Thank you for all of the cherry sales, and donations! Thank you Susea & Sandy for helping Dan and I find a room to stay in LA!! Thank you Big Wave Dave & Sally for letting us stay in your home!! Thank you Auntie Lynn for using your air miles for our flights!! We are completely taken care of, all we need to worry about is making the correct medical decision, and I know that very soon, we will have the information to do that.
At 4:55 pm today, Dan and I fly to California to get answers. Who knows what will happen. We will keep you posted.
Thank you for all of the support, both financially and emotionally. It's crazy to think about another brain surgery. I'm finally understanding that it's not just a brain surgery, it would be MY brain surgery. They would shave my head, put me under, saw open my skull, dig around in my tissue, screw the skull back together, staple my skin back together, and then wake me back up. It's pretty intense. And that's if they don't wake me up, it's a whole new ball game if it's another awake craniotomy. But, we don't need to worry about that quite yet. We still don't know if we're going to join into the trial. First things first we'll meet with Dr Linda Liau.
If you're in Friday Harbor for the Fourth of July, please go watch the parade for me. Best. Parade. Evah!! Seriously, it is the best in the nation.
If you're interested in reading an article about a different clinical trial given by Dr Liau, please scroll down.
Personalized vaccine doubles survival time in patients with deadly brain cancer
By Kim Irwin
March 21, 2011
Dr. Linda Liau
A dendritic cell vaccine personalized for each individual
based on the patient's own tumor may increase median survival time in
those with a deadly form of brain cancer called glioblastoma, an
early-phase study at UCLA's Jonsson Comprehensive Cancer Center has
found.
Published last week in the peer-reviewed journal Clinical Cancer
Research, the study also identified a subset of patients more likely to
respond to the vaccine — those with a subtype of glioblastoma known as
mesenchymal, which accounts for about one-third of all cases. This is
the first time in brain cancer research that a subset of patients more
likely to respond to an immunotherapy has been identified, said the
study's senior author, Dr. Linda Liau, a Jonsson Cancer Center
researcher and a professor of neurosurgery.
The study found that the vaccine, administered after conventional
surgery and radio-chemotherapy, was associated with a median survival of
31.4 months, double the 15 months of historical controls in the
published literature. In all, 23 patients were enrolled in the Phase I
study, which was launched in 2003. Of those, about one-third are still
alive, some more than eight years after their diagnosis.
The study also found that the vaccine was safe and that side
effects were minimal, limited mostly to flu-like symptoms and rashes
near the vaccine injection site.
"This is quite an encouraging result, especially in an early-phase
study like this," Liau said. "It's promising to see patients with this
type of brain cancer experience such long survivals."
However, Liau cautioned that the findings need to be confirmed in
larger, randomized studies. She currently is leading a Phase II,
randomized study at UCLA testing the vaccine in newly diagnosed
glioblastoma patients. The patients will receive either the standard of
care (surgery, radiation and chemotherapy) or the standard of care plus
the vaccine. The study is a multi-center trial, and UCLA is the only
site in California.
How the vaccine works
The vaccine preparation is personalized for each individual. After
the tumor is removed, Liau and her team extract the proteins, which
provide the antigens for the vaccine to target. After radiation and
chemotherapy, the white blood cells are taken from the patient and grown
into dendritic cells, a type of white blood cell that is an
antigen-presenting cell.
The vaccine preparation from this point takes about two weeks, as
the dendritic cells are grown together with the patient's own tumor
antigens. The tumor-pulsed dendritic cells are then injected back in to
the body, prompting the T cells to go after the tumor proteins and fight
the malignant cells.
"The body may have trouble fighting cancer because the immune
system doesn't recognize it as a foreign invader," Liau said. "The
dendritic cells activate the patient's T cells to attack the tumor,
basically teaching the immune system to respond to the tumor."
The individualized vaccine is injected into the patient in three
shots given every two weeks for a total of six weeks. Booster shots are
given once every three months until the cancer recurs. Patients are
scanned every two months to monitor for disease recurrence, Liau said.
Success with mesenchymal glioblastoma
It has recently been discovered that there are at least three
subtypes of glioblastoma: proneural, proliferative and mesenchymal.
During the course of her study, Liau and her colleagues saw that one
group of patients seemed to be responding very well to the vaccine. The
researchers examined their tumors using a microarray analysis of their
DNA and found that those with a gene expression profile identifying
their cancers as mesenchymal responded better to the vaccine.
The finding was surprising, Liau said, because patients with the
mesenchymal subtype generally have more aggressive disease and shorter
survival times than those with the other subtypes. In patients with this
type of glioblastoma, several genes that modulate the immune system are
dysregulated, meaning they don't work properly. Liau speculates that
the vaccine helped replenish the immune system, allowing that subset of
patients to more easily fight the brain cancer.
"Glioblastoma remains one of the diseases for which there is no
curative therapy ... and the prognosis for patients with primary
malignant brain tumors remains dismal," the study states. "Our results
suggest that the mesenchymal gene expression profile may identify an
immunogenic sub-group of glioblastoma that may be more responsive to
immune-based therapies."
Eight years of survival
Brad Silver, 41, who grew up in Southern California and now lives
in a Cleveland suburb, was diagnosed with glioblastoma in 2003 and was
told that he had, at best, two months to live. He was stunned.
"I was 33 years old, and my wife was seven months pregnant with my
son," said Silver, a college water polo instructor. "I didn't think I
was going to live to see my son born, let alone grow up."
Silver sought a second opinion at UCLA, and the golf-ball sized
tumor in his left lateral lobe was removed. He underwent radiation and
chemotherapy and enrolled in the vaccine clinical trial. Today, eight
years later, he remains cancer free. His son, named Brad Silver II, will
celebrate his eighth birthday in April.
"If I had listened to that first doctor, I would not be here today.
If not for Dr. Liau, I would not be here today," Silver said. "I'm 100
percent back to being me because of this vaccine and that clinical
trial. It's almost unbelievable."
This study was funded in part by the National Institutes of Health,
the Philip R. and Kenneth A. Jonsson Foundation, the Neidorf Family
Foundation, STOP Cancer, the Ben & Catherine Ivy Foundation and
Northwest Biotherapeutics Inc.
UCLA's Jonsson Comprehensive Cancer Center
has more than 240 researchers and clinicians engaged in disease
research, prevention, detection, control, treatment and education. One
of the nation's largest comprehensive cancer centers, the Jonsson Center
is dedicated to promoting research and translating basic science into
leading-edge clinical studies. In July 2010, the center was named among
the top 10 cancer centers nationwide by U.S. News & World Report, a
ranking it has held for 10 of the last 11 years.
