Leukine

Ann,

Since i've never had GM-CSF nor am a participant in that trial, I risk of putting my foot in my mouth saying much of anything about it.

It's a great idea to look for a melanoma center up on the latest treatments. Memorial Sloan Kettering in NY is certainly a big Mel center (7 melanoma oncologists listed, Dr. Wolchok is nationally known for sure).

Good luck,

Kyle

Ann,

Since i've never had GM-CSF nor am a participant in that trial, I risk of putting my foot in my mouth saying much of anything about it.

It's a great idea to look for a melanoma center up on the latest treatments. Memorial Sloan Kettering in NY is certainly a big Mel center (7 melanoma oncologists listed, Dr. Wolchok is nationally known for sure).

Good luck,

Kyle

Ann,

Since i've never had GM-CSF nor am a participant in that trial, I risk of putting my foot in my mouth saying much of anything about it.

It's a great idea to look for a melanoma center up on the latest treatments. Memorial Sloan Kettering in NY is certainly a big Mel center (7 melanoma oncologists listed, Dr. Wolchok is nationally known for sure).

Good luck,

Kyle

I have heard the same thing that Kyle heard– Leukine (trade name for GM-CSF) was FDA approved 20 years ago for certain purposes. It has been tested as a vaccine treatment for melanoma but although some patients did benefit, most did not. This new formulation being delivered by a virus might be successful. We don't know yet. 

Since you are now considered Stage IV NED (no evidence of disease), you would probably be elegible for ipi (trade name Yervoy) which was FDA approved 2 years ago. I don't know if your NED status would be a problem for that. Other than that, there are a number of promising new treatments now in clinical trials. Again, most clinical trials want you to have at least one tumor so that they can test it via a biopsy and so that they can track whether their treatment is working. If you would like to investigate clinical trials, let us know and we will try to help you find information.

The best idea is for you to go to a melanoma specialty clinic– the specialists there are usually "up" on most of the local clinical trials. Memorial Sloan Kettering is well-regarded, as is NYU Langone Medical Center. There are several excellent melanoma centers in the Boston area, too. Farther from your home, Moffitt in Tampa and MD Anderson in Houston are highly rated as are probably half a dozen others in various states. 

Before you spend much time looking for clinical trials, it would probably be a good idea to have your tumor tissue tested for the BRAF, c-KIT and NRAS mutations if that hasn't been done yet. Many clinical trials are limited to people having one or another of such genetic factors. 

Good luck, and please do keep us posted as to how things are going with you.

I have heard the same thing that Kyle heard– Leukine (trade name for GM-CSF) was FDA approved 20 years ago for certain purposes. It has been tested as a vaccine treatment for melanoma but although some patients did benefit, most did not. This new formulation being delivered by a virus might be successful. We don't know yet. 

Since you are now considered Stage IV NED (no evidence of disease), you would probably be elegible for ipi (trade name Yervoy) which was FDA approved 2 years ago. I don't know if your NED status would be a problem for that. Other than that, there are a number of promising new treatments now in clinical trials. Again, most clinical trials want you to have at least one tumor so that they can test it via a biopsy and so that they can track whether their treatment is working. If you would like to investigate clinical trials, let us know and we will try to help you find information.

The best idea is for you to go to a melanoma specialty clinic– the specialists there are usually "up" on most of the local clinical trials. Memorial Sloan Kettering is well-regarded, as is NYU Langone Medical Center. There are several excellent melanoma centers in the Boston area, too. Farther from your home, Moffitt in Tampa and MD Anderson in Houston are highly rated as are probably half a dozen others in various states. 

Before you spend much time looking for clinical trials, it would probably be a good idea to have your tumor tissue tested for the BRAF, c-KIT and NRAS mutations if that hasn't been done yet. Many clinical trials are limited to people having one or another of such genetic factors. 

Good luck, and please do keep us posted as to how things are going with you.

I have heard the same thing that Kyle heard– Leukine (trade name for GM-CSF) was FDA approved 20 years ago for certain purposes. It has been tested as a vaccine treatment for melanoma but although some patients did benefit, most did not. This new formulation being delivered by a virus might be successful. We don't know yet. 

Since you are now considered Stage IV NED (no evidence of disease), you would probably be elegible for ipi (trade name Yervoy) which was FDA approved 2 years ago. I don't know if your NED status would be a problem for that. Other than that, there are a number of promising new treatments now in clinical trials. Again, most clinical trials want you to have at least one tumor so that they can test it via a biopsy and so that they can track whether their treatment is working. If you would like to investigate clinical trials, let us know and we will try to help you find information.

The best idea is for you to go to a melanoma specialty clinic– the specialists there are usually "up" on most of the local clinical trials. Memorial Sloan Kettering is well-regarded, as is NYU Langone Medical Center. There are several excellent melanoma centers in the Boston area, too. Farther from your home, Moffitt in Tampa and MD Anderson in Houston are highly rated as are probably half a dozen others in various states. 

Before you spend much time looking for clinical trials, it would probably be a good idea to have your tumor tissue tested for the BRAF, c-KIT and NRAS mutations if that hasn't been done yet. Many clinical trials are limited to people having one or another of such genetic factors. 

Good luck, and please do keep us posted as to how things are going with you.

To my knowledge, GM-CSF on it's own is not effective for Melanoma, but it has shown some promise when used along side Ipilimumab (Yervoy) by reducing side effects and potentially increasing any benefit from the Ipi. Use of the combo is still in trials, but since GM-CSF has been approved for many years my local oncologist was able to prescribe it for me to use alongside the Ipi I recieved this past summer. 

GM-CSF, or Leukine, has been approved and used for many years as a way to help immunocompromised patients boost their white blood cell counts. It's also frequently used in patients who recieve a bone marrow transplants. GM-CSF stands for Granulocyte Macrophage- Colony Stimulating Factor. Without getting too deep into the immunology and physiology/cell biology of it all basically a granulocyte is the grandfather cell in your bone marrow to the majority of your white blood cells; so a granulocyte colony stimulating factor tells the granulocytes in your marrow to pick up the pace and kick out more white blood cells. The granuloctyes make all of your white cells EXCEPT lymphocytes, which are the ones that attack Melanoma, which is why it's not really used for Melanoma on it's own. 

The other part of the "GM" though is Macrophage, and this is where the renewed intrest and trials with Ipi comes in. If you look on a Complete Blood Count (CBC, where they look at your red and white cells) one of the cell types listed is Monocyte. A monocyte comes from the granulocyte I talked about earlier, and after a while circulating in your bloodstream it leaves the blood and hangs out in your tissues as a macrophage. A macrophage's job is to clean up. For example in your lungs, they clean up any dust or stray bacteria that make it past your nasal passages, sinuses, etc. They also clean up dead cells. Some of these macrophages morph again into what is called a dendritic cell.

Dendritic cells look a little like starfish, with lots of arms. Their job is to gather "stuff" (dead bacteria, viurses, tumor cells, etc). Once it's gotten enough stuff it goes running off to your lymph nodes with it. The lymph nodes are where the lymphocytes (the cancer fighting cells) live and wait to be told what to do. The Dendritic cell's job is to give the lympocytes their marching orders, so to speak. They take their "stuff" to the lymph node and stimulate the multiplying of lymphocytes that are "trained" to attack the "stuff" the dendritic cell brought back. Here's the part that's useful for Melanoma treatment- getting more lymphocytes.

Back to those Macrophages: In immunology research, when they want to make Dendritic cells, they expose Macrophages to GM-CSF to entice them to do their morphing into the dendritic cell. So for Melanoma, the goal of using GM-CSF is to first increase production of Monocytes, which turn into increased numbers of Macrophages, which hopefully wil turn into increased numbers of Dendritic cells, which hopefully will be more likely to bring back peices of tumor to make more lymphocytes.

Phew… That's a lot, and a very round about way of trying to get more lymphocytes. Used on it's own, however GM-CSF has a reputation for making tumors (including Melanoma) grow more quickly, which is why it's not generally used as a stand alone therapy. Used aong side Ipi, however early data indicates that it may enhance any benefit gained from the Ipi. Ipi is large doses of an antibody, whose job it is to help your immune system recognize that the Melanoma is bad. The combo is an effort to maximize your body's possible response by increasing the number of teachers (dendritic cells) available for the students (lympocytes), so to speak.

This is a very oversimplified explanation, but I also hope I haven't confused anyone. I'm sorry if I have, but the use of GM-CSF has been coming around a lot and it seems like a lot of people don't really know what it is, how it works, or why it's being used. I thought I'd take a shot at explaining it. 

To my knowledge, GM-CSF on it's own is not effective for Melanoma, but it has shown some promise when used along side Ipilimumab (Yervoy) by reducing side effects and potentially increasing any benefit from the Ipi. Use of the combo is still in trials, but since GM-CSF has been approved for many years my local oncologist was able to prescribe it for me to use alongside the Ipi I recieved this past summer. 

GM-CSF, or Leukine, has been approved and used for many years as a way to help immunocompromised patients boost their white blood cell counts. It's also frequently used in patients who recieve a bone marrow transplants. GM-CSF stands for Granulocyte Macrophage- Colony Stimulating Factor. Without getting too deep into the immunology and physiology/cell biology of it all basically a granulocyte is the grandfather cell in your bone marrow to the majority of your white blood cells; so a granulocyte colony stimulating factor tells the granulocytes in your marrow to pick up the pace and kick out more white blood cells. The granuloctyes make all of your white cells EXCEPT lymphocytes, which are the ones that attack Melanoma, which is why it's not really used for Melanoma on it's own. 

The other part of the "GM" though is Macrophage, and this is where the renewed intrest and trials with Ipi comes in. If you look on a Complete Blood Count (CBC, where they look at your red and white cells) one of the cell types listed is Monocyte. A monocyte comes from the granulocyte I talked about earlier, and after a while circulating in your bloodstream it leaves the blood and hangs out in your tissues as a macrophage. A macrophage's job is to clean up. For example in your lungs, they clean up any dust or stray bacteria that make it past your nasal passages, sinuses, etc. They also clean up dead cells. Some of these macrophages morph again into what is called a dendritic cell.

Dendritic cells look a little like starfish, with lots of arms. Their job is to gather "stuff" (dead bacteria, viurses, tumor cells, etc). Once it's gotten enough stuff it goes running off to your lymph nodes with it. The lymph nodes are where the lymphocytes (the cancer fighting cells) live and wait to be told what to do. The Dendritic cell's job is to give the lympocytes their marching orders, so to speak. They take their "stuff" to the lymph node and stimulate the multiplying of lymphocytes that are "trained" to attack the "stuff" the dendritic cell brought back. Here's the part that's useful for Melanoma treatment- getting more lymphocytes.

Back to those Macrophages: In immunology research, when they want to make Dendritic cells, they expose Macrophages to GM-CSF to entice them to do their morphing into the dendritic cell. So for Melanoma, the goal of using GM-CSF is to first increase production of Monocytes, which turn into increased numbers of Macrophages, which hopefully wil turn into increased numbers of Dendritic cells, which hopefully will be more likely to bring back peices of tumor to make more lymphocytes.

Phew… That's a lot, and a very round about way of trying to get more lymphocytes. Used on it's own, however GM-CSF has a reputation for making tumors (including Melanoma) grow more quickly, which is why it's not generally used as a stand alone therapy. Used aong side Ipi, however early data indicates that it may enhance any benefit gained from the Ipi. Ipi is large doses of an antibody, whose job it is to help your immune system recognize that the Melanoma is bad. The combo is an effort to maximize your body's possible response by increasing the number of teachers (dendritic cells) available for the students (lympocytes), so to speak.

This is a very oversimplified explanation, but I also hope I haven't confused anyone. I'm sorry if I have, but the use of GM-CSF has been coming around a lot and it seems like a lot of people don't really know what it is, how it works, or why it's being used. I thought I'd take a shot at explaining it. 

To my knowledge, GM-CSF on it's own is not effective for Melanoma, but it has shown some promise when used along side Ipilimumab (Yervoy) by reducing side effects and potentially increasing any benefit from the Ipi. Use of the combo is still in trials, but since GM-CSF has been approved for many years my local oncologist was able to prescribe it for me to use alongside the Ipi I recieved this past summer. 

GM-CSF, or Leukine, has been approved and used for many years as a way to help immunocompromised patients boost their white blood cell counts. It's also frequently used in patients who recieve a bone marrow transplants. GM-CSF stands for Granulocyte Macrophage- Colony Stimulating Factor. Without getting too deep into the immunology and physiology/cell biology of it all basically a granulocyte is the grandfather cell in your bone marrow to the majority of your white blood cells; so a granulocyte colony stimulating factor tells the granulocytes in your marrow to pick up the pace and kick out more white blood cells. The granuloctyes make all of your white cells EXCEPT lymphocytes, which are the ones that attack Melanoma, which is why it's not really used for Melanoma on it's own. 

The other part of the "GM" though is Macrophage, and this is where the renewed intrest and trials with Ipi comes in. If you look on a Complete Blood Count (CBC, where they look at your red and white cells) one of the cell types listed is Monocyte. A monocyte comes from the granulocyte I talked about earlier, and after a while circulating in your bloodstream it leaves the blood and hangs out in your tissues as a macrophage. A macrophage's job is to clean up. For example in your lungs, they clean up any dust or stray bacteria that make it past your nasal passages, sinuses, etc. They also clean up dead cells. Some of these macrophages morph again into what is called a dendritic cell.

Dendritic cells look a little like starfish, with lots of arms. Their job is to gather "stuff" (dead bacteria, viurses, tumor cells, etc). Once it's gotten enough stuff it goes running off to your lymph nodes with it. The lymph nodes are where the lymphocytes (the cancer fighting cells) live and wait to be told what to do. The Dendritic cell's job is to give the lympocytes their marching orders, so to speak. They take their "stuff" to the lymph node and stimulate the multiplying of lymphocytes that are "trained" to attack the "stuff" the dendritic cell brought back. Here's the part that's useful for Melanoma treatment- getting more lymphocytes.

Back to those Macrophages: In immunology research, when they want to make Dendritic cells, they expose Macrophages to GM-CSF to entice them to do their morphing into the dendritic cell. So for Melanoma, the goal of using GM-CSF is to first increase production of Monocytes, which turn into increased numbers of Macrophages, which hopefully wil turn into increased numbers of Dendritic cells, which hopefully will be more likely to bring back peices of tumor to make more lymphocytes.

Phew… That's a lot, and a very round about way of trying to get more lymphocytes. Used on it's own, however GM-CSF has a reputation for making tumors (including Melanoma) grow more quickly, which is why it's not generally used as a stand alone therapy. Used aong side Ipi, however early data indicates that it may enhance any benefit gained from the Ipi. Ipi is large doses of an antibody, whose job it is to help your immune system recognize that the Melanoma is bad. The combo is an effort to maximize your body's possible response by increasing the number of teachers (dendritic cells) available for the students (lympocytes), so to speak.

This is a very oversimplified explanation, but I also hope I haven't confused anyone. I'm sorry if I have, but the use of GM-CSF has been coming around a lot and it seems like a lot of people don't really know what it is, how it works, or why it's being used. I thought I'd take a shot at explaining it. 

My husband was in a clinical trial using both the Ipi 10 mg/kg and GM-CSF in a combo.

It worked well for him and I really  like the explanation by ecc.

The only problem he had with the GM-CSF was when he got the full 1ml shots he had enormous red, hot, raised blotches at the site so he had to cut the dosage in half and then he was fine.  GM-CSF is given in self injections of 14 days on and 7 days off.  He did this for 2 years 9 months.

Judy (loving wife of Gene Stage IV and now NED)

My husband was in a clinical trial using both the Ipi 10 mg/kg and GM-CSF in a combo.

It worked well for him and I really  like the explanation by ecc.

The only problem he had with the GM-CSF was when he got the full 1ml shots he had enormous red, hot, raised blotches at the site so he had to cut the dosage in half and then he was fine.  GM-CSF is given in self injections of 14 days on and 7 days off.  He did this for 2 years 9 months.

Judy (loving wife of Gene Stage IV and now NED)

My husband was in a clinical trial using both the Ipi 10 mg/kg and GM-CSF in a combo.

It worked well for him and I really  like the explanation by ecc.

The only problem he had with the GM-CSF was when he got the full 1ml shots he had enormous red, hot, raised blotches at the site so he had to cut the dosage in half and then he was fine.  GM-CSF is given in self injections of 14 days on and 7 days off.  He did this for 2 years 9 months.

Judy (loving wife of Gene Stage IV and now NED)