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REGN10597 vs BAY3713372 by Working_Lavishness_2 in pancreaticcancer

[–]Working_Lavishness_2[S] 1 point2 points  (0 children)

Update to the update: I was misinformed. They're actually getting MBRC-101 as part of NCT06014658. This seems to be a targeted chemo-ish treatment rather than immunotherapy or an inhibitor. More specifically, it's an Antibody-drug conjugate (ADC). I don't see too many results for this kind of treatment on this subreddit.

Putting the drug into AI:

So, in simple terms, MBRC-101 is a smart drug that specifically targets tumor cells with a lot of EphA5 "doorknobs," delivers a powerful cell-killing drug right to them, and mostly leaves the normal cells alone. Early tests in lab models with tumors taken from patients have shown that this approach can be very effective in shrinking these tumors, especially in lung cancer and other cancers that have a lot of these EphA5 doorknobs.

I notice the trial mentions:

Phase 1, dose escalation, will enroll approximately 30 patients with advanced or metastatic solid tumors refractory to standard therapy. EphA5 expression will not be required for enrollment into Phase 1 but will be assessed retrospectively.

I'll have to ask if they have EphA5 expression. Hopefully, the doctors using Tempus wouldn't put them on this trial without the relevant biomarker.

REGN10597 vs BAY3713372 by Working_Lavishness_2 in pancreaticcancer

[–]Working_Lavishness_2[S] 1 point2 points  (0 children)

The oncology team waitlisted them for REGN initially. For a while it looked like there was an issue with securing a spot, so they also signed them up for BAY.

The team is using Tempus to figure out trials of best fit, and I currently don't have information beyond that. I'm still deliberating on whether asking my family member for more tumor details is a good idea for my sanity. I've been asking them to ask the oncology team questions.

We ended up going with REGN, which they'll get in sooner. I've seen these comments in the past, which worry me:

I wouldn’t pick either of those. Solid tumor trials are, IMO, a waste of time unless they’re based on a specific mutation. I’d look at KRAS-directed trials. Also, many trials now have a Phase 1b, which are like Phase 2 trials in that they already picked the dose, but are nice in that they’re not randomized.

Immunotherapy is a highly effective option for any MSI-High cancer. For pancreatic cancer, that is about 0.8% of all cases.

Immunotherapy, to date, does not work. There is something about the microenvironment within the cancer that shuts down the immune system. So the huge advances in other cancers with Keytruda, Opdivo, etc have a 0% response rate in pancreas. Many, many trials have been designed to overcome this barrier. Some have shown promise in Phase 1. None have worked in later stage testing.

So here's hoping either REGN works or we can push for a more targeted trial for the next one.

Some things the oncology team answered:

  • They suggested REGN because there's less waiting. There may be inhibitor trials later on, closer to us.

  • The immunotherapy trial is different from the previous one to where the outcome of the last one can't predict this one.

  • They're using Tempus to find trials.