Home Forums Melanoma Diagnosis: Stage IV ADC versus TIL treatment

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  • #21571
    CarolW
    Participant

    Hi. I am new to this forum with questions about ADC and TIL. My brother-in-law was diagnosed 6 years ago and has undergone the following treatments after which his disease has progressed: surgery, radiation, Interferon, IL-2; and Ipi & Yervoy.

    Jeff has recently completed 6 rounds of the Merck anti-PD 1 with mixed results: liver lesions stayed the same but lymph tumors grew and are threatening his intestines and pancreas. He is considering his next clinical trial options. An ADC trial is an option and TIL treatment may be a possibility as well. I am wondering if there are patients that did not respond to IL-2 that had success with the TIL treatment. If so, what percent of those who failed with IL-2 succeeded with TIL? I would also love to hear from anyone with experience with the ADC treatment.

    Thanks for your help.

    #62478
    Catherine Poole
    Keymaster

    Hi Carol,

    Welcome to our forum. You should read Jonathan’s posts which are very thorough on the ADC drug. He has done quite well on it so far but given the highest dose. So to reduce side effects he will be reducing the dosage. The trial he is on is Phase I looking for optimal dosage. Side effects have not been terribly toxic and I’ll let you read up on that yourself.

    TIL is a very grueling therapy. Yes, it involves chemo taking your immune system to zero and the TIL infusion and high does IL2. You must hospitalized for much of this therapy. I feel we don’t know enough about it, no large randomized trials to truly attest to its efficiency. Where has he been offered this? I know that results at NCI have been better than at MDA and Moffitt. But they also are very particular about who is accepted into their therapy.

    I’m sure others will weigh in here and tell you more. Keep in touch and let us know how things are going for you both.

    #62479
    CarolW
    Participant

    Jeff would undergo the TIL treatment at MD Anderson most likely.

    I forgot to mention that the START clinic in San Antonio also suggested at trial of GSK1120212 (JTP-74057, Trametinib) and Akt inhibitor GSK2141795. I can’t find much info about the testing of these drugs. It seems like the Tramentinib is for those with a BRAF mutation and he doesn’t have one. The mutation that Jeff has is NRAS but I have not read of any treatments directed towards that. Have you?

    Also, I am curious about the implantable vaccine that is to go into Phase 1 trials at Dana Farber.

    Thanks for your help!

    #62480
    Catherine Poole
    Keymaster

    The MEK drugs are often used for NRAS positive folks. There is one trial I know of with Novartis: http://clinicaltrials.gov/show/NCT01320085

    The ADC is very promising too. I personally feel the less toxic trials are better for the immune system which is what we need to fend off melanoma.

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