-therapy than a combinatorial therapy. So the big Pharma will do clinical trials as a mono-therapy and then maybe as a combinatorial therapy. Only time will tell.
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- February 9, 2014 at 8:32 pm
Publications or clinical trials investigating the timing for combining checkpoint inhibitors with IL-2 administration are very scarce due to the fact that Big Pharma wants to use their drugs as a mono-therapy. It is a lot easier to get FDA approval mono-therapy than a combinatorial therapy. So the big Pharma will do clinical trials as a mono-therapy and then maybe as a combinatorial therapy. Only time will tell.
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- February 9, 2014 at 8:34 pm
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- February 9, 2014 at 8:34 pm
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- February 9, 2014 at 8:34 pm
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- February 9, 2014 at 8:48 pm
Jim-
This is good info. I just finished ipi on Dec 9 and began HD IL2 on Jan 6th. The timing here would be too early? I'm in a trial sponsored by Prometheus Labs and that was guideline. The 2nd round began January 20th which is obviously better timing so I wonder if my benefit from combo would be compromised. Just trying to better understand. Also if this dose timing is out there why don't pharmacy companies try to adhere more to it? I'm a little disappointed but hoping I realize the benefit!
Josh
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- February 9, 2014 at 9:04 pm
Josh,
When did you start Ipi?
Since combinatorial immuno-therapy is quite new, Timing of the two or three have not been explored in the context of a clinical trial.
HD IL-2 + Ipilimumab in Patients With Metastatic Melanoma (PROCLIVITY 02)
This study is currently recruiting participants.Verified November 2013 by Prometheus LaboratoriesSponsor:Prometheus LaboratoriesCollaborators:M.D. Anderson Cancer CenterJohns Hopkins UniversityInformation provided by (Responsible Party):Prometheus LaboratoriesClinicalTrials.gov Identifier:NCT01856023First received: May 10, 2013Last updated: November 21, 2013Last verified: November 2013 -
- February 9, 2014 at 9:04 pm
Josh,
When did you start Ipi?
Since combinatorial immuno-therapy is quite new, Timing of the two or three have not been explored in the context of a clinical trial.
HD IL-2 + Ipilimumab in Patients With Metastatic Melanoma (PROCLIVITY 02)
This study is currently recruiting participants.Verified November 2013 by Prometheus LaboratoriesSponsor:Prometheus LaboratoriesCollaborators:M.D. Anderson Cancer CenterJohns Hopkins UniversityInformation provided by (Responsible Party):Prometheus LaboratoriesClinicalTrials.gov Identifier:NCT01856023First received: May 10, 2013Last updated: November 21, 2013Last verified: November 2013 -
- February 9, 2014 at 9:04 pm
Josh,
When did you start Ipi?
Since combinatorial immuno-therapy is quite new, Timing of the two or three have not been explored in the context of a clinical trial.
HD IL-2 + Ipilimumab in Patients With Metastatic Melanoma (PROCLIVITY 02)
This study is currently recruiting participants.Verified November 2013 by Prometheus LaboratoriesSponsor:Prometheus LaboratoriesCollaborators:M.D. Anderson Cancer CenterJohns Hopkins UniversityInformation provided by (Responsible Party):Prometheus LaboratoriesClinicalTrials.gov Identifier:NCT01856023First received: May 10, 2013Last updated: November 21, 2013Last verified: November 2013 -
- February 9, 2014 at 8:48 pm
Jim-
This is good info. I just finished ipi on Dec 9 and began HD IL2 on Jan 6th. The timing here would be too early? I'm in a trial sponsored by Prometheus Labs and that was guideline. The 2nd round began January 20th which is obviously better timing so I wonder if my benefit from combo would be compromised. Just trying to better understand. Also if this dose timing is out there why don't pharmacy companies try to adhere more to it? I'm a little disappointed but hoping I realize the benefit!
Josh
-
- February 9, 2014 at 8:48 pm
Jim-
This is good info. I just finished ipi on Dec 9 and began HD IL2 on Jan 6th. The timing here would be too early? I'm in a trial sponsored by Prometheus Labs and that was guideline. The 2nd round began January 20th which is obviously better timing so I wonder if my benefit from combo would be compromised. Just trying to better understand. Also if this dose timing is out there why don't pharmacy companies try to adhere more to it? I'm a little disappointed but hoping I realize the benefit!
Josh
-
- February 9, 2014 at 8:32 pm
Publications or clinical trials investigating the timing for combining checkpoint inhibitors with IL-2 administration are very scarce due to the fact that Big Pharma wants to use their drugs as a mono-therapy. It is a lot easier to get FDA approval mono-therapy than a combinatorial therapy. So the big Pharma will do clinical trials as a mono-therapy and then maybe as a combinatorial therapy. Only time will tell.
-
- February 9, 2014 at 5:59 pm
Hi, Jim-
Thanks for checking in. I am delighted that you are still here sharing your knowledge and experience with us. If you don't mind, I do have a question for you.
Partly as a result of your publications and persistent efforts, we are beginning to see a resurgence of IL-2 used in combination with checkpoint inhibitors like ipi and anti-PD1. The hope is that IL-2 will enhance and extend the benefits of the checkpoint inhibitors resulting is long-term NED or even permanent cures.
My concern is that in some of your prior posts here, you have described what I call a "window of opportunity" for IL-2. You seem to think that it is important that the IL-2 be administered 50-60 days after the first ipi infusion. Is this still your recommendation? How important is the timing? In other words, if a patient completes the whole course of ipi or anti-PD1 (12-16 weeks) and then gets IL-2, will they still benefit from the IL-2? Are there any publications or clinical trials investigating the timing for combining checkpoint inhibitors with IL-2 administration?
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- February 9, 2014 at 4:33 pm
Yes, I am here in the background.
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