Update

There's also Merck's EAP NCT02083484. Seems like you would qualify. Although it is also PD1 one of my 3 medical oncologists had 5 PD1s going on at the same time last year and he said he could tell the difference by manufacturer. Apparently each PD1 is made differently. Thought it might help get you through until you get in the trial you want or maybe it would work great for you.

Agree with Arthur, the previous use of nivo (BMS antiPD1) is not a exclusion criteria for Mercks EAP.  You should try to get in this trial ASAP.  I am not sure how big your tumour load is but for TILs they need to remove a certain size tumour for multiplying the TIL cells he lab, and I don't know if the 3cm liver tumour is big enough (not to mention is hard to get to it).

keep us in the loop, fingers crossed you can get accepted in the Mercks EAP!

Agree with Arthur, the previous use of nivo (BMS antiPD1) is not a exclusion criteria for Mercks EAP.  You should try to get in this trial ASAP.  I am not sure how big your tumour load is but for TILs they need to remove a certain size tumour for multiplying the TIL cells he lab, and I don't know if the 3cm liver tumour is big enough (not to mention is hard to get to it).

keep us in the loop, fingers crossed you can get accepted in the Mercks EAP!

Agree with Arthur, the previous use of nivo (BMS antiPD1) is not a exclusion criteria for Mercks EAP.  You should try to get in this trial ASAP.  I am not sure how big your tumour load is but for TILs they need to remove a certain size tumour for multiplying the TIL cells he lab, and I don't know if the 3cm liver tumour is big enough (not to mention is hard to get to it).

keep us in the loop, fingers crossed you can get accepted in the Mercks EAP!

There's also Merck's EAP NCT02083484. Seems like you would qualify. Although it is also PD1 one of my 3 medical oncologists had 5 PD1s going on at the same time last year and he said he could tell the difference by manufacturer. Apparently each PD1 is made differently. Thought it might help get you through until you get in the trial you want or maybe it would work great for you.

There's also Merck's EAP NCT02083484. Seems like you would qualify. Although it is also PD1 one of my 3 medical oncologists had 5 PD1s going on at the same time last year and he said he could tell the difference by manufacturer. Apparently each PD1 is made differently. Thought it might help get you through until you get in the trial you want or maybe it would work great for you.

Here's one Catherine Poole posted on MIF several months ago:

The first is called the NEMO trial by Novartis, it is for NRAS positive folks only.
It is a randomized phase III trial with their Mek inhibitor. Look it up at Clinicaltrials.gov by: NCT01763164

Here's one Catherine Poole posted on MIF several months ago:

The first is called the NEMO trial by Novartis, it is for NRAS positive folks only.
It is a randomized phase III trial with their Mek inhibitor. Look it up at Clinicaltrials.gov by: NCT01763164

Here's one Catherine Poole posted on MIF several months ago:

The first is called the NEMO trial by Novartis, it is for NRAS positive folks only.
It is a randomized phase III trial with their Mek inhibitor. Look it up at Clinicaltrials.gov by: NCT01763164

Dana,

If you are mage positive you may be eligible for this trial at NCI.  Terrie on this site is currently in the trial.

This one is a little different than TIL. I'm not sure of all the technical jargon but basically it sounds like they genectically alter your white blood cells to recognize the mage antigen on the melanoma. Pretty amazing stuff. One advantage of this trial is I don't think you have to have resectable melanoma to harvest the TIL cells. It sounds like they do leukapheresis to obtain the white blood cells. They then genectically alter them. The patient first does chemo, then the white blood cells are reintroduced, and lastly a couple rounds of IL-2.

http://clinicalstudies.info.nih.gov/cgi … C-0052@@@@
 

Dana,

If you are mage positive you may be eligible for this trial at NCI.  Terrie on this site is currently in the trial.

This one is a little different than TIL. I'm not sure of all the technical jargon but basically it sounds like they genectically alter your white blood cells to recognize the mage antigen on the melanoma. Pretty amazing stuff. One advantage of this trial is I don't think you have to have resectable melanoma to harvest the TIL cells. It sounds like they do leukapheresis to obtain the white blood cells. They then genectically alter them. The patient first does chemo, then the white blood cells are reintroduced, and lastly a couple rounds of IL-2.

http://clinicalstudies.info.nih.gov/cgi … C-0052@@@@
 

Dana,

If you are mage positive you may be eligible for this trial at NCI.  Terrie on this site is currently in the trial.

This one is a little different than TIL. I'm not sure of all the technical jargon but basically it sounds like they genectically alter your white blood cells to recognize the mage antigen on the melanoma. Pretty amazing stuff. One advantage of this trial is I don't think you have to have resectable melanoma to harvest the TIL cells. It sounds like they do leukapheresis to obtain the white blood cells. They then genectically alter them. The patient first does chemo, then the white blood cells are reintroduced, and lastly a couple rounds of IL-2.

http://clinicalstudies.info.nih.gov/cgi … C-0052@@@@
 

These were the ones I was looking for:

http://clinicaltrials.gov/ct2/show/NCT01941927 (Phase 2, wild-type only)
http://clinicaltrials.gov/ct2/show/NCT01138085 (Phase 1, any type I think)
 

These were the ones I was looking for:

http://clinicaltrials.gov/ct2/show/NCT01941927 (Phase 2, wild-type only)
http://clinicaltrials.gov/ct2/show/NCT01138085 (Phase 1, any type I think)
 

These were the ones I was looking for:

http://clinicaltrials.gov/ct2/show/NCT01941927 (Phase 2, wild-type only)
http://clinicaltrials.gov/ct2/show/NCT01138085 (Phase 1, any type I think)
 

One quick note to my prior post…  some newer trials for TIL, including at least one at NIH, do not require a round of IL-2 to be administered after infusion of the TIL cells.

One quick note to my prior post…  some newer trials for TIL, including at least one at NIH, do not require a round of IL-2 to be administered after infusion of the TIL cells.

What doesTIL stand for? What is the process? Sorry to be so uninformed. Thanks

What doesTIL stand for? What is the process? Sorry to be so uninformed. Thanks

Thanks Joey.  That was fantastic. 

Have you watched this?

http://webcast.aacr.org/console/player/23029?mediaType=audio&

It's Dr. Rosenburg's latest twist to his TIL treatment where he is "personalizing" the TIL treatment based on the patients cancer mutations.  Pretty neat stuff.

I think I remember seeing a trial where Dr. Weber at Moffitt is combining TIL and ipi.  I remember reading sometime last year where Moffitt got a big grant to further their TIL research.

Thanks Joey.  That was fantastic. 

Have you watched this?

http://webcast.aacr.org/console/player/23029?mediaType=audio&

It's Dr. Rosenburg's latest twist to his TIL treatment where he is "personalizing" the TIL treatment based on the patients cancer mutations.  Pretty neat stuff.

I think I remember seeing a trial where Dr. Weber at Moffitt is combining TIL and ipi.  I remember reading sometime last year where Moffitt got a big grant to further their TIL research.

Dana, the possibility of radiation or surgery delaying treatment is a valid concern. Also keep in mind that, especially for the bone met, they might prefer that you have surgery prior to treatment. As I wrote in response to an earlier post of yours, I was in a similar situation with a bone lesion in my proximal humerus. We were ready to proceed with TIL, but at one of the scans closer to starting, the lesion had grown enough that my doctors were concerned about the risk of fracture. A fracture occuring when the immune system is weakened (or with TIL, completely depleted) would have been a very dangerous situation. Ultimately, I had the TIL about three months after my surgery, but it took about a month for them to grow my cels anyway – I probably could have started the TIL six weeks after finishing surgery, but there were some other complications that delayed the start.

Dana, the possibility of radiation or surgery delaying treatment is a valid concern. Also keep in mind that, especially for the bone met, they might prefer that you have surgery prior to treatment. As I wrote in response to an earlier post of yours, I was in a similar situation with a bone lesion in my proximal humerus. We were ready to proceed with TIL, but at one of the scans closer to starting, the lesion had grown enough that my doctors were concerned about the risk of fracture. A fracture occuring when the immune system is weakened (or with TIL, completely depleted) would have been a very dangerous situation. Ultimately, I had the TIL about three months after my surgery, but it took about a month for them to grow my cels anyway – I probably could have started the TIL six weeks after finishing surgery, but there were some other complications that delayed the start.

Dana, the possibility of radiation or surgery delaying treatment is a valid concern. Also keep in mind that, especially for the bone met, they might prefer that you have surgery prior to treatment. As I wrote in response to an earlier post of yours, I was in a similar situation with a bone lesion in my proximal humerus. We were ready to proceed with TIL, but at one of the scans closer to starting, the lesion had grown enough that my doctors were concerned about the risk of fracture. A fracture occuring when the immune system is weakened (or with TIL, completely depleted) would have been a very dangerous situation. Ultimately, I had the TIL about three months after my surgery, but it took about a month for them to grow my cels anyway – I probably could have started the TIL six weeks after finishing surgery, but there were some other complications that delayed the start.

Thanks Brian.  I haven't seen that presentation, although I have seen many of the slides in the first portion of it that report on melanoma specifically.  Amazing to me what they're doing with this; truly outsmarting cancer and beating it at it's own game, not allowing it to hide.  I count myself fortunate to have been treated by Dr. Rosenberg and his team of investigators, clinicians, researchers, and fellows.  I was so impressed by him and everyone I met there.  The attending physicians rotate on a one or two month cycle, so I had a chance to meet many of them during my scans and in-patient stays.

Yes, there are a number of trials combining TIL with ipi and other agents, including the BRAF inhibitors.  I also imagine that if one hasn't started already that they'll be combining it with anti-PD-1, too, very soon.  I know of at least one person who participated in the TIL:/ipi combo trial at Moffitt.  He had disease progression soon after completing the treatments and moved on to a PD-1 trial, where he's done quite well.  No telling for sure if the TIL/ipi combo ultimately played a role in a subsequent response to PD-1, but in my case, what seems clear is that even without a complete response, even a partial response can be durable and slow the disease down, with the effects of multiple immunotherapies being cumulative.  On more than one occasion, my medical onc has reminded me that my immune system is "primed".

Thanks again for sharing the presentation.  The findings made it to most of the mainsteam news outlets last month, but I hadn't seen this much detail.

Thanks Brian.  I haven't seen that presentation, although I have seen many of the slides in the first portion of it that report on melanoma specifically.  Amazing to me what they're doing with this; truly outsmarting cancer and beating it at it's own game, not allowing it to hide.  I count myself fortunate to have been treated by Dr. Rosenberg and his team of investigators, clinicians, researchers, and fellows.  I was so impressed by him and everyone I met there.  The attending physicians rotate on a one or two month cycle, so I had a chance to meet many of them during my scans and in-patient stays.

Yes, there are a number of trials combining TIL with ipi and other agents, including the BRAF inhibitors.  I also imagine that if one hasn't started already that they'll be combining it with anti-PD-1, too, very soon.  I know of at least one person who participated in the TIL:/ipi combo trial at Moffitt.  He had disease progression soon after completing the treatments and moved on to a PD-1 trial, where he's done quite well.  No telling for sure if the TIL/ipi combo ultimately played a role in a subsequent response to PD-1, but in my case, what seems clear is that even without a complete response, even a partial response can be durable and slow the disease down, with the effects of multiple immunotherapies being cumulative.  On more than one occasion, my medical onc has reminded me that my immune system is "primed".

Thanks again for sharing the presentation.  The findings made it to most of the mainsteam news outlets last month, but I hadn't seen this much detail.

Thanks Brian.  I haven't seen that presentation, although I have seen many of the slides in the first portion of it that report on melanoma specifically.  Amazing to me what they're doing with this; truly outsmarting cancer and beating it at it's own game, not allowing it to hide.  I count myself fortunate to have been treated by Dr. Rosenberg and his team of investigators, clinicians, researchers, and fellows.  I was so impressed by him and everyone I met there.  The attending physicians rotate on a one or two month cycle, so I had a chance to meet many of them during my scans and in-patient stays.

Yes, there are a number of trials combining TIL with ipi and other agents, including the BRAF inhibitors.  I also imagine that if one hasn't started already that they'll be combining it with anti-PD-1, too, very soon.  I know of at least one person who participated in the TIL:/ipi combo trial at Moffitt.  He had disease progression soon after completing the treatments and moved on to a PD-1 trial, where he's done quite well.  No telling for sure if the TIL/ipi combo ultimately played a role in a subsequent response to PD-1, but in my case, what seems clear is that even without a complete response, even a partial response can be durable and slow the disease down, with the effects of multiple immunotherapies being cumulative.  On more than one occasion, my medical onc has reminded me that my immune system is "primed".

Thanks again for sharing the presentation.  The findings made it to most of the mainsteam news outlets last month, but I hadn't seen this much detail.

Thanks Joey.  That was fantastic. 

Have you watched this?

http://webcast.aacr.org/console/player/23029?mediaType=audio&

It's Dr. Rosenburg's latest twist to his TIL treatment where he is "personalizing" the TIL treatment based on the patients cancer mutations.  Pretty neat stuff.

I think I remember seeing a trial where Dr. Weber at Moffitt is combining TIL and ipi.  I remember reading sometime last year where Moffitt got a big grant to further their TIL research.

Joe, I just want to say that I really appreciate your posts (TIL, melanoma response to radiation, etc.).  They are required reading!

Joe, I just want to say that I really appreciate your posts (TIL, melanoma response to radiation, etc.).  They are required reading!

Thanks for the feedback Mat, I'm glad it's helpful. I just looked at your profile and saw that you're at Penn. I saw Dr. Schuchter about a month after my original diagnosis to talk about what eventually became vemurafenib. We were trying to consider all of our options and my surgical onc at Fox Chase had done a fellowship at NIH 6 or 7 years prior, so also started us down the path of TIL. By the time we saw Dr. Schuchter, we had already visited and started the process of trying to get into the TIL trial. She basically said that if I was accepted to the TIL trial that she'd recommend we pursue it first, which we ultimately did. We're now back at Fox Chase, but I've been so appreciative of doctors like her and my surgical onc who are willing to honestly assess and recommend options to patients, even if it means sending them elsewhere.

Thanks for the feedback Mat, I'm glad it's helpful. I just looked at your profile and saw that you're at Penn. I saw Dr. Schuchter about a month after my original diagnosis to talk about what eventually became vemurafenib. We were trying to consider all of our options and my surgical onc at Fox Chase had done a fellowship at NIH 6 or 7 years prior, so also started us down the path of TIL. By the time we saw Dr. Schuchter, we had already visited and started the process of trying to get into the TIL trial. She basically said that if I was accepted to the TIL trial that she'd recommend we pursue it first, which we ultimately did. We're now back at Fox Chase, but I've been so appreciative of doctors like her and my surgical onc who are willing to honestly assess and recommend options to patients, even if it means sending them elsewhere.

Joe, thanks.  Yes, I'm very happy with Dr. Schuchter (and her staff!).  I moved my care to Penn following my Stage IV diagnosis and haven't looked back.

I read your post on TIL with great interest.  I pursued TIL at the NIH as an initial treatment when I was diagnosed last summer.  I was accepted, but when I went back for my surgery, I was re-scanned.  My tumor burden had increased substantially (in just 20 days), and the NIH sent me home.  That was a tough day . . . .  In any case, I'm grateful to be stable now with a significantly reduced tumor burden (primarily due to the GSK combo).  I plan to revisit TIL/NIH in the future should that become necessary.  I'm glad that you posted on TIL–aside from it being a very informative and detailed post, the reality is that we don't have a lot of patients on this site or MIF that have been through TIL.  You tend to hear more about the "challenging" stories than the good ones.  Thanks again.

Joe, thanks.  Yes, I'm very happy with Dr. Schuchter (and her staff!).  I moved my care to Penn following my Stage IV diagnosis and haven't looked back.

I read your post on TIL with great interest.  I pursued TIL at the NIH as an initial treatment when I was diagnosed last summer.  I was accepted, but when I went back for my surgery, I was re-scanned.  My tumor burden had increased substantially (in just 20 days), and the NIH sent me home.  That was a tough day . . . .  In any case, I'm grateful to be stable now with a significantly reduced tumor burden (primarily due to the GSK combo).  I plan to revisit TIL/NIH in the future should that become necessary.  I'm glad that you posted on TIL–aside from it being a very informative and detailed post, the reality is that we don't have a lot of patients on this site or MIF that have been through TIL.  You tend to hear more about the "challenging" stories than the good ones.  Thanks again.

Joe, thanks.  Yes, I'm very happy with Dr. Schuchter (and her staff!).  I moved my care to Penn following my Stage IV diagnosis and haven't looked back.

I read your post on TIL with great interest.  I pursued TIL at the NIH as an initial treatment when I was diagnosed last summer.  I was accepted, but when I went back for my surgery, I was re-scanned.  My tumor burden had increased substantially (in just 20 days), and the NIH sent me home.  That was a tough day . . . .  In any case, I'm grateful to be stable now with a significantly reduced tumor burden (primarily due to the GSK combo).  I plan to revisit TIL/NIH in the future should that become necessary.  I'm glad that you posted on TIL–aside from it being a very informative and detailed post, the reality is that we don't have a lot of patients on this site or MIF that have been through TIL.  You tend to hear more about the "challenging" stories than the good ones.  Thanks again.

Thanks for the feedback Mat, I'm glad it's helpful. I just looked at your profile and saw that you're at Penn. I saw Dr. Schuchter about a month after my original diagnosis to talk about what eventually became vemurafenib. We were trying to consider all of our options and my surgical onc at Fox Chase had done a fellowship at NIH 6 or 7 years prior, so also started us down the path of TIL. By the time we saw Dr. Schuchter, we had already visited and started the process of trying to get into the TIL trial. She basically said that if I was accepted to the TIL trial that she'd recommend we pursue it first, which we ultimately did. We're now back at Fox Chase, but I've been so appreciative of doctors like her and my surgical onc who are willing to honestly assess and recommend options to patients, even if it means sending them elsewhere.

Joe, I just want to say that I really appreciate your posts (TIL, melanoma response to radiation, etc.).  They are required reading!

What doesTIL stand for? What is the process? Sorry to be so uninformed. Thanks

One quick note to my prior post…  some newer trials for TIL, including at least one at NIH, do not require a round of IL-2 to be administered after infusion of the TIL cells.