I alas failed Keytruda for squamous cell carcinoma of the head and neck, in 2023; right now I'm on an antibody-drug conjugate from Seagen called PDL1V, which, as the name implies, also targets PD-L1: https://jakeseliger.com/2024/05/20/in-which-the-antibody-drug-conjugate-adc-pdl1v-shrinks-the-tumors-in-my-neck-and-buys-me-more-time/. Ma…
Yes, ICI use in HNSCC hasn't been as successful as hoped. I'm a big fan of the ADC approach and ICI-type ADCs are cool - ideally the best of the chemo and immuno approaches combined. Glad you had a response to the Seagen ADC even with the signs of adaptation! Lots to learn about optimal payloads and mechanism of action for ADC. We need more like T-DxD.
Another ADC, this one by Abbvie: https://clinicaltrials.gov/study/NCT06084481?term=ABBV-400&rank=1 is a possible next step. But its payload is also MMAE, and if my HNSCC has somehow managed to adapt to MMAE already, then something else probably makes more sense.
Another possibility is from TScan Therapeutics, in the form of "A Basket Study of Customized Autologous TCR-T Cell Therapies." https://www.clinicaltrials.gov/study/NCT05973487?term=tscan002&rank=1 Promising, but also first-in-human happened a few months ago, if I recall correctly, and a lot of promising approaches don't actually work.
A big part of the challenge is also mechanical-logistical: https://bessstillman.substack.com/p/please-be-dying-but-not-too-quickly. Since none of these trials are using a distributed-site process, I have to be able to commute or move to the site itself, which is, to understate things, not so easy right now.
I alas failed Keytruda for squamous cell carcinoma of the head and neck, in 2023; right now I'm on an antibody-drug conjugate from Seagen called PDL1V, which, as the name implies, also targets PD-L1: https://jakeseliger.com/2024/05/20/in-which-the-antibody-drug-conjugate-adc-pdl1v-shrinks-the-tumors-in-my-neck-and-buys-me-more-time/. May CT scans showed that it had shrunk tumors; scans from last week, though, appear to show tumors adapting to it as well.
Yes, ICI use in HNSCC hasn't been as successful as hoped. I'm a big fan of the ADC approach and ICI-type ADCs are cool - ideally the best of the chemo and immuno approaches combined. Glad you had a response to the Seagen ADC even with the signs of adaptation! Lots to learn about optimal payloads and mechanism of action for ADC. We need more like T-DxD.
Another ADC, this one by Abbvie: https://clinicaltrials.gov/study/NCT06084481?term=ABBV-400&rank=1 is a possible next step. But its payload is also MMAE, and if my HNSCC has somehow managed to adapt to MMAE already, then something else probably makes more sense.
Another possibility is from TScan Therapeutics, in the form of "A Basket Study of Customized Autologous TCR-T Cell Therapies." https://www.clinicaltrials.gov/study/NCT05973487?term=tscan002&rank=1 Promising, but also first-in-human happened a few months ago, if I recall correctly, and a lot of promising approaches don't actually work.
A big part of the challenge is also mechanical-logistical: https://bessstillman.substack.com/p/please-be-dying-but-not-too-quickly. Since none of these trials are using a distributed-site process, I have to be able to commute or move to the site itself, which is, to understate things, not so easy right now.