Saturday, December 3, 2011

Latest info on anti-pd1...

Check out:
http://www.melanoma2011.com/slide-postings/

Scroll down to "Saturday" and at number 79...you can click on Dr. Weber's presentation.

He talks about ipi in general.  He notes that anti-PD1 priming followed by anti-CTLA-4 boosting might be useful.  Two patients who failed anti-PD1 had a major response when subsequently placed on ipi.  He discusses my cohort (Phase 1 trial of HLA A*0201 positive patients with resected stage IV melanoma with dosing every 2 weeks up to 24 weeks, then every 12 weeks for up to 2 years....1, 3, and 10mg/kg cohorts in groups of 10 and multi-peptide vaccines given with every injection up to week 24.)  He reports that "one episode of grade 3 colitis was observed" at 3 mg/kg; "grade 1-2 fatigue, hypothyroidism, dry mouth and rash were the most commonly seen toxicities, and there were several infusion-related hypersensitivity reactions without sequelae"; "vitiligo was observed in a handful of patients and may correlate with response"; "side effects did not appear to be cumulative and predominantly occurred in the first 4-8 weeks".  In final comments he states: "I believe that a phase III randomized placebo controlled stage IV NED trial with anti-PD1 antibody should be conducted."

So....my take on all that....well, sir....my vitiligo, granuloma flares, itching, weird mouth situation, and enlarged inguinal nodes did become evident around my 4th infusion.  However, in my opinion, the effects are most certainly cumulative as they have become much more prevalent and consistent over time (not just flaring after the infusion and diminishing as it was about time for another dose) and have continued even as I am now on the every 3 month dosing schedule.  I suppose his call for additional trials means that he thinks anti-PD1 holds promise.  However, it is ironic that in the coming trials some portion of the participants will not be getting the drug.  I feel a far better trial would be to pit anti-PD1 against ipi rather than placebo.  I think we are all clear on what happens to stage IV melanoma patients with no treatment.

For what it's worth....c

2 comments:

  1. I agree! Should go against ipi! It is cruel to have them take a placebo... :(

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  2. placebo is just plain wrong here!

    ReplyDelete