Tuesday 13 March 2018

COC Protocol and study

Hey Stephen,

This article came to my attention - http://dailym.ai/2tJq8aJ and I decided to investigate a little.

That article relates to this study/trial --
Study of the Safety, Tolerability and Efficacy of Metabolic Combination Treatments on Cancer (METRICS)   https://clinicaltrials.gov/ct2/show/NCT02201381

The protocol is all about repurposing 4 well know drugs. It originated in London - http://careoncologyclinic.com/ and is now in the US https://careoncology.com/  They mention some strong data related to GBM OS of 27.1 months.

Here's their paper on their Metabolic Combination Therapy http://bit.ly/2tOUKHU  

Here's their patent info https://patentimages.storage.googleapis.com/96/0b/f7/6cab0db42f7dab/US9622982.pdf

Are you at all familiar with this?  Thank you.
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13 comments:

  1. Stephen W13 March 2018 at 15:43

    Yes I'm familiar with the Care Oncology protocol, and it has been discussed on the blog previously (see the "care_oncology_clinic" label).

    Also see my comments on Annie's post which came just before yours.

    The 27.1 months median is encouraging, but I'm waiting to see the details in publication (patient characteristics, time of recruitment into trial - how many patients were enrolled after completion of standard therapy, and how long after?)

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  2. Guy Lipof13 March 2018 at 16:46

    Very interesting, two inhibitors, an antibacterial agent and an antiprotozoal agent. I'd like to see the clinical trial details and if it will be picked up for Phase II or III confirmation.

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  3. Maria Teixeira15 March 2018 at 09:40

    I emailed Thomas Seyfried and he provided careoncology website and tools for implementing the ketogenic diet. His response was sort of a stock response with some personal words to me...but interesting that he recommends them too.

    The tumour they removed from my brain is IDH1 mutated and has p53 loss ... which in theory makes it extremely vulnerable to metabolic deprivation but IDH1 complicates that. If the tumour is p53 negative then I’d suggest reading some pubmed articles on metabolism and p53. This is the biggest reason I’m giving keto a try.

    I can share Thomas Seyfried’s email if you don’t want to email him yourself.

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    1. Stephen W15 March 2018 at 12:51

      New review of ketogenic diet for brain tumors here:

      https://www.frontiersin.org/articles/10.3389/fnut.2018.00011/full

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  4. Semyon18 March 2018 at 18:03

    "Oral atorvastatin up to 80mg uid, oral metformin up to 1000mg uid, increased to bid, oral doxycycline 100mg uid, oral Mebendazole 100mg uid".

    What means "uid"?

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    1. Stephen W18 March 2018 at 18:20

      Apparently it means "once daily" as in this abstract:

      https://www.ncbi.nlm.nih.gov/pubmed/1485591

      but it's not that common, I've never seen it used before. Usually once daily is abbreviated "qd" from the Latin quaque die.

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    2. Stephen W18 March 2018 at 18:22

      I confirmed that u.i.d. means "once daily" in a book online called "Calculations for Veterinary Nurses".

      https://books.google.ca/books?id=kzjcMdZxMRUC&pg=PT23&lpg=PT23&dq=uid+once+daily&source=bl&ots=ce_p5w_D4d&sig=jcfoqudx30pdGMEbkbP4CAwIZH4&hl=en&sa=X&ved=0ahUKEwjQ2Jy4m_fZAhWIs1QKHU9BALUQ6AEITjAD#v=onepage&q=uid%20once%20daily&f=false

      Delete
    3. Stephen W18 March 2018 at 18:28

      I never studied Latin but Google say "one" is "unus" in Latin. i.d. is for the Latin "in die".

      Delete
    4. Semyon18 March 2018 at 19:36

      Thank you, dear Stephen!

      We are now using a ketogenic diet + "Metabloc" regimen. We can not use everything at once, but given these articles, we will have to add something.

      We will begin to add Mebendazole 100mg during lunch and Metformin 500mg after breakfast and 500mg after dinner.

      Since in another study the dose of Mebendazole is 2-3 grams per day, it is very strange that a dose of 100 mg can be useful ...

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    5. Stephen W18 March 2018 at 22:16

      100 mg of mebendazole is useful for killing intestinal worms, which is its approved indication. I have strong doubts that this low dose is useful for brain tumors.

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    6. Stefan4 August 2018 at 13:05

      In a description of the clinical trial
      https://clinicaltrials.gov/ct2/show/NCT01837862, they say

      "Mebendazole doses will be escalated from the initial dose level of 50 mg/kg/day divided twice daily, to a second dose level of 100 mg/kg/day divided twice daily, to the final dose level of 200 mg/kg/day divided twice daily, in cohorts of three patients per dose level"

      So they consider doses like 50-200mg/kg/day x 30 kg (a pediatric patient) = 1500 mg up to 6000 mg.

      Delete
  5. Semyon21 March 2018 at 08:52

    Does anyone know how COC recommends taking these 4 medicines: at what time of the day? Before, during or after a meal?

    For example, Metformin in this protocol is taken 1 time per day. But there is no information when exactly ?! After breakfast or after dinner? The effect can be different.

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  6. Unknown9 August 2018 at 06:20

    The COC Protocol is specific to tumor type, patient blood work and other factors. It is frequently adjusted for patients and should only be administered by a registered COC physician as it is a patented treatment. In addition, COC certifies the correct form of one of the critical drugs for brain tumor patients. They are not all the same and quality varies significantly. More information is available at https://careoncology.com/ or you can reach them directly at 310-625-3617

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