In Case of Emergency, Break Glass

Well… a blog post I certainly don’t want to write and I did not plan on writing…

I was told to never bury the lead of a story – so here it is:

My oncolytic virus clinical trial plans have been canceled (hopefully just postponed).

What? How?? Why???

I assure you the decision was not made lightly but it is also a decision I am 100% comfortable was the correct one to make.

As a part of my pre-trial testing last week, I got a run of the mill CT-scan.  Not a big deal. I have had dozens over the past almost 5 years.  For those close to 5 years, my disease has acted very predictably.  Slight shrinkage and stability on active therapy… slow growth when resistant or without treatment.  You could set you watch by them they were so laid back & regular.

Until now.

My disease has decided to flip a genetic switch.  Tumors are allowed to do that, they are genetically unstable after all… A switch has been flipped to a “more aggressive phenotype“.  What does that mean in English? It means that when I saw my CT-scan of my previously (for almost 5 years) clean liver – my jaw dropped.  And not in a good way.  My liver was covered with spots – too many too count.  Some of them quite large.

The war inside my body had escalated without me knowing it.

The Oncolytic Virus Immunotherapy Trial

I love the concept of the my planned oncolytic immunotherapy trial!  I still do. But in this instance it has one major flaw.  It does not act fast.  Best case scenario, it takes a while to ramp up the immune system.  Looking at my liver, in a split second, I made my decision.  Those tumors needs to shrink now, as soon as possible, as fast as possible.  There is only one type of treatment that does that.

Chemo. ASAP. Today.

A Return to Chemo (sort of 🙂 )

So today, only a few hours after seeing my CT-scans: My trial has been canceled (hopefully just postponed until after things are under control!) and I am getting chemo, not a day to waste.  Yes, the situation was that serious.

But you know me… I am always thinking – and I always have multiple “planes” on my treatment idea taxiway…

My Own (n of 1) MSS-CRC Immunotherapy Clinical Trial

In my taxiway of immunotherapy planes, I have always had one with a special insignia on it.  An insignia that only I could see: In case of emergency, break glass.  The immunotherapy plane with this written on it? Maraviroc (CCR5 inhibitor) dosed on top of standard of care chemotherapy.  It has shown intriguing activity in its preliminary Phase 1 trial; it is FDA approved and relatively cheap so it can be prescribed by any oncologist “off-label” and paid for out-of-pocket (no insurance argument or compassionate use required); it can be given “on top of” standard chemo without additive toxicity. It is the closest thing to an off the shelf experimental immunotherapy that MSS-CRC has.  The best “I need to try something fast” i.e. “in case of emergency break glass” MSS CRC experimental immunotherapy there is!

So… due to a serious change in medical circumstance, one clinical trial has closed – and another one (of my own design!) has opened.  It is just pending final OK from my oncologist since it is a medical decision…

Today was definitely a big shock.  I hope to try the oncolytic virus trial in the future but we shall see if that is offered to me… But this is why I have developed layers upon layers upon layers of plans over the past 2 years.  Cancer is wily foe.  It surprises you when you least expect it.  To combat that kind of foe, you need to have your own surprises lined up.  And this is mine.  My goal has not changed, just some facts on the ground.  My goal is to beat my cancer, using science and my brain as my weapons, by any means necessary. Today was I disappointed? Yes. A bit scared? Yes.  Deterred? Never. This is why you should always have plenty of planes on your taxiway – you never know when one might be needed. 

Now most of you probably are curious of how Maraviroc is hoped to work?  I wrote a blog post on it last fall but instead of just having you chase after links, due to importance, I’ll copy and paste the entire old post below.

I mean this more today than perhaps ever before.  To Life!

-Tom

IMMUNOTHERAPY FROM AN AIDS DRUG START: THE CCR5 RECEPTOR ANTAGONIST MARAVIROC

maraviroc_recycle

Cobimetinib  + Atezolizumab  might have grabbed all the Microsatellite Stable-Colorectal Cancer (MSS-CRC) immunotherapy headlines in 2016 but quietly in the background was a second published/presented  Phase 1 Immunotherapy Clinical Trial with preliminary signs of activity in MSS-CRC patients.  I suspect it slipped under the medical radar earlier this year because its Phase 1 Clinical Trial results and related preclinical data were published in a (albeit very good!) scientific journal (Cancer Cell) rather than a medical journal.  The authors have recently been trying to address this by giving talks at major scientific/medical meetings such as the “Second CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival” conference in September.  Likewise, I am attempting to address this oversight of what I think are some pretty exciting preliminary clinical results with today’s blog!

Recycling in general is good for society & the planet Earth but have you ever heard of recycling drugs?  The official term for recycling drugs is “repurposing”.  It is an active area of research and an area of research I love for a number of reasons.  The major reason I love it is the potential major impacts on reducing the time to FDA-approval (and associated cost of the related drug development).  In a nutshell, it tests a drug which is FDA-approved for one disease against other diseases which preclinical scientific experiments indicate it may work.  This is a very cost and time efficient way to do drug development because aside from confirming efficacy in Clinical Trials for the new disease, in general most other aspects of clinical development have already been done when the drug was FDA-approved for its first use!

A CCR5 Receptor Antagonist AIDS Drug: Maraviroc

Maraviroc (brand-named Selzentry™, or Celsentri™ outside the U.S.) is an AIDS drug FDA approved in 2007.  It is a “CCR5 receptor antagonist” which works against AIDS because the CCR5 receptor is necessary for HIV to enter into its immune system host cells. The drug binds to the CCR5 receptor on immune cells, which then blocks the HIV protein gp120 from binding to the same receptor. By doing this, HIV viral particles are then unable to enter immune cells, blocking its AIDS disease line of attack.

maraviroc_graphical-abstract

Figure from Halama et al. Cancer Cell (2016) used with permission

Other Impacts of Maraviroc Blockage of the CCR5 Receptor: Potential MSS-CRC Immunotherapy

Blocking the CCR5 receptor on immune cells has impacts way beyond blocking HIV from infecting immune cells.  In cancer tumor immunology: Enter the macrophage.

Macrophages and MSS-CRC

One of the cell types in the innate immune system  is the macrophage.  Macrophages can either be tumor fighting (“M1-subtype”) or tumor helping (“M2-subtype”).  Discovering ways to control macrophages and switch which sub-type they are is an intense area of current research.

In CRC, macrophages within the tumor (“tumor-associated macrophages (TAMs)”) are often of the “tumor promoting” M2-subtype.  An area of active research has been to switch (or as scientists say, “repolarize”) these macrophages into M1-subtype tumor fighters.  As M1-subtype tumor fighters and members of the innate immune system, macrophages can either attack cancer cells directly or serve as intermediaries to facilitate attack by the adaptive immune system.

Scientists have discovered that one of the master switches for determining whether a macrophage is tumor promoting (M2-subtype) vs. tumor fighting (M1-subtype) is the “CCR5 receptor”. This research has been recently published in the journal Cancer Cell.  The exciting thing is that by blocking the CCR5 receptor with a CCR5 antagonist (e.g. Maraviroc), tumor promoting (M2-subtype) macrophages in CRC metastases can be switched (“repolarized”) into M1-subtype tumor fighters!

This not only can initiate direct innate immune system attack on tumors but it also has impacts on chemoresistance of these same tumors! Why is chemoresistance impacted?  Recent studies have shown that cytotoxic chemotherapies promote recruitment of tumor promoting macrophages into the tumor – and this is one immune system aspect of chemoresistance. Switching these macrophages into M1-subtype tumor fighters may get rid of this resistance mechanism and also attack the tumor with its own “defense”!

Now the Preliminary Clinical Data…

In a small exploratory clinical trial (NCT01736813, only 14 patients), patients received 300 mg twice daily the FDA-approved (for HIV treatment) commercially available drug Maraviroc.  All patients had MSS-CRC and were chemo resistant. The anti-CRC effects they saw in this small, preliminary patient population were encouraging:

  • Extensive tumor necrosis without harm to adjacent healthy tissue
  • Partial regression of lung metastases
  • Reductions in pro-tumor growth & chemo resistance signals within the tumors, as macrophages were switched to a tumor-fighting M1-subtype
  • Resensitization to various, previously failed standard of care chemotherapies used for CRC – producing tumor regressions
  • A well tolerated side effect profile with the most common side effect being elevation of liver enzymes

An example CT-scan image from trial is shown below (Figure 5C, Halama et al. Cancer Cell (2016), Figure used with permission).  This shows the total resolution of a MSS-CRC lung metastases (indicated with black arrow in the left image) of a patient receiving Maraviroc as monotherapy.

maraviroc_monotherapy_lung-activity

Following an initial treatment period of Maraviroc monotherapy, a number of patients on the trial began to receive previously failed chemotherapy in combination with Maraviroc (Table 4, Halama et al. Cancer Cell (2016), Table used with permission).  As shown, in the eight patients studied in this portion of the Clinical Trial, 3/8 patients showed a partial response of at least 30% tumor shrinkage and the remaining 5/8 patients all showed signs of clinical benefit.

maraviroc_combination-with-soc-chemo-table

All of this is quite exciting as far as preliminary data from a very small (14 patient!) Phase 1 trial can go.  A follow-up larger confirmatory Phase 2 trial, including study arms combining Maraviroc with either immunotherapy or chemotherapy drugs is slated to begin in Germany in January of 2017.

The specific repositioning aspect of this preliminary CRC data on Maraviroc has a number of interesting consequences however.  First of all, more than one company has done R&D on CCR5 receptor antagonists which leads to the possibility of relatively rapid large confirmatory US-clinical trials of CCR5 receptor antagonists – whether of Maraviroc or of a different CCR5 receptor antagonist – starting up.  Confirmatory trials, which if successful, could lead to a much faster than normal path to FDA approval for CRC use.

Secondly, Maraviroc is already FDA-approved (for anti-HIV use) and commercially available.  This opens up the possibility of off-label use while confirmatory studies are still in progress.  Oncologists can legally prescribe drugs off-label for their patients to use, if it is in their medical opinion that based upon clinical data (even if only preliminary) the drug could provide clinical benefit to their patients.  I anticipate that this is a medical discussion that will be happening between many CRC patients and their doctors based upon: the preliminary clinical data published in this Cancer Cell paper, the absence of a US clinical trial option (for now) and the known clinical safety profile of Maraviroc from its use in the AIDs patient population.

Where Do Things Stand Now?

This study was very small, only 14 (!) MSS-CRC patients – and small studies sometimes do not confirm in later larger clinical trials. But signs of clinical efficacy were seen in a significant proportion of the patients including objective responses.  It is also intriguing that the study showed that Maraviroc could be given both as a monotherapy as well combined with multiple types of standard of care chemotherapy for CRC – in both cases showing objective responses. 

The confirmatory Phase 2 trial will be starting soon in Germany (January, 2017).  The current Phase 1 trial data may only be preliminary but unfortunately the prognosis of many Stage IV MSS-CRC patients may not allow a lifespan long enough to wait for the German Phase 2 trial results to be known.

Looking at the commercial availability of Maraviroc and its preliminary clinical profile in MSS-CRC patients, it is likely that many stage IV CRC patients will be seeking the medical advice of their oncologists on its potential off-label use, especially as they begin to run out of standard of care treatment options.  In my own case, my standard of care options are dwindling and my life is on the line.  In that situation, it is an easy decision in my mind to ask for medical advice from my oncologist. The outcome of these medical advice discussions will be very patient specific – but I for one, know I will be having that discussion!

Of note: If you decide to ask your oncologist about Maraviroc, I strongly recommend bringing him/her a printout of the full scientific/trial paper I have hyperlinked in this post.  It contains much more information for them to use to make a medical judgement than I could fit into a blog post.  Buying it as a single paper PDF download is $30 – it would also be available free from any college or university library. 

Recycling is good for society, good for the planet, and in this case it may be good for MSS-CRC patients!

 

 

 

43 Comments on “In Case of Emergency, Break Glass

  1. Thanks for the upddate, Tom. Break all the glass necessary to get to the next step in your recovery!

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  2. “Cancer is wily foe. It surprises you when you least expect it. To combat that kind of foe, you need to have your own surprises lined up. And this is mine. My goal has not changed, just some facts on the ground. My goal is to beat my cancer, using science and my brain as my weapons, by any means necessary. Today was I disappointed? Yes. A bit scared? Yes. Deterred? Never.”
    YES. BIG YES.
    Onward, my friend! Got your back xoxox

    Like

    • Tom, you have an amazing attitude and a great back up plan. I may be stealing yor plan. You are an inspiration to all of us who all face unhappy surprises in our battle. Always have a plan B at the ready!

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  3. “This is why you should always have plenty of planes on your taxiway – you never know when one might be needed.” Words to truly live by…I continue to learn, be inspired and make change because of you and your journey. I will be thinking the best, most healthy thoughts for you! Continue to kick ass!!

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  4. You are such an inspiration! I love that you are your own secret weapon! Sending positive thoughts your way!!

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  5. So sorry to hear your change of events, but glad to see the fight is still on. I have some similarities as I have been told we need to try a clinical trial as my MSS-CRC appears to be quite resistant after we thought we finally were making progress following surgery, micro-wave ablation, two courses of aggressive chemo, and sterotactic radiation during the past year. I went skipping in for a CT scan feeling great, and … lesions growing in the same location again!!!! WHAT?? My oncologist describes as a “difficult situation” and we are looking for a clinical trial that I may potentially benefit from. I have been following along, and appears your roller coaster is also continuing. THe info will be some that I will ask about, especially if we strike out on finding a suitable trial.

    I appreciate you sharing your battle, as it gives others the hope that we need to keep fighting… even when you may not want to. There is nothing else to do but to keep fighting. Right now I am waiting on others and having patience for this is one of the most difficult things I have had to do.

    Just another challenge or hurdle to get over, as we move forward. I really want the Maraviroc to work. We need to beat it.

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  6. I was diagnosed Stage IV in Nov 2013, mets to lymph nodes, liver and lung. 12 rounds of 5FU and Avastin and continuing maintenance on Xeloda/Avastin resulted in primary tumour in colon disappearing, lymph and lung all clear but those pesky liver mets……… not a candidate for surgery never will be had to get a nice big tumour around the main portal vein didn’t I. Am feeling your disappointment but also spurred on by your relentless optimism – so glad I found your blog. Hang in there – everyone reacts differently to treatments, the nature of the disease but the work you are doing and the trials you inform us about are vital to us all – thank you.

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  7. Oh my goodness, what a post! Tom, you are a true inspiration, this sounds like an incredibly good plan, thank you for sharing, all the very, very best to you.

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  8. Hi Tom,

    I’m very sorry to hear this bad news. My mother has many mets on her liver (liver limited) and due to very encouraging recent studies from a norwegian surgery group we currently prepare for a living donor liver transplantation in Germany (no trial, a regular individual cure attempt). I suppose you know these studies which were published in top journals like the Annals of Surgery. Average 5 year survival was 60% for the liver transplantation arm and 9 for the chemotherapy arm, so the results were excellent compared to the alternative and was also superior to results from two-stage hepatectomy.
    Following this surprisingly good results there are now several further ongoing trials on liver transplantation for colorectal cancer, for instance in Toronto, Paris and Norway.
    Maybe you could also add this option to you set of choices…

    Wish you the best!
    Sven

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    • Oh one additional remark: the results were also good for people with mets that are not only limited to the liver. For instance lounge mets are not considered as a contra indication.

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    • Correct, Maraviroc is a systemic treatment (pill), in theory it can treat my tumors elsewhere as well (lungs, lymph nodes)… Take care, Tom

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  9. Tom. I am sorry your plane was temporarily diverted, and not surprised by your ability to change course. I have a question about your comments on Maraviroc. I understood that the cost would be between $1400 – $2000 a month. Can an oncologist write a prescription for Maraviroc that would make it more affordable? Thank you for this blog and your never ending enthusiasm for life.

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    • Hi Gail, I have heard a huge range in prices as people have shopped around in the range of $650-$2000 a month. Certainly not a small amount of money but an amount achievable by some and an amount potentially small enough for a gofundme campaign – certainly much smaller than many cancer drugs which cost $100,000+/year. The oncologist will not be able to prescribe a cost discount directly. IF after a medical discussion with your oncologist he/she believes it is in your best medical advice to give it a try, I certainly recommend “shopping around various US drug stores/suppliers to find the cheapest choice -. Best of luck and thank you for your message.

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  10. My heart goes out to you and may the CCR5 inhibitor work out! Sending all the positive thoughts.

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  11. Tom,
    I’m glad to find your blog. My mother’s cancer is MSS. I am Japanese. Recently a useful news was released in Japan.

    Mitochondrial activation chemicals synergize with surface receptor PD-1 blockade for T cell-dependent antitumor activity
    doi: 10.1073/pnas.1620433114
    One of the authors is PhD. Honjo. He is the PD-1 discoverer. Bezafibrate is a drug of Hyperlipidemia and it is known very cheap, safe. We can easily adopt off-label use.
    In Japan, PD-1 inhibitor with bezafibrate clinical trial is planed for the patients with lung cancer.

    Additionally, Maraviroc is a drug of CCR5. You know that not only CCR5 also CCR2 may important for cancer therapy. CCR2 inhibition with chemotherapy FOLFIRINOX is good for pancreatic cancer. In Japan propagermanium is approved for the drug of Hepatitis B, very cheap, safe, and it is known as CCL2 inhibitor.(a trade name: Seroshion)
    Please check this article blow.
    F-box protein Fbxw7 inhibits cancer metastasis in a non-cell-autonomous manner
    doi: 10.1172/JCI78782
    In Japan, propagermanium trial is ongoing in the breast cancer and colorectal cancer
    UMIN000022494, UMIN000022129
    I want to know results of these trial…

    I hope that these informations will be useful for you.

    Liked by 1 person

  12. I am so sorry to read about this diversion. I am glad to read that you have a plan. My husband is an engineer and I asked him to help me follow some of your more scientific writings so he shares my concern for you but thinks in ways that you do. Have more than one plan. Next week we will see if we need to implement our next ideas. I think of you often and am so grateful to have found your blog. Hugs to your family as well.

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  13. Tom,
    Wishing you complete success in fighting this wily foe. Your attitude, knowledge and planning continue to inspire! To Life!!
    Diana

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  14. Hi Tom, I must be a bit like you. I am on Plan A Chemo, but I made damn sure that my oncologist has a Plan B and Plan C. All the best to you from New Zealand , Regards – Lisa

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  15. WHY are you overlooking cobimetinib and atezolizumab. THis is a PHASE 3 trial! you’ll find no other Phase 3 trials with as much background success. The Phase 1 results are not squeaky clean but this combo went directly from Phase 1 to Phase 3. That is very rare. This trial is worth a serious look.

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    • Hi Mike – This trial, for the reasons you mentioned, has already completely filled up all accrual slots in the United States – it is no longer available to incoming patients. -Tom

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  16. Thank you so much for much for continuing to share your story, educate us all, and fight the good fight. You are incredibly inspiring and us colon cancer patients are so lucky to have you! Sending lots of prayers and positive energy to you and your family.

    Like

  17. Hi Tom,
    I have already mentioned that we currently prepare for a living donor liver transplantation for my mother. Is this something you would also consider or absolutely not? If you exclude this option, is there a special reason which I potentially overlooked?

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    • Hi Sven, I would not be given this opportunity I believe because I have widespread disease outside the liver. Outside of trial it is not a part of standard of care in America. All the best to you and your mother! -Tom

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      • In Germany it is the same and liver transplantation is actually not considered as an option for the treatment of liver metastases. But due to the recent very encouraging studies some surgeons now think it is worth trying. As mentioned, the studies showed that liver transplantation was even succesful for patients which additionally had metastases to the lungs. In our case the donor liver is to small for my mother but the center now suggested the so called RAPID concept as an alternative (some kind of an ALPPS operation , https://www.ncbi.nlm.nih.gov/pubmed/25692361). In any case, it is not hopeless to contact several centers and maybe you find a center that gives you this opportunity. If not, I know that ASAN Medical center (which is the best center for liver transplantation worldwide), would certainly do this. Anyway, I am very thankful for the help you provide to so many desperate families and I wish you all the best. My prayers are with you.
        Sven

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  18. I checked it out and unfortunately it is currently closed. HOWEVER, I communicated with Dr. Cathy Eng, and they are hoping to convince Genentech to open the study for more US slots.

    Cathy Eng, M.D., F.A.C.P.
    Professor
    Sophie Caroline Steves Distinguished Professor in Cancer Research
    Associate Medical Director, Colorectal Center
    Director of Network Clinical Research, GI Medical Oncology
    The University of Texas M. D. Anderson Cancer Center
    Department of Gastrointestinal Medical Oncology
    1515 Holcombe Blvd, Unit 426
    Houston, TX 77030
    Office: (713) 792-2828
    Fax: (713) 794-1873

    Please keep in touch with someone involved in this trial. You may have the chance to consider this trial again with openings. If you are faced with systematic progression following all conventional treatments please ask Genentech to donate these drugs outside of the trial. I know for a fact that they can and have donated these drugs!

    Hang in there, things are moving quickly!

    Liked by 1 person

    • Thank you Mike! It is on my list of options, I think there is a good chance I could get it compassionate use if it was medically advanced to the first plane on my taxiway! All the best -Tom

      Like

      • Thank you for sharing your treatment plans. Your posts about your treatment make me feel like I have a someone super-smart sitting next to me at the computer, helping me figure out where to look and what to analyze.

        I wanted to mention that we (i.e., my wife, who is Stage IV CRC, MSS, NRAS-mutant) received cobi + atezo free from Genentech in November 2016 through their compassionate use process, which is explained on their website. Genentech was quick to approve our application and very easy to deal with thereafter. Pam did 6 treatment cycles and had adverse reactions significant enough to require two treatment interruptions. Really tough drugs. She stopped when scans at the end of December early February showed continued progression, and we are on to a Mass General phase I trial involving trametinib and navitoclax (NCT02079740).

        All the best to you.

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      • Hi Lisa, thank you for sharing the story of your wife. I am sorry that Atezo/Cobi did not work for her but I am heartened that you found the Genentech compassionate use program well run and easy to work with – that is great to hear! Best of luck on the new trial (NCT02079740) combination of a Bcl-2 inhibitor + MEK inhibitor! Wishing your entire family the very best, -Tom

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  19. Tom – Im really really sorry to read this. I know how much the trial meant to you from reading just how happy you were to get accepted late and the extent you went to to be part of it. I really hope this is just a little diversion and you get back on track asap.

    You may know of this also but there is a company listed in Australia called SirTex (SRX AU) that essentially has developed internal radiation spheres for liver mets with some success. They noted recently that ‘competition’ had increased (not sure exactly if this competition is a better method) but I hope that means there are other avenues for you to look into. http://www.sirtex.com/us/ . I know its not as advanced as immuno etc but I hope it gives you another plane as you mention.

    You are such an inspiration for us all and a massive wealth of knowledge that we are all so grateful to have learned from. I wish you absolutely every ounce of success to get through this and back onto your trial. I have faith you will do this as you have shown us your resilience many times before. Go get em mate.

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  20. Pingback: Working to Save My Life (and Ending Up With a Full Hour Interview on The Charlie Rose Show!) | AdventuresInLivingTerminallyOptimistic

  21. Tom, so sorry your clinical trial is on hold right now. Hoping your “In Case of Emergency, Break Glass” plan will be just what you need right now!
    Unfortunately, my now 47 yr. old son was diagnosed a year ago with stage IV CRC -K-RAS wild, with numerous tumors in liver. Because he was apparently very healthy, an “Iron Man” and marathon runner, we were all floored by this. He has been on chemo but am afraid the liver lesions are coming back strong now. Surgery is out. I am searching desparately for a clinical trial now. Your blog is helping me, a non scientist, to understand some of this, but it is so complicated. Please know your words have power for all of us searchers. Thank you! Know you are being lifted !

    Like

  22. I’m so inspired by your blog. I was Dx Stage 4 ovarian cancer at age 39 in 2013. I was not expected to live past one year. With the support of my parents, siblings, husband and children (ages 1, 4, 6, and 18 at time of Dx) – I’m still here. My cancer “switched up” on me in late 2015, after a wonderful 20 month remission. It mutated to a more aggressive form, and metastasized to my breast. While the rest of the tumors in my body grow at a slower rate, the tumor in my breast increases in size dramatically fast. I had the breast tumor removed in Oct 2016 with no implant placed into the breast, and 3 months later, the tumor came back so quickly that it filled my breast back up to a “B” cup. I’m currently on a trial for EpicentRx’s RRX-001. It works on the macrophage level of the tumor cells, hopefully to cause the tumor cells to resensitize to platinum based chemo. This is the link: http://www.epicentrx.com/?page_id=112
    I saw some notes on their site about CRC and RRX-001. It might be worth something to you to take a look at it and see if you can add it to your arsenal. Good luck to you. I will keep you in my prayers.

    Like

    • Thank you for your comment – I have definitely been intrigued by RRx-001 for a number of years now (as you saw with my blog post on it!) – I sincerely wish you the best of luck and please check back in! Stay hopeful – there are therapeutics coming down the pipe that look amazing in preclinical testing – we are truly entering a golden age of oncology drug discovery… which as a fellow Stage IV patient I am ecstatic for myself, beyond my excitement as a scientist! Take care -Tom

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      • My apologies, as I’m new to your blog, and I haven’t yet made it to all the past posts. I will search for the one that you wrote mentioning RRx-001 and read it. Best wishes,
        J. Radz

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      • RRx-001 has a very unique and fascinating story! I hope it makes it in the Clinic! Fingers crossed!

        Like

  23. Pingback: Chemo Through the Years (Hope is Very Much Alive!) | AdventuresInLivingTerminallyOptimistic

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  25. Hi Tom,
    Hope your SIRT procedure went well and all is great.
    I wanted to ask you about this post, did you try this Maraviroc? What you wrote about it and the cited paper are very convincing. Do you think this will be relevant in case of nonsmall cell lung cancer, or is CCR5 irrelevant for NSCLC?? if you have any advice about this I would appreciate that since my dad just started chemo for stage 4 NSCLC.
    Best
    Farah

    Like

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