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IL 21 + anti PD 1 combo trial

shamrocklady's picture
shamrocklady
Posts: 19
Joined: Feb 2014

Hello All!

This is a trial that I know is currently available at Yale Univ (where my dad will be going) though I don't know yet if we will be offered it or if he will qualify of course, but I am looking for some background info so I can be prepared.

First I've read a ton about IL-2, but barely anything on IL-21... does anyone know if IL-21 is used besides in clinical trials at this point? I've read a bit about it on google & pubmed. Does anyone here have experience using IL-21? All I've seen is that IL-21 can have similar flu like effects as IL-2 though I don't know if the sides effects are quite "as bad" as IL-2. Although both are cytokines, I do see they are quite different. I basically know nothing about IL-21 so any input would be much appreciated.

Also, I believe the anti PD 1, they list as BMS-936558. Is that nivolumab? Or a different anti PD-1?  

Here's the link to the trial http://clinicaltrials.gov/ct2/show/study/NCT01629758

Thanks so much!

Shamrock :)

foxhd's picture
foxhd
Posts: 1923
Joined: Oct 2011

I'm glad you had a positive experience by going to Yale. The immunological therapy trials are the way to go. Good for your dad. You need to know that several cancer centers told me there was nothing they could do to help me because of the extent of my disease progression. But Yale was much more optimistic. I feel pretty comfortable saying that of all our members here, I may be in the top few for health, fitness, and outlook thanks to Yale and their care. Good luck!

Jojo61's picture
Jojo61
Posts: 383
Joined: Oct 2013

I am happy you BOTH found Yale!!

Hugs

Jojo

Darron's picture
Darron
Posts: 222
Joined: Jun 2013

Yes, that is Nivolumab.

I recently saw an article from my doctor that talked about how IL-2 and Nicolumab has not been explored And it has huge potential. I know nothing about IL-21

rook
Posts: 7
Joined: Feb 2014

Stand-alone IL-21 saw good efficacy in RCC:

"Recombinant IL-21 (rIL-21) therapy resulted in objective responses in ~20% of melanoma and renal cell carcinoma patients."

Combination studies of IL-21 + nivolumab were highly synergistic in mice:

"Combination of both agents led to synergistic antitumor activity, with complete regressions (CR) in 7/10 mice and 99.9% median TGI (p=0.046)."

http://meetinglibrary.asco.org/content/115394-132

There is a substantial likelihood this trial will result in stunning regressions for a lucky 30-50% of participants.

foxhd's picture
foxhd
Posts: 1923
Joined: Oct 2011

the use of both drugs has done me wonders. I don't know how you could do both at the same time in a trial. I'm also happy with the order I got them. I'm amazed how good I feel. It makes me nervous thinking about it. I am so thankful for the care I'm getting. Everything has been done right. When I think of all the other things that could have been done or not done, I appreciate that I've gotten the surgery, tests and drugs that I have.

When I started the nivolumab trial, there weren't any other regular posters recieving the drug. I started getting better quickly. It was hot news. Little by little more people have started recieving the drug and everyone seems to be doing well. It's so exciting. Personally I think I will be back on this drug sometime. My chances of living a long time are good.

I also think that nivolumab is a far better first choice than IL-2. Especially since qualifying for IL-2 is restrictive because of cardiac risks. The nivolumab was essentially side effect free.

rook
Posts: 7
Joined: Feb 2014

foxhd,

IL-2 and IL-21 are two different cytokines. The above study combines IL-21 with nivolumab, and is given at the same time.  I believe no one has yet tried to combine IL-2 (the drug you recently took) with a pd-1 inhibitor as it is extremely harsh, very expensive to administer, and the response rate is a very low 5%.

Many people fail IL-2 then try PD-1 or vice versa. It is very rare to respond to both. The immunogenicity of your mets is incredible.

http://en.wikipedia.org/wiki/Interleukin_21

http://en.wikipedia.org/wiki/Interleukin_2

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