Monday, 17 September 2018
DNX-2401
Does anyone have any information on the trial using DNX-2401? We are trying to decide if the risks outweigh the benefit or vice versa. Its great for the 20% that had extended life but what they won't tell us is how those people were living. Did there side effects continue where even thought they lived three more years they were miserable? If anyone has any information to shed some light on this that would be great. Thank you!
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ReplyDeleteThis mentions someone who did well on the therapy, but without many details.
There is a formal list of Adverse Events in Table 2 of this publication:
https://www.ncbi.nlm.nih.gov/pubmed/29432077
Phase I Study of DNX-2401 (Delta-24-RGD) Oncolytic Adenovirus: Replication and Immunotherapeutic Effects in Recurrent Malignant Glioma.
However the current trial combining the virus with a PD-1 inhibitor (pembrolizumab) would probably have increased side effects due to that drug, but is also likely a more potent therapeutic combination.
Ashley,
ReplyDeleteMy experience with DNX2401:
1st my background:
* initial resection in June 2015
* 1st re-currence in August 2017
* Based on options at that time, decided to participate in the DNX2401 trial in November 2017. Only deficient is a left side visual field cut. biopsy with DNX2401 injection in november 2017. followed by Ketruda infusions every 3 weeks. I had no issues with the bipsy and injection. Home after a couple of days and back to work within a couple of more days. Only side effects was tired and very minor headaches the 1st couple of infusions. Since then I have continued keytruda off label and off trial every three weeks. details to follow but no side effects.
My 1st note regarding treatments like this is that the NO's are still working on how to interrupt the MRI's and course of actions based on what they are seeing.
My post procedure MRI's were very stable showing no growth but after a couple of months, there was no decrease in mass size. So after a couple of months, the NO's recommended a debulking to investigate. I had that surgery in March 2018. The mass removed was determined to be dead matter surrounding live tumor. So I was removed from the study but continued receiving Keytruda off label based on the NO's recommendation. The MRI's continued to show no tumor but there were contrasted area's in the original cavity. Those contrast area's continued to slowly grow so another surgery was recommended. That was done in May 2018. THis time 99% of the matterremoved was dead tissue thought to be treatment effect. So again, It was recommended to continue keytruda since the Tcell count was high. I believe at that time, I should have also added more chemo to the treatments. Because today, I am back at contrast area's that the NO's believe is treatment effect along with swelling. Still no symptoms or new deficits. The options now are wait for symptoms to start taking steroids to reduce the swelling or avastin to "cleanup" the MRI image so they can have a better idea of what is being contrasted, continue to wait or another surgery.
So now I am having a 3rd debulking since starting the trial next week. I anticipate again the removal of treatment effect and dead matter. If that is the case, I will be looking for recommendations on which Chemo to start taking while continuing keytruda. Every case is different but I am fortunate that everything so far has been in area's that can be accessed via surgery with limited risk or additional deficits. I have already done 12 cycles of TMZ so most likely will start CCNU after surgery.
Reach out if you have any further questions.
Hi Marc -- where was your tumor located? Also, can you provide a little more info on what the what the debulking procedure is. Is this a full surgery or something less invasive? Thank you
DeleteHi Marc. In the phase 1 modified poliovirus trial at Duke University, they are finding that after treating a tumor with poliovirus, the tumors are very sensitive to lomustine/CCNU. This led to the design of the current phase 2 trial: poliovirus alone versus poliovirus followed by a single dose of CCNU.
Deleteright occipital lobe. Debulking
ReplyDeleteis a full surgical resection.
Marc
Stephen, Thanks for the info. a Couple of my NO's did recommend CCNU as a treatment after this surgery and continue with the keytruda. Most likely going with the ccnu and adding optune.
ReplyDeleteMarc