The Houston Trial

The most interesting and promising trial I found in my research is at Baylor College of Medicine and Houston Methodist Hospital. Called HPV-16/18 E6/E7-Specific T Lymphocytes, Relapsed HPV-Associated Cancers (HESTIA), this trial is a different approach to immunotherapy for cancer featuring Adoptive Cell Transfer.

Here’s a description of Adoptive Cell Transfer, from Cancer Research:

Another major avenue of immunotherapy for head and neck cancer is adoptive T cell transfer. In this approach, T cells are removed from a patient, genetically modified or treated with chemicals to enhance their activity, and then re-introduced into the patient with the goal of improving the immune system’s anti-cancer response.

adoptive-t-cell-transfer

This is a phase 1 trial, so there are no results available. However, the same team performed a similar study on cancers caused by the Epstein-Barr virus, with astonishing results:

The investigators have previously studied cancers caused by a different virus, called Epstein-Barr virus (EBV). These EBV-cancers are like HPV-cancers, since they turn off the T cells that would otherwise destroy them, and so can keep growing. They investigators have found, however, that if they removed the T cells from the blood of patients with EBV-cancers and grew them outside the body, they could increase the number and the activity of T cells directed against the tumors. When these T cells were given back to the patients, the T cells eliminated the cancers in over half the recipients. Investigators also found that they could engineer the T cells to be even more active against the EBV-cancer cells by making them resist an inhibitory chemical called TGF-beta, which is produced by these cancer cells.

Elimination of cancer has been exceptionally rare for metastatic cancer patients who failed first-line therapy (the patients treated in the Epstein-Barr trial). Fifty percent response is an unheard of response rate for a novel treatment. Combined, a fifty percent response rate that eliminated the cancer is astonishing.

I’ve been accepted into this trial in Houston, and have the blood kits waiting for me to head to the doctor and have a bunch of little vials filled up. Then it takes 6-8 weeks for them to generate the T-cells. It was great news that I’d been accepted, but even better news that the cells will be waiting for me when I want them–there’s no rush to get them if the combination trial works for me. They’ll hold the cells for me for up to fifteen years!

So why am I not doing this trial first? I can begin the combination trial almost two months before the cells would be ready in Houston. In order to have the Houston treatment, I would have to drop out of the combination trial–and I would not be allowed to re-enter it. There were limited spots in the combination trial and I was lucky to get one, and if the drug combination works for me, it’s in my best interest to stay on it as long as it continues working.

I’ll blog about the steps in the Houston trial as they occur although, of course, the hope is that I respond well enough to the combination trial that I don’t need those T-cells for a long time.

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