Friday, May 28, 2010

The quantal theory of how the immune system discriminates between "self and non-self"..Melanoma..Jim Breitfeller

The quantal theory of how the immune system discriminates between "self and non-self"
Kendall A Smith
2004

If you get a chance to read this paper; You will now know why, the combinatorial therapy of Anti-CTLA-4 Blockade and HD Interluekin-2 will work on jump starting your Immune System.

Please take your time in reading this paper. It could save your Life!!!

"In the past 50 years, immunologists have accumulated an amazing amount of information as to how the immune system functions. However, one of the most fundamental aspects of immunity, how the immune system discriminates between self vs. non-self, still remains an enigma. Any attempt to explain this most intriguing and fundamental characteristic must account for this decision at the level of the whole immune system, but as well, at the level of the individual cells making up the immune system. Moreover, it must provide for a molecular explanation as to how and why the cells behave as they do. The "Quantal Theory", proposed herein, is based upon the "Clonal Selection Theory", first proposed by Sir McFarland Burnet in 1955, in which he explained the remarkable specificity as well as diversity of recognition of everything foreign in the environment. The "Quantal Theory" is built upon Burnet's premise that after antigen selection of cell clones, a proliferative expansion of the selected cells ensues. Furthermore, it is derived from experiments which indicate that the proliferation of antigen-selected cell clones is determined by a quantal, "all-or-none", decision promulgated by a critical number of cellular receptors triggered by the T Cell Growth Factor (TCGF), interleukin 2 (IL2)."
The quantal theory of how the immune system discriminates between "self and non-self"





“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

~Charles Darwin~

Take Care,
Jimmy B

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Friday, May 21, 2010

High Dose Interluekin-2 followed by low-dose metronomic temozolomide (TMZ) to induce a complete immune Response.Melanoma ..Jim Breitfeller

High Dose Interluekin-2 followed by low-dose metronomic temozolomide (TMZ) to induce a complete immune Response

Background
CD4+CD25+ regulatory T cells (Treg), which constitute about 2–3% of CD4+ human T cells, are the main contributors to the maintenance of immune tolerance. Cancer patients, including Melanoma patients bear increased number of circulating and tumor infiltrating Treg that exert functional inhibition on tumor-specific T cells.

Temozolomide (sometimes referred to as TMZ) is an imidazotetrazine derivative of the alkylating agent dacarbazine.

Immunological factors relating to the antitumor effect of temozolomide ... appeared to suppress the frequency of CD4(+) CD25(+) regulatory T cells (Treg).
So base on the research, if activation occurs (mmune activation induced by the HD IL-2) IL-2 being a growth factor for the T-cells, will help fuel their expansion. Since the Tregs are a subset of the CD4+ T-cells, they too will proliferate.

By adding TMZ to the protocol, it suppresses the Treg function and shifts the balance tolerance toward activation of an immune response.

See the abstract at the ASCO Symposium 2010 "Ability of unsuccessful high-dose IL-2 therapy followed immediately by low-dose metronomic temozolomide to induce complete and near-complete remissions in metastatic melanoma."


Source:http://www.abstract.asco.org/AbstView_74_41534.html







“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

~Charles Darwin~

Take Care,
Jimmy B
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Thursday, May 20, 2010

CTLA-4 blockade with ipi: Long-term follow-up of 179 patients with metastatic melanoma ASCO 2010.Jim Breitfeller

Cytotoxic T lymphocyte-associated antigen 4 blockade with ipilimumab: Long-term follow-up of 179 patients with metastatic melanoma.

The combination of ipilimumab and IL-2 appears to have an increased complete response rate

Meeting: 2010 ASCO Annual Meeting



Citation: J Clin Oncol 28:7s, 2010 (suppl; abstr 8544)

Abstract No: 8544
Attend this session at the ASCO Annual Meeting!

Session: Melanoma/Skin Cancers

Type: General Poster Session

Time: Sunday June 6, 8:00 AM to 12:00 PM

Location: S Hall A2

Personalize your Annual Meeting experience with a suggested or customized itinerary!





Author(s): P. A. Prieto, J. C. Yang, R. M. Sherry, M. S. Hughes, U. S. Kammula, D. E. White, C. L. Levy, S. A. Rosenberg, G. Q. Phan; Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD; National Cancer Institute, National Institutes of Health, Bethesda, MD; National Cancer Institute, Bethesda, MD; Surgery Branch, National Cancer Institute, Bethesda, MD



Abstract:

Background: We have previously shown objective clinical responses in patients with metastatic melanoma treated with CTLA-4 blockade using ipilimumab. We have treated 179 patients in 3 separate clinical trials and now have long-term follow-up to evaluate the durability and unique features of this immunotherapy. Methods: A total of 179 patients with metastatic melanoma were treated in 3 trials: In Protocol 1, 56 patients received ipilimumab with gp100 peptide vaccines. In Protocol 2, 36 patients received ipilimumab with high-dose interleukin-2 (IL-2). In Protocol 3, 87 patients received intra-patient dose escalation of ipilimumab and were randomized to receive gp100 peptides. We have updated and analyzed the follow-up and survival data for these trials. Results: With median follow-up for Protocol 1, 2, and 3 being 80, 71, and 60 months, median survival was 15, 16, and 13 months, respectively. Objective tumor regression was 12% for Protocol 1, 25% for Protocol 2, and 21% for Protocol 3. Patients in Protocol 2 had a 17% complete response rate (6 patients: 77+, 74+, 72+, 71+, 71+, and 69+ months), as compared to 7% in Protocol 1 (4 patients: 82+, 81+, 79+, and 66+ months) and 8% in Protocol 3 (5 patients: 64+, 63+, 62+, 60+, and 55+ months); all complete responses are ongoing. Many patients who eventually became complete responders had continual tumor shrinkage after stopping therapy.

Conclusions: CTLA-4 blockade with ipilimumab can achieve durable objective tumor regression in patients with metastatic melanoma. The combination of ipilimumab and IL-2 appears to have an increased complete response rate, although this needs to be tested in a prospective randomized trial. This report represents the largest single-institution experience with the longest follow-up for this agent; our results support its role as a viable treatment option for patients with metastatic melanoma.


Source:http://www.abstract.asco.org/AbstView_74_53615.html


Cytotoxic T lymphocyte-associated antigen 4 blockade with ipilimumab: Long-term follow-up of 179 patients with metastatic melanoma.


It has taken them two years to see the synergy of Ipi + IL-2

My Theory is becoming a reality!!!!!!!!!!!!!!!
Melanoma and the Magic Bullet





The Making of an Immune Response by Combinatorial Therapy Using Anti-CTLA-4 Blockade and Interleukin-2



“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

~Charles Darwin~

Take Care,
Jimmy B
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Smart bombing Melanoma..Jim Breitfeller




Smart bombing Melanoma

“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

~Charles Darwin~

“Most tumors arise from a single normal cell through a sequential evolutionary process of mutation and selection. Tumors are initiated by escaping non-immune surveillance, which includes defective DNA repair, gene alternation, resistance to apoptosis and loss of intercellular contact inhibition. Tumor cells harbor mutations in a number of critical genes that provide selective advantages at various stages during the evolution of the tumor. The tumor cells that circumvent the tumor suppressor mechanisms of the non-immune surveillance process are edited by the immune system, resulting in the selection of a resistant tumor variant. The selection of the tumor cell is further shaped by its interactions with cells and other factors in its microenvironment. Tumor evolution is thought to adhere to Darwinian principles by escaping both non-immune (intrinsic) and immune (extrinsic) responses against self-altered tumor cells. At end-stage, tumors have escaped both non-immune and immune surveillance with increased threshold of apoptosis. Combination therapy has been proposed, by exploring the non-immune and immune suppressive nature of the tumor, and has been found to have a therapeutic efficiency on tumor regression as compared with monotherapies. The combination of immunotherapy and other different modalities, especially vaccines, with conventional anticancer therapies with optimized dosage and scheduling can offer synergistic antitumor effects.”

Source: http://www.cellbiolint.org

Chemotherapy

The combination of chemotherapy and immunotherapy is synergized as chemoimmunotherapy; chemotherapy can kill or slow the growth of cancer cells and immunotherapy stimulates or restores the ability of the immune system to fight against cancer (Emens and Jaffee, 2005; Gulley et al., 2007). Apoptotic death, particularly massive apoptosis by chemotherapy, can be a priming event for antitumor immunity, allowing the tumors to act as its own vaccine by releasing a large amount of tumor antigen. This priming event sets the stage and the direction of the immune response. With the right tumor antigen, the activated T-cells (CTL’s) Cytotoxic T Lymphocytes can zero in on their target, the tumor cell. Smart bombing Melanoma!!!!!



Source: http://thefutureofthings.com/articles/1012/smart-bombing-cancer.html


Source: NCI



“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

~Charles Darwin~

Take Care,
Jimmy B
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Tuesday, May 18, 2010

'Holy Grail' cancer vaccine that blasts tumours in weeks hailed as huge leap in fighting disease..Melanoma ..Jim Breitfeller

'Holy Grail' cancer vaccine that blasts tumours in weeks hailed as huge leap in fighting disease

The vaccine contains DNA and fragments of tumor. These activate only the specific immune cells which target melanoma.

WHERE DID YOU HEAR ABOUT TUMORS SHEDDING ANTIGENIC PEPTIDES(ANTGENS)?

RIGHT HERE

Amy Dickenson had aggressive bone cancer but survived with the help of a cancer vaccine
The treatment, developed by the company Scancell, will initially be given both to patients with advanced skin cancer which has spread to other parts of the body, and to those in the earlier stage of the disease.
Trials will begin at hospitals in Manchester, Nottingham and Newcastle. If successful, the jab could be available within ten years.


Read more: http://www.dailymail.co.uk/health/article-1278836/Holy-Grail-cancer-vaccine-blasts-tumours-weeks-hailed-huge-leap-fighting-disease.html#ixzz0oJfHaJ6j

'Holy Grail' cancer vaccine that blasts tumours in weeks hailed as huge leap in fighting disease



Read more: http://www.dailymail.co.uk/health/article-1278836/Holy-Grail-cancer-vaccine-blasts-tumours-weeks-hailed-huge-leap-fighting-disease.html#ixzz0oJeWO9pT


The Making of an Immune Response by Combinatorial Therapy Using Anti-CTLA-4 Blockade and Interleukin-2




"Mike Weber was kind to forward your paper and email. It appears that you have a very good sense of, and interest in, the immune response to melanoma and to cancer in general. I believe you are right that timing of the various components of the immune response, especially with combination therapies, is important, just as it is in the orchestration of a beautiful symphony."


~ Dr. Craig Slingluff ~


Melanoma and the Magic Bullet (Monoclonal Antibodies)


“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

~Charles Darwin~
Take Care,
Jimmy B
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ICOS is the first immunologic marker to be identified in patients treated with anti-CTLA-4 ..Melanoma ..Jim Breitfeller

ICOS is the first immunologic marker tobe identified inboth tumor tissues and the peripheral blood of patients treated with anti-CTLA-4

Increased ICOS expression is detected on CD4 and CD8
T cells after treatment with 10 mg/kg/dose of anti–CTLA-4
antibody.

An increased and sustained frequency of CD4+ICOS hi
T cells correlated with improved overall survival.

At 10 mg/kg/dose Ipi, CD8+ICOS hi T cells were detectable in tumor tissues
At 3 mg/kg/dose Ipi, CD8+ICOS hi T cells were undetectable in tumor tissues
untreated patients, CD8+ICOS hi T cells were undetectable in tumor tissues

Preoperative CTLA-4 Blockade- Tolerability and Immune
Monitoring in the Setting of a Presurgical Clinical Trial



Preoperative CTLA-4 Blockade: Tolerability and Immune
Monitoring in the Setting of a Presurgical Clinical Trial



This is why the dose should be at least 10mg/kg not 3mg/kg.

Bristol Myer Squibb, please take note!!!!


“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

~Charles Darwin~

Take Care,

Jimmy B
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Thursday, May 13, 2010

How therapy can teach your own immune system to fight cancer..Melanoma. Jim Breitfeller

How therapy can teach your own immune system to fight cancer

"The immune response to cancer
The immune system is our natural defense against disease. It destroys harmful bacteria and viruses that enter our bodies. In order to do this it has to recognize and label them as “foreign”. Once this happens, special types of cells in the immune system move in and destroy the invaders.

Our natural immune system can also detect cancer, because cancer cells are different from normal cells. In many cases, it will destroy these cancer cells before they turn into a detectable cancer.

Helping the immune system fight cancer
Sometimes our immune response to cancer fails and the cancer continues to grow. This can happen when cancer cells are not recognized by the immune system, or develop ways to cheat the system and escape detection. As a result, our immune system mistakes them for healthy cells and does not react.
Cancer immunotherapy aims to teach our natural defenses to identify cancer cells correctly – and then kill them.

ASCI*: a new approach that targets cancer antigens
ASCI* (Antigen-Specific Cancer Immunotherapeutics) is a new type of immunotherapy in development that targets cancer antigens and potentially destroys the cancer cells that bear these antigens. Cancer antigens are substances found on the surface of cancer cells, and are recognized as “foreign” by the body’s immune system.

ASCI* uses our own immune system to attack cancer. It does this by educating our immune system to identify and attack antigens displayed on cancer cells.
The immune system reacts towards the antigen in ASCI* – a reaction called immune response – and then attacks the cancer cells where this antigen is found."
Source:GlaxoSmithKline
http://www.immunotherapyforcancer.info/melanoma/index.shtml

There is only one major problem. Each melanoma patient has his or her own set of antigens based on their own tumors. Reseachers are trying to discover what are the major antigens that Melanoma patients exibit. For instance, MAGE-A3. There are literally thousands to choose from.

What if you get your body to produce them for you from your tumors. It sounds hard to believe but, radiation, chemotherapy with Dacarbazine plus (Patrin-2) Lomeguatrib and oblimersen sodium may help shed the right antigenic peptides. You have to get the right antigen to be presented on the dendritic cells acting as Antigen Presenting Cells (APCs) in order for the immune response to the cancer. The concentration of the antigen plays a major role in the intensity of the response.

Another problem is that you have to deplete or Block the suppressive function of the Tregs cells. This can be accomplished by lymphodepletion by preconditioning with cyclophosphamide and fludarabine or Anti-CTLA-4 blockade.

The final step of this process is the addition of interleukin-2 to activate and maintain the function of the CD8 + T-cells that mature into Cytotoxic T Lymphocytes (CTL’s). Dosing schedule and concentration of the drugs also play major role in weather an immune response is generated.



The Making of an Immune Response by Combinatorial Therapy Using Anti-CTLA-4 Blockade and Interleukin-2




"Mike Weber was kind to forward your paper and email. It appears that you have a very good sense of, and interest in, the immune response to melanoma and to cancer in general. I believe you are right that timing of the various components of the immune response, especially with combination therapies, is important, just as it is in the orchestration of a beautiful symphony."


~ Dr. Craig Slingluff ~



Melanoma and the Magic Bullet (Monoclonal Antibodies)







Take Care,
Jimmy B
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Friday, May 7, 2010

For the Record, Ipilimumab, Melanoma..Jim Breitfeller

For the Record, Ipilimumab, Melanoma

During Bristol-Myers Squibb's investor day March 4, 2010, management's enthusiasm for an important late-stage drug in development for metastatic melanoma, ipilimumab, was palpable. CEO designate Lamberto Andreotti told the room full of analysts and investors that ipilimumab "has the potential to become a paradigm changer in the emerging field of immuno-oncology."

Ipilimumab, the immunotherapy in development by Bristol-Myers Squibb and Princeton, N.J.-based Medarex to treat melanoma, may be more effective at higher, and more toxic, doses, but the side effects are a small price for survival, according to one of the lead investigators studying the drug. June 1, 2008

Two-year melanoma survival data from three Phase II studies of Medarex/Bristol-Myers Squibbs' immunotherapeutic ipilimumab presented at the American Society of Clinical Oncology meeting May 31 bode well for an ongoing pivotal Phase III study and an eventual first approval for the oncologic. June 1, 2009

Medarex/Bristol Myers Squibb took pains to differentiate its CTLA-4 immunotherapy ipilimumab from Pfizer's failed tremelimumab during a July 10 2008 R&D update.

The BLA delay for ipilimumab for melanoma, disclosed April 24 2008 by Medarex and Bristol-Myers Squibb, surprised few in the wake of Pfizer's Phase III fizzle earlier this month with a similar drug, tremelimumab.

Pfizer is discontinuing a Phase III clinical trial evaluating the CTLA-4 (cytotoxic T lymphocyte-associated antigen 4) inhibitor tremelimumab as a single agent in patients with advanced melanoma after an interim review showed it performed no better than standard chemotherapy, the firm said April 1, 2008.


Dosage_____________Patient Response Rate
0.3 mg/kg__________ 0
3.0 mg/kg__________ 4.2 %
10 mg/kg___________ 11.1 %

February 2010 Dr. Jedd Wolchok


For the record, I see a combinatorial therapy in Ipilimumab’s near future



The Making of an Immune Response by Combinatorial Therapy Using Anti-CTLA-4 Blockade and Interleukin-2



Take Care,
Jimmy B
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Thursday, May 6, 2010

The Proof is in the Science..Is Bristol Myer Squibb missing the Boat? Melanoma..Jim Breitfeller

The Proof is in the Science..Is Bristol Myer Squibb missing the Boat?

So why is Bristol Myer Squibb going to commercialize Ipilimumab at 3mg/Kg instead of 10 mg/kg?

Could it be possible that BMS is looking to add a Maintenance phase to the therapy? Or is it because of the high 3-4 adverse effects at the higher dosage?

Findings
The best overall response rate was 11•1% (95% CI 4•9—20•7) for 10 mg/kg, 4•2% (0•9—11•7) for 3 mg/kg, and 0% (0•0—4•9) for 0•3 mg/kg (p=0•0015; trend test). Immune-related adverse events of any grade arose in 50 of 71, 46 of 71, and 19 of 72 patients at doses of 10 mg/kg, 3 mg/kg, and 0•3 mg/kg, respectively; the most common grade 3—4 adverse events were gastrointestinal immune-related events (11 in the 10 mg/kg group, two in the 3 mg/kg group, none in the 0•3 mg/kg group) and diarrhea (ten in the 10 mg/kg group, one in the 3 mg/kg group, none in the 0•3 mg/kg group).

Interpretation
Ipilimumab elicited a dose-dependent effect on efficacy and safety measures in pretreated patients with advanced melanoma, lending support to further studies at a dose of 10 mg/kg.

Funding
Bristol-Myers Squibb

Source: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(09)70334-1/abstract



Elliott Sigal said in the Bristol-Myers Squibb Q1 2010 Earnings Call “We do plan to commercialize the 3-milligram dose and the indication that I mentioned.”

So with that, there may be a problem with dose being to low. Based on the information that I have obtained, 3mg/ Kg may be to low to block all the CTLA-4/B-7 receptors on the T-cells. Cells known to express CTLA-4 include activated CD4+ and CD8+ T cells, and B cells.

So if you don’t activate the T-cells, the CTLA-4 receptor is not up-regulated and the Ipilimumab is not tied up. That is why we see excess Ipilimumab at low concentrations.
What we want to look at is the maximum delta (change between) time intervals. If the T-cells are activated, then the delta would be greater than the half-life of the Ipilimumab.

It has been noted that we need at least 10ug/ml in the serum Ipilimumab to block all the CTLA-4 receptors. With that in mind we need to take into account the drug’s half life and we must also take into account the T-cells expansion over time of the Activation.

So we need to start out with enough Ipilimumab to last through the T-cell expansion and activation.

With that in mind, we should start at 0 to 33 days. That is the time the CD4+ T-cells need to reach maximum propagation.

We should also look at the interval of 33 to 64 days. That is the time frame when the CD8+ T-cells are at their maximum expansion.

The 0.1 and 0.33 mg/kg are to low to complete the 33 day interval. This means those two points are substrate limited. (Not enough Ipilimumab)

The mean ± SD MDX-CTLA4-01 terminal elimination half-life was 299.4 ± 126.9 h (12.475 days).

12.5+/-5.3 days is the elimination Half Life of the Ipilimumab

Source: http://clincancerres.aacrjournals.org/content/13/6/1810.full


Adaptive from A. Bashey

At 1536 hours or 64 days at 3mg/kg, there is still some anti-CTLA-4 in the blood system, but it is far below 10 ug/ml level
According to the research, you need at least 10 ug/ml to saturate all the CTLA-4 receptors in host’s body. Base on the work research done by Bashey et al, 3 mg/kg dose of Ipilimumab will only get you to about 4ug/ml in the host’s serum. 3mg/kg of Ipilimumab falls short of blocking all the CTLA-4 receptors. This is why I believe that this is one of the reasons for such a low response rate.

By back calculating from day 64, and using the half-life of 12.5 days, one would need at least 9.6 mg/kg to block all the CTLA-4/B-7 pairs. But does this take into the account of the expanding and activated T-cells?

Dr. Jedd Wolchok did a dose concentration experiment and determined that 10mg/kg of Ipilimumab gave the best response rates.


But the new dose concentration 10 to 15 mg/kg used, so there is 3 to 4 times amount of Anti-CTLA-4 in the serum which means at 64 days into the activation of T-cells, there should be enough anti-CTLA-4 antibodies to block the newly upregulated CTLA-4 receptors of the expanded CD4 and CD8 T-cells and Tregs, not to mention the B-cells.


Elliott Sigal
“Yes, Jami. Let me address the comment. I would not call 020 not pivotal. It wasn't pivotal in our thinking years ago. And as a result of conversations with health authorities, and this is why we do this, we decide what is an appropriate indication on file for and do we have data to enable a review. Of Phase III study, that's survival with ipilimumab that does compare against an experimental vaccine in previously treated patients. We consider pivotal to the indication of metastatic melanoma in previously treated patients, where there is no standard of care and therefore we feel it's appropriate standard of care is often experimental regimen to compare with the well-characterized experimental treatment and we chose the vaccine. We have an adequate study to check the contribution of ipi alone as well as ipi in combination with the vaccine. We do not to commercialize the vaccine. We do plan to commercialize the 3-milligram dose and the indication that I mentioned. The old 24 first-line study is a different patient population and a different regiments. And when that data becomes available, we hope to provide enough information from that study to talk about an expanded indication for the drug.”


Source: http://seekingalpha.com/article/201918-bristol-myers-squibb-q1-2010-earnings-call-transcript?page=9


Conclusion: 3mg/kg of Ipilimumab is to low in my opinion to produce the response rates that the patients are looking for. We desperately need the dose range between 10 to 15 mg/kg to get more complete responses. We need to suppress the Treg function and keep the T-cells activated longer.



The Making of an Immune Response by Combinatorial Therapy Using Anti-CTLA-4 Blockade and Interleukin-2



Take Care,

Jimmy B

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Saturday, May 1, 2010

The news Is good!!!!! I am still Stable..Melanoma.. Jim Breitfeller

The news Is good!!!!! I am still Stable

Have I beaten this Beast? Time will only tell. As it gets longer from the day of regression, the better the chance of survival.

I believe that it was the combination of treatments that saved my life.

I just wish the clinical research oncologists would take notice.

My immune system did all the work. I believe I am the first patient to get immunized by my own T-cells. Medical history in the making.



The Making of an Immune Response by Combinatorial Therapy Using Anti-CTLA-4 Blockade and Interleukin-2



Take Care,
Jimmy B
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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

Disclaimer

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
(not a PASSIVE RECIPIENT)"

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.

Preview:

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..

https://app.box.com/shared/kjgr6dkztj

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.


http://www.melanomaresearchalliance.org/news/PSA/

Source Fastcures blog



Join the Relay for Life!!!

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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!!!

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Sincerely,

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)
PingpankJF@UPMC.edu


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.