Breaking news: Sherri has been accepted into this immunotherapy trial at Johns Hopkins, in the arm that receives a vaccine/ drug combination instead of her current chemotherapy treatment. We’ll be starting the trial on Jan 28, Sherri’s birthday. Let’s hope it will be a poetic re-birth day! (More info below)
There is perhaps a turning point coming into focus, but it’s a little bit renegade. Last Monday, Jan 13, we visited the Johns Hopkins Kimmel Cancer Center in Baltimore to meet with the team in charge of a clinical trial underway there. This is one of the immunotherapy trials that we’ve been keeping an eye on, and the time seems to be right for considering it now. The trial combines a pancreatic tumor vaccine with an antibody called ipilimumab (“ipi”) in a new test for effectiveness compared to FOLFIRINOX (the current chemo regimen that Sherri is on).
According to the research disclosure, the concept behind the trial is to boost the immune system using the vaccine in combination with ipi. The vaccine uses genetically altered pancreatic cancer cells to make a factor called GM-CSF that helps attract a person’s own immune cells to the vaccine site where they can become activated to help recognize and attack cancer cells. Ipi is used to block CTLA-4, which is a molecule that can shut down immune response to infection or cancer cells. An antibody to CTLA-4 can stop it from turning off an immune response, and may be able to boost the immune system against the cancer. Both the vaccine and ipi have been used with some success, but not yet tried in combination for pancreatic cancer.
Here comes the tricky part. The trial is randomized, so once enrolled Sherri would be selected for either the vaccine/ipi treatment or for continuation with FOLFIRINOX. If selected for the vaccine/ipi arm, there are substantial new risks and side-effects from both the vaccine and ipi. The FOLFIRINOX regimen is currently controlling and shrinking the tumors, which makes it difficult to make the decision to move on to something else. However, continuation of this chemo treatment will inevitably reach a point of diminishing returns where a different treatment would be required anyway. One advantage of moving to a new treatment now is that her own immune system would be stimulated while it is still healthy and to fight a cancer that is more or less under control. Going forward with this treatment would not preclude a return to chemotherapy, and in fact in some cases has made chemo more effective. Also it appears from our inquiries with UPenn that going down this path still leaves open the possibility to qualify for their upcoming immunotherapy clinical trial using CAR T-cells. So several of our immediate concerns have been addressed.
Sherri did the initial screening for the vaccine/ipi trial when we were at Hopkins on Monday. Some of her blood counts were slightly lower than required, so with the concurrence of her oncology team here at FCCC we decided to skip the chemo treatment last Thursday. After a short reprieve this week we’ll be back to FCCC on Thursday for another blood test to see if everything is rebounding as it should. All other requirements for the trial have been met and we’ll be making a decision soon, so we’ll keep you posted.
Thanks again to the Bryn Athyn College athletics programs and fans for raising awareness and funds for the Pancreatic Cancer Action Network! And thanks to everyone for your continued support at every level; physical, emotional and spiritual. We may get behind in keeping in touch with you all, but please know that your thoughts and prayers, messages and visits are all making a huge difference.