Tuesday, October 31, 2006

10/31/06 We are off to see the Wizard

We are off to Pittsburgh to start the toughest chemo to date.

All I can say is:

“Hit me with your best shot, fire away” Pat Benatar
Well you're the real tough cookie with the long history
Of breaking little hearts, like the one in me
That's O.K., lets see how you do it
Put up your dukes, lets get down to it!

Hit Me With Your Best Shot!
Why Don't You Hit Me With Your Best Shot!
Hit Me With Your Best Shot!Fire Away!

You come on with a come on, you don't fight fair
But that's O.K., see if I care!
Knock me down, it's all in vain
I'll get right back on my feet again!

Hit Me With Your Best Shot!
Why Don't You Hit Me With Your Best Shot!
Hit Me With Your Best Shot!Fire Away!

Well you're the real tough cookie with the long history
Of breaking little hearts, like the one in me
Before I put another notch in my lipstick case
You better make sure you put me in my place

Hit Me With Your Best Shot!
Come On, Hit Me With Your Best Shot!
Hit Me With Your Best Shot!
Fire Away!

Hit Me With Your Best Shot!
Why Don't You Hit Me With Your Best Shot!
Hit Me With Your Best Shot!
Fire Away!

Take Care
Jimmy B.

Monday, October 30, 2006

10/30/06 Melanoma 101 based on the Interlukin-2 Therapy

Page # 2


“One-hundred forty-seven patients received IL-2 720,000 IU/kg every 8 hours (four studies), 118 patients received 600,000 IU/kg every 8 hours (three studies), and five patients received either 360,000 or 540,000 IU/kg. Patients treated with the higher doses of IL-2 received fewer doses; consequently, the median cumulative amount of IL-2 for the first course of therapy was similar for each dose level (Table 3). Clinical factors such as PS did not influence the amount of IL-2 delivered. Patients received up to five courses of therapy (mean, 1.4 courses; median, one course), with 81 patients receiving more than one treatment course. Information on the number of patients treated and the amount of IL-2 administered per treatment course is listed in Table 4.”


“The median duration of response for all responders was 8.9 months. Response duration curves according to response classification are displayed in Fig 1. The median response duration for patients who achieved a CR has not been reached, with 10 of the 17 CRs ongoing at 24 to 106 months. The median duration of PRs was 5.9 months. Two patients who achieved a PR had ongoing responses of 55 and 92 months' duration. Although these patients were classified as achieving a PR and had persistent scan abnormalities at follow-up evaluations, they remained progression-free without further treatment. The median PFS time for all responding patients was 13.1 months. The median PFS time for patients who achieved a CR has not yet been observed but is at least 54 months. Fifty-eight percent of the responders remained progression-free at 12 months. The median PFS time for the patients who achieved a PR was 8.3 months. In 37% of the PR, the PFS time exceeded 12 months. There were no relapses in responding patients after 30 months.”

CR= Complete Response
PR= Partial Response
PFS= Progression Free Symptoms

Class will take 15 minutes recess!!!!!

Take Care,

Jimmy B.

10/30/06 Melanoma 101 based on the Interlukin-2 Therapy

Page # 1

“MELANOMA POSES AN increasingly important health problem.

It is estimated that by the end of 1999, the lifetime risk of developing melanoma in the United States will have reached one in 75.1 Although surgery with or without interferon alfa (IFN ) therapy can be curative in stage I, II, or III disease, a large number of patients will develop distant metastases.

Disseminated metastatic disease is associated with a poor prognosis and a mortality rate of more than 95%. In several large series, survival correlated inversely with the number of involved organ sites, visceral involvement, the disease-free interval, and performance status (PS).2-4 Several treatment options are available to patients with metastatic disease, including single-agent dacarbazine (DTIC) chemotherapy, a variety of combination chemotherapy regimens, and combinations of chemotherapy with tamoxifen or IFN . DTIC chemotherapy produces responses in approximately 20% of patients, with a median response duration of 4 to 6 months, a 5-year survival rate of 2%, and a median survival time of 6 to 9 months.5 Although single-institution phase II studies and small phase III trials have shown that combination chemotherapy, or the addition of either tamoxifen or IFN to DTIC chemotherapy, has potential benefit, no regimen has yet proved superior to DTIC chemotherapy alone.6-13

Interleukin 2 (IL-2), a T-cell growth factor, was first identified in 1976,14 and isolation of the cDNA clone was described in 1983.15

Subsequently, recombinant IL-2 (rIL-2) was shown to have potent antitumor activity in a number of murine tumor models.16 Based on animal model data, a high-dose IL-2 regimen was developed in which IL-2 was administered by short intravenous infusion every 8 hours, with or without lymphokine-activated killer cells.17,18 High-dose bolus IL-2, as a single agent, received United States Food and Drug Administration approval in 1992 after demonstration of durable responses in patients with metastatic renal cell carcinoma.19 In this report, we describe findings from a recently updated 270-patient database of metastatic melanoma patients treated with the same high-dose IL-2 regimen between 1985 and 1993.”

Thursday, October 26, 2006

10/26/06 PM Got The Insurance Approval to Have the treatment down in Pittsburgh

PollyAnn just gave me the good news. I am going to Disney World to ride the famous Roller Coaster.
Heather Blair contacted me and we are on for the start of Interlukin 2 on Wednesday November 1. Warmups are at 9:00 am and the game begins at 3:00 pm. I got a bedside seat at 50 yard line. I can’t wait to see the cheerleaders.

Let the games begin!!!!!

Jimmy B.

10/26/2006 Finals Week… Tests are completed. Yeh!!!!!!

I just finished my Nuclear (Thallium) Stress Test.

A nuclear stress test lets doctors see pictures of your heart while you are resting and shortly after you have exercised. The test can give information about the size of the heart's chambers, how well the heart is pumping blood, and whether the heart has any damaged or dead muscle. Nuclear stress tests can also give doctors information about your arteries and whether they might be narrowed or blocked because of coronary artery disease.

How does it work?

This test is almost the same as the exercise stress test, except doctors will give you a small amount of a radioactive substance just before the end of the exercise part of the test. This radioactive substance is not harmful to your body or your organs.The results of the nuclear stress test can show doctors if the heart is not working properly while you are resting, exercising, or both. If the test shows that blood flow is normal while you are resting but not normal while you are exercising, then doctors know that your blood flow to your heart is not adequate during times of stress. The heart normally pumps more blood during times of physical exertion. If the test results are not normal during both parts of the test (rest and exercise), part of your heart is permanently deprived of blood or is scarred. If doctors cannot see the radioactive substance in one part of your heart, it probably means that section of heart muscle has died, either because of a previous heart attack or because the coronary arteries supplying blood to that area of the heart are blocked.

The other two tests were CT Scan and the Pulmonary Function Tests. I gave you the results for the CT scan. I think I passed the Pulmonary Function Tests.
Pulmonary function tests are tests performed to make measurements of how your lungs and airways function. Results from pulmonary function tests enable your physician to evaluate your breathing, make diagnosis, recommend treatment and follow your progress.DLCO – Lung Diffusion Capacity TestingThis test measures how well gases (oxygen) move through the lung and into the bloodstream. I got an 88 out of a possible 100. Hey a b+ isn’t bad.

Waiting to get approval for IL-2 treatment

Jimmy B.

Wednesday, October 25, 2006

10/25/2006 Major Set Back!!!!!

Yesterday while at the Rochester Oncologist (Dr. Pandya) office we received bad news. The cancer is spreading in my lungs quite rapidly according to the CT scans. There are now over 40 nodules ranging from 15 mm down to < 5 mm. No wonder I been having shortness of breath. I thought it was my lack of exercise. Dr. Pandya gives my prognosis a poor rating. I guess I won’t be getting a raise this year.
I have started the long term disability process with disbelief. My fight is not over for a long shot. I just need to speed up my trials to find the right one. I will be contacting Dr. Kirkwood today to see where we stand on the Molecular Profiling route. I feel I am in the race of life and second place is not an option. I am going for the Gold.

Stay tune things may get very interesting.

Take care

Jimmy B.

Monday, October 23, 2006

10/23/2006 Going to be a busy week!!!!!

Well, I got all my tests scheduled for this week. Today I go for a CT scan at 11:00 am. They seem to know me by name there. That is not good is it? Tomorrow, I see my Rochester oncologist. This is just to keep them informed. Wednesday, I go to Rochester General for a pulmonary test. To check out my lungs to see if they are in good enough shape to proceed with the Interlukin 2 therapy. Finally, Thursday, will be the stress test to checkout my heart. This test will be induced by some drugs. I won’t be put on a tread mill. It will take about 4 hours.
That’s my week in review.
P.S. I will keep you posted if anything comes up.

Take care Jimmy B.

Wednesday, October 18, 2006

This is the first step forward!!!!

An email from Arlet Alarcon to Kirkwood

Hello Dr. Kirkwood,

Please call me at your earliest convenience at any of the numbers below, so that we can discuss how to best help Mr. Jim Breitfeller.

Thank you,


Arlet Alarcon, M.D.
Manager, Target Now/Horizon
Molecular Profiling Institute (MP)
445 N. 5th Street, 3rd Floor
Phoenix, AZ. 85004
(602) 358-8982 (direct)
(602) 358-8920 (fax)
(602) 909-7667 (cellular)

Tuesday, October 17, 2006

10/17/2006 The Molecular Profiling Institute Called Yeh!!!!!!

I just received a call from Dr. Arlet Alarcon from the Molecular Profiling Institute. She is the clinical coordinator at the Institute. She gave me some background on what they do and how it would pertain to my situation.
Here the Deal:They would take a biopsy of my tumor and run a genomic sequence on it to determine the pathways that the tumor is using to nourish itself with the blood supply using the supercomputer. Once they determine the pathways, they try to figure out what chemotherapy or drugs would shut down the pathways choking off the blood supply to the tumors. The tumors would slowly die. Easier said than done.

It sounds like Science Fiction.

All I need is to get buy in from Dr. Kirkwood.

Luke Skywalker Here I come!!!!!!!!

Jimmy B. Signing off

10/17/06 Need a cocktail treatment for malignant melanoma using a supercomputer.

There was a program on the CBS Evening News October 13 2006 with Katie Couric using supercomputers to analyze blood and tumor tissues. It would analyze the genomic makeup of the samples and then calculate what the best probable therapy treatment for that patient. The only problem was, it was set up for prostate cancer. The Researcher’s Name was Dr. David B, Agus.
So I emailed him:
Dr. Agus,I am presently a patient of Dr. John Kirkwood of the Hillman Cancer Center in Pittsburgh. I am in the battle of my life trying to overcome melanoma. I am 48 yrs. old just in the prime of my life. I have tried Interferon, Dicarbazine and CTLA-4 monoclonal antibodies therapies without any success. I saw your story on the CBS Evening News and was hoping that if I submitted my blood sample or donate a tumor, maybe we could get a handle on the treatment protocol for my cancer. Any Help would be greatly appreciated.
Here is Dr. Agus’s response:
JimJohn is an excellent doctor and I am happy to help in any way I can. Presently we do not have melanoma protocols in the database to do correlations. There is a group out of TGEN called MPI (molecular profiling institute) which does a Target now analysis:


the group is run by dan von hoff and is excellent. The data from this analysis can be used to help ‘guide’ therapeutic decisions.
Use my name if you would like when you call them.

Good luck

David B. Agus, M.D.Director,
Spielberg Family Center for Applied ProteomicsResearch Director,
Cedars-Sinai Prostate Cancer Center
8631 West Third Street, Suite 215ELos Angeles, CA 90048

Tel (310) 423-7600
Fax (310) 423-1998

Here is an excerpt of Molecularprofiling:

"The Molecular Profiling Institute's Target Now research program provides advanced tumor analysis for cancer patients whose disease has progressed despite having received first and second-line standard therapies. This unique analysis has resulted in some positive individual outcomes that are presently being validated in a clinical study.
Target Now offers advanced molecular tumor analysis and provides potential therapeutic options to cancer patients for whom several standard therapies have failed. These are patients who need a targeted approach to treat their cancer – now
Based on the molecular profile of a patient's tumor, our program generates potential treatment options that would likely otherwise not be considered. Target Now is going through a prospective clinical trial prior to wider availability. Cancer patients who have clinically progressed despite having received first and second-line standard treatments are now able to access an opportunity - not offered anywhere else in the country - to have their cancer sampled, profiled and assessed to determine if one or more drug targets may exist in their tumor tissue.
The physician report for Target Now patients is generated by our proprietary Personalized Medicine Expert System (PerMedEx). PerMedEx and the associated report assists the physician to more clearly link drug targets to the molecular profile of a patient's tumor and offers the associated references and abstracts to the supporting medical literature."

So I sent this information to Melissa in Pittsburgh and I am waiting to hear their response.

That is it for now.

P.S. You can't say I am not giving it the "Old College Try"

Jimmy B.

Thursday, October 12, 2006

Results of early PROLEUKIN® IL-2 Clinical Trials

Metastatic MelanomaYear received FDA Approval 1998Number of Patients 270 patientsNumber of Trials 8Response In 16% of the patients, tumors shrank or disappeared as a result of PROLEUKIN® IL-2 therapy.
In 6% of the patients, the tumors disappeared completely.Results From these trials, it was determined that a patient whose tumors completely disappeared from the treatment remained cancer-free for a median of 4.9 years.

10/12/2006 Back to square one !!!

A couple of days ago, Dee noticed two new growths on my back. I was hoping for the best. Anyway, we got confirmation from the Hillman Center that it is 2 new tumors growing. This really stinks. I think it is time to take out the “Weed be Gone”. This is not what I was hoping to hear.
My batting is like the the NY Yankees, and they missed the playoffs. But there is one good thing, I saved money on car insurance by switch to Gieco. Only Kidding
So, it is on to the next trial. I am not sure what is going to be, but they mention Interlukin 2.

I am NOTTTTTTT throwing in the towel.
Jimmy B.

Tuesday, October 10, 2006

On the road again!!!!!

Back to Pittsburgh.I still have fatigue but I am managing it. What really bothers me is my right arm where they removed the lymph nodes. I can't get the swelling down which in turn puts pressure on my nerves.I have to baby it to try to bring down the swelling. Some days it feel like it is caught in a vise. I am going ask if they can drain the excess fluid if possible. I should be back on in a day so.
"All Quiet on the Western Front"

Jimmy B.

Greetings to One and All

This Blog is dedicated My Brother Kenny B. who passed away in the late 1970's with Cancer before the Internet.

It was he, who showed me How to live and give back. He was wise beyond his years.

Kenny B

Jimmy and Dee

Carepage: Jimmybreitfeller
Jimmy Breitfeller

My Profile as of 2009

My photo
Last July (2005)I was riding my bicycle to work at the Eastman Kodak Research Labs about 3 miles from home. I was wearing a knapsack to carry my things to and from the labs. I started noticing an ache on my back. So I decide to go to the dermatologist. To make the long story short, it was cancer. I knew from my research that I would be needing adjuvant therapy. So I started communicating with Sloan Kettering, University of Pittsburgh Cancer Center, and a couple of others including the Wilmot Cancer Center at Strong. I realized that by telling my story, I might help someone else out there in a similar situation. So to all who are linked by diagnosis or by relation to someone with melanoma, I wish you well. Stay positive, read as much as you can (information helps to eliminate the fear associated with the unknown), and live for today, as no one can predict what tomorrow may bring. Jimmy B. posted 12/15/08


The information contained within this Blog is not meant to replace the examination or advice of your Oncologist or Medical Team. The educational material that is covered here or Linked to, does not cover every detail of each disorder discussed.

Only your physician/Oncologist can make medical decisions and treatment plans that are appropriate for you. But, An Educated Consumer is a Smart consumer.

As Dr. Casey Culberson Said:

"The BEST melanoma patient is an ACTIVE PARTICIPANT in his or her treatment

Melanoma and the “Magic Bullet” (Monoclonal Antibodies)

Just to let you know I posted the first draft of the Melanoma and the “Magic Bullet” (Monoclonal Antibodies). on Melanoma Missionary In the Shared File Section. you can download it for 19.95 (Only kidding) it is Free for the taking.

It is 33 pages long and may help you in your quest for the Yellow Brick Broad. Just to let you know it is only the first draft. Revisions are sure to come. I wanted to get it to the people that need it the most, the Melanoma Patients.


So, where does Interluekin-2 (IL-2) come into play? According to Byung-Scok et al and recent reports, IL-2 is not needed for developmental CD4+ CD25+ Treg cells in the thymus but does play an important role in the maintenance and function in the peripheral.18 Peripheral is defines as secondary system outside the bone marrow and thymus. It entails the site of antigen, immune system interaction. IL-2 is required for the peripheral generation of Tregs based Abbas’s and colleagues research.19

IL-2 prevents the spontaneous apoptosis of the CD4+ CD25+ Treg cells. It has been reported that patients with multiple advance-stage tumors have elevated levels of Tregs within the tumor microenviroment.20 Interluekin-2 is the survival factor for CD4+ CD25+ Treg cells.21 If the addition of IL-2 is on or before the maximum propagation of the CD4+ T cells, the Tregs population can increase 5-fold in a 96 hour period based on certain growth mediums.

By controlling the addition of the endogenous IL-2, one has a knob to turn and can lead to the control of the expansion of the Tregs. When you combined this control with the anti-CTLA-4 blockage, you can shift the balance of the immune response.

Now here is the catch. The maintenance and function of the CD8+ T-cells require CD4+ cells which secrete IL-2. So we don’t want to deplete the CD4+ cells, we want to control the expansion of the Tregs which are a subset of the CD4+ cells. It has been postulated by some researchers that the Anti-CTLA-4 blockage also suppresses the Treg function in a different mechanism. By using IL-2 as the rate limiting factor, we can suppress the CD4+ CD25+ Treg cell expansion by controlling the concentration and timing of the Inerluekin-2 at the tumor microenvironment.

The Interluekin-2 plays another role in this Melanoma Maze. In a study by Janas et al, Il-2 increases the expressions of the perforin and granzyme A, B and C genes in the CD8+ T-cells. This increase expression causes the CD8+ T-cells to mature into Cytoxic T Lymphocytes (CTLs). The exogenous IL-2 is required for the granzyme proteins. As stated previously, CTLs have cytoplasmic granules that contain the proteins perforin and granzymes. A dozen or more perforin molecules insert themselves into the plasma membrane of target cells forming a pore that enables granzymes to enter the cell. Once in the tumor cell, these enzymes are able to breakup (lyse) the cell and destroy it. This is the beginning of the end for the cancer cells. The tumors begin to shrink and the rest is history,

On the other hand, prolong therapy with Il-2 can result in causing apoptotic death of the tumor- specific CD8+ T-cells.23

Clearly in a clinical setting, timing, dose, and exposure to these drugs play a major roll in the immunotherapy, and can have dramatic effects on the outcome.

All it takes is that one magic bullet to start the immune reaction..


Melanoma And The Magic Bullet (Monoclonal Antibodies)

Public Service Announcement

A call for Melanoma Patients by Dr. Steven A Rosenberg

"We continue to see a high rate of clinical responses in our cell transfer immunotherapy treatments for patients with metastatic melanoma", Dr. Rosenberg said.

"We are actively seeking patients for these trials and any note of that on a patient-directed web site would be appreciated."

If you would like to apply for his trials, here is the website and information.

Dr. Rosenberg's information

Dr. Rosenberg's Clinical Trials

For the Warriors

The Melanoma Research Alliance has partnered with Bruce Springsteen, the E Street Band, and the Federici family to alleviate suffering and death from melanoma. Please view Bruce Springsteen’s public service announcement inspired by Danny Federici. Danny was the E Street Band’s organist and keyboard player. He died on April 17, 2008 at Memorial Sloan-Kettering Cancer Center in New York City after a three year battle with melanoma.


Source Fastcures blog

Join the Relay for Life!!!


Dear Family and Friends,

I’ve decided to take a stand and fight back against cancer by participating in the American Cancer Society Relay For Life® event right here in my community! Please support me in this important cause by making a secure, tax-deductible donation online using the link below.

To donate on line now, click here to visit my personal page.
Jimmy B AKA Melanoma_Missionary

Relay For Life® is a life-changing event that brings together more than 3.5 million people worldwide to:

CELEBRATE the lives of those who have battled cancer. The strength of survivors inspires others to continue to fight.

REMEMBER loved ones lost to the disease. At Relay, people who have walked alongside people battling cancer can grieve and find healing.

FIGHT BACK. We Relay because we have been touched by cancer and desperately want to put an end to the disease.

Whatever you can give will help - it all adds up! I greatly appreciate your support and will keep you posted on my progress.

Keep the Fire Burning!!!



Jimmy Breitfeller
Turn off Music before you "Click to Play"
Signs of Melanoma Carcinoma Skin Cancer

How Skin Cancer Develops by "About.com : Dermatology"

Call for Patients with Unresectable Liver Metastases Due to Melanoma

Delcath Systems Granted Orphan-Drug Designations for Cutaneous and Ocular Melanoma

Delcath is actively enrolling patients in a Phase III clinical trial testing its proprietary drug delivery system, known as Percutaneous Hepatic Perfusion (“PHP”), with melphalan for the treatment of ocular and cutaneous melanoma metastatic to the liver.

This NCI-led trial is enrolling patients at leading cancer centers throughout the United States. Commenting on these orphan-drug designations, Richard L. Taney, President and CEO of Delcath, stated, “These favorable designations are important steps in our efforts to secure Delcath’s commercial position upon conclusion of our pivotal Phase III trial for metastatic melanoma. We remain steadfast in our commitment to become the leader in the regional treatment of liver cancers and we continue to enroll patients in this study, and advance our technology and the promise that it offers to patients with these deadly forms of melanoma and other cancers of the liver, all with limited treatment options.”

Orphan drug designation, when granted by the FDA’s Office of Orphan Products Development, allows for up to seven years of market exclusivity upon FDA approval, as well as clinical study incentives, study design assistance, waivers of certain FDA user fees, and potential tax credits.

Current Trial Centers

Phase I Study of Hepatic Arterial Melphalan Infusion and Hepatic Venous Hemofiltration Using
Percutaneously Placed Catheters in Patients With Unresectable Hepatic Malignancies

James F. Pingpank, Jr., MD, FACS
Associate Professor of Surgery
Division of Surgical Oncology
Suite 406, UPMC Cancer Pavillion
5150 Centre Avenue
Pittsburgh, PA 15232
412-692-2852 (Office)
412-692-2520 (Fax)

Blog Archive

Call For Melanoma Patients!!!!

Call For Melanoma Patients!!!!

Dr. Rosenberg Has a New Clinical Trial.

Our latest treatment has a 72% objective response rate with 36% complete responses.

We are currently recruiting patients for our latest trial.

Is there some way to post this “Call for Patients” on the web site?

Steve Rosenberg

Dr. Rosenberg's Clinical Trials

(For a copy of the research paper.. see My Shared files)

The news headlines shown above for Melanoma / Skin Cancer are provided courtesy of Medical News Today.