Partner due to have first vaccine as part of Duke Elevate trial on Wednesday. He went through SOC and had 1st five day Temodar. Duke said MRI two weeks after final radiation showed pseudo progression with swelling. My question is does swelling eventually go down without steroids? Symptoms have gotten worse in last week. Concerned steroids might not fit with immunotherapy. Haven't talked to doctor yet.
ELEVATE is one of my favorite trials, glad to hear that he got in!
ReplyDeletePseudo-progression will probably clear up on its own eventually, but if there is too much swelling/fluid build up, steroids still might be necessary. Whether or not that would interfere with immunotherapy likely depends on the dose. Hopefully the situation could be kept under control with a low dose, if they are necessary at all.
Thank you Stephen, I spoke to Duke and they said he could take 2mg of Dex and be in the trial, but we decided to wait til we talk to them tomorrow when he gets vaccine #1. I also want to ask about Celebrex instead. We both feel very fortunate to have this opportunity.
ReplyDeleteFollow up - had first vaccine. Asked about Celebrex and we're told that while they wouldn't prescribe it as there was no clinical proof it helped with brain edema, it was okay to take as it would not interfere with the vaccine.
ReplyDeleteThere's a fair amount of mouse evidence to suggest that it Celebrex could help improve the efficacy of anti-cancer vaccines. Celebrex (and other COX-2 inhibitors) inhibit the COX-2 dependent production of prostaglandin E2, which has immunosuppressive properties.
DeleteThere is also mouse evidence showing Celebrex can reduce cerebral edema, but I don't think of it as a replacement for steroids, but it might allow a dose reduction of steroids, which is good too.
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