Hello everybody!
Can I ask for help in choosing a German clinic for immunotherapy?
At the moment, we only have histology and immunohistochemistry, the location of tumor left temple - that's all we know so far.
1.Histology.
this is a very cellular glial neoplasm consisting of pleomorphic, atypical gemistocytic astrocytes which diffusely infiltrate the cerebral cortex and subcortical white matter, forming secondary structures of Scherer. Mitotic figures, including atypical forms, are readily recognized, as well as prevascular lymphocytic infiltrates and foci of microvascular proliferation. In addition, there are large areas of confluent necrosis with early organisation and some trombotic blood vessels.2.Immunohistochemistry:ki-67 ( sp6)- positive tumor expression to 15 %Bcl-2a Ab-1 (Clone 100/D5)- tumor expression weakly positive,p53 ( clone Sp5) positive expression to 5 %/And another part of brain (left temple)/ki-67- positive expression to 5 %CD 45/T200/LCA Ab-2 ( clone PD7/26/16 +2B11)- positive expression in abscess,GFAP glial fibrillary Acidic Protein Ab-6(GFAP) positive expression.
Conclusion :Pleomorfhic glioblastoma ( ki-67- to 15 %) with a plot of abscecc.
Now we have a proposition to send blocks to clinic Hallwang to make tests ( Next generation Sequencing 3+tumor surface makers and amplification analysis 9500 euro, and Screening for tumor Associated Antigens TAA 3800 euro) to start producing of vaccines.
( From mail from clinic: It is known, that tumors show the accumulation of several genetic modifications, thus providing cancer cells with the selective growth advantage to initiate expansion. Now, sophisticated high-throughput technologies enable the identification of these mutated genes in cancers, leading to potent targeted immunotherapy - by so called tumor-associated–antigen-
Another one proposal is from Dr. H. Bojar.
Can I ask for help in choosing a German clinic for immunotherapy?
At the moment, we only have histology and immunohistochemistry, the location of tumor left temple - that's all we know so far.
1.Histology.
this is a very cellular glial neoplasm consisting of pleomorphic, atypical gemistocytic astrocytes which diffusely infiltrate the cerebral cortex and subcortical white matter, forming secondary structures of Scherer. Mitotic figures, including atypical forms, are readily recognized, as well as prevascular lymphocytic infiltrates and foci of microvascular proliferation. In addition, there are large areas of confluent necrosis with early organisation and some trombotic blood vessels.2.Immunohistochemistry:ki-67 ( sp6)- positive tumor expression to 15 %Bcl-2a Ab-1 (Clone 100/D5)- tumor expression weakly positive,p53 ( clone Sp5) positive expression to 5 %/And another part of brain (left temple)/ki-67- positive expression to 5 %CD 45/T200/LCA Ab-2 ( clone PD7/26/16 +2B11)- positive expression in abscess,GFAP glial fibrillary Acidic Protein Ab-6(GFAP) positive expression.
Conclusion :Pleomorfhic glioblastoma ( ki-67- to 15 %) with a plot of abscecc.
Now we have a proposition to send blocks to clinic Hallwang to make tests ( Next generation Sequencing 3+tumor surface makers and amplification analysis 9500 euro, and Screening for tumor Associated Antigens TAA 3800 euro) to start producing of vaccines.
( From mail from clinic: It is known, that tumors show the accumulation of several genetic modifications, thus providing cancer cells with the selective growth advantage to initiate expansion. Now, sophisticated high-throughput technologies enable the identification of these mutated genes in cancers, leading to potent targeted immunotherapy - by so called tumor-associated–antigen-
Besides this test we would strongly suggest one of the most upfront analytic approaches by next generation sequencing (NGS). We entered the third generation of NGS, namely NGSIII that offers the analysis of all therapeutic relevant cancer driving mutations, thus offering the chance for a targeted genetic therapy and an efficient immunotherapy.)
Vaccine design
1. Transcriptome analysis (activity of all 20 000 human genes) including selected immunohistochemical analyses: 1 500 €
2. Exome analysis tumor DNA versus blood DNA (mutation analysis of all 20 000 protein-coding genes): 6 500 €
3. HLA class I & II haplotype determination:
Vaccine production
1. Synthesis of 10 mutated neoantigen peptides
2. Production of the vaccine cocktails incl. quality control (sterility etc.)
Also we are still waiting for information from another clinics from Stephen list of german clinics.
can I ask to help me understand? the price of the study of the tumor is very different if a higher price is justified? I apologize in advance for the stupid question, certainly I ask about elementary things.
Thank you in advance!
Tania.
Active specific immunotherapy in order to induce an immune reaction against a tumor is not easy. The vaccine requires three important components: 1/ tumor antigens so that the immune system can be targeted to these; 2/ a vehicle to bring the tumor antigens towards the immune system; and 3/ a danger signal so that the immune system becomes activated. 1/ There are several ways to prepare tumor antigens. Without need of genetic testing, one can obtain tumor antigens out of tumor tissue and make them immunogenic (Vandenberk et al. Onco-Immunology 2015;11: 5(2):e1083669). The advantage of the use of immunogenic tumor lysate is that all potential antigens from different components of the tumor are covered: bulky tumor cells, infiltrating tumor cells, tumor stem cells. 2/ Most centres use patient-specific mature dendritic cells as vehicle to bring the tumor antigens towards the immune system (Van Gool. Front Oncol 2015;5:98). These cells are produced according to the current legislation for Advanced Therapy Medicinal Products. The quality controls to produce these personalized vaccines are the main cause of the costs of the vaccine. 3/ The danger signal in the tumor micro-environment and in the vaccine is induced with Newcastle Disease Virus, which itself causes also immunogenic tumor cell death (Koks et al. Int J Cancer 2015;136:e313-25). Only IOZK has the license from the German authorities to integrate Newcastle Disease Virus within the dendritic cells as complete anti-tumor vaccine. With the multimodal immunotherapy an increase in long-term overall survival is aimed. The therapy is available on an individualized basis. Side effects are minimal.
ReplyDeleteThank you for your comment, SVG!
ReplyDeleteWe are still waiting reply from IOZK...
It is very difficult for me to understand the theme of the vaccine. Thank you for such a detailed answer, it helped me a lot!
Tania.
Hi Tania
ReplyDeleteI heard from another patient that there are also other places to get the virus vaccines
they called them thallervirus?
Mary
Hello Tania,
ReplyDeleteI have been treated with immunotherapy at the Hallwang clinic, and had both TAA screening and NGS. Luckily, they found 2 antigens to target, and I received a first round of 5x vaccines, followed by boosts every two to three months (1 shot only). I can only recommend the Hallwang clinic. I have done LOTS of research and found the clinic to be very professional, honest and realistic. Two of the doctors, including Dr Nolting, hold an extensive research background on cancer immunotherapy, so they really know what they are talking about instead of just "selling" it to you. But what amazes me most are the results from me and my fellows here at the clinic. Most of them, including me, had tons of chemo and/or radiation before, and nowhere else to go. My doctor did not want to offer me any more treatment. And now----I am living already 8 months more than my former doctors expected, my tumor markers dropped and I am feeling alive. I came in a really bad stage to the clinic and I am so grateful for what they have done for me and can only recommend the clinic and their doctors. As I studied biology myself, I was quite impressed with what they offer and how close to research and clinical trials they are. Most clinics I visited or talked to just copied stuff and made it sound nice without having the actual background. From what I have seen, patients here come with all kind of cancers and show great results, even with pancreatic cancer and brain tumors, which we know, are very aggressive. Hope you find the right treatment for you,
Andrea
Andrea, Marie, thanks!)
ReplyDeleteHello,
ReplyDeleteWas You at Hallwag? any results ?
Best wishes,
Dmitry
Hi Tanya thanks for your post I have been looking at Hallwang for my father. We are being fobbed off with really slow times with the NHS and don't have that time to wait now. I know they have tests to do but honestly, how long ws it before you started actual treatment?
ReplyDeleteThank you
Hi, Totallyrocks! we have been in Hallwang.
ReplyDeleteDr. Noltin reported that part of the test and is ready to draw conclusions, and then we waited for the next results. The first data came about a week after we sent bloks to the clinic. I'm not happy with the clinic. They may forget to ask for some data in the test, or to submit a bill for 5,000 euros higher than the need, to say that will be discharged some supplements and not write. So, you have to control always. Unfortunately, we have no results with vaccines.
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ReplyDelete