two articles

It was thanks to my buddy Charles, who left a comment a few posts ago, that I learned that the name of the drug referred to in my "How Not to Do Journalism" post is CDX-110. Armed with that knowledge, and with the name of the main researcher running the experiments, Dad was able to find two articles that provide plenty of detail about the properties of CDX-110, and the nature of the trials currently being done. The articles are linked below.

1. Can a Vaccine Prevent Brain Cancer Recurrence? (May 11, 2009)

2. Can a Vaccine Stop Brain Cancer from Occurring? (September 25, 2009)

Despite the similar titles,* these aren't the same article.

I should note that Mom's prospects for getting into the trial are gloomy. As Charles noted when he viewed the ClinicalTrials.gov reference to the CDX-110 trial (last updated November 2009), it appears the researchers are not recruiting any new patients.

And when you read the above-linked articles, you'll see that the ideal candidates for CDX research are those whose tumors were almost totally resected during initial debulking surgery, and who successfully underwent standard in-tandem radiation and Temodar therapy. Longtime readers know that Mom suffered a severe MRSA infection, necessitating three surgeries after the first debulking surgery. This interrupted her planned therapy; she not only went through the operations, but also underwent eight weeks of antibiotic treatment to flush the MRSA out of her system to the extent possible.

By the time Mom was ready to begin in-tandem radio- and chemotherapy in earnest, she was growing a second tumor-- precisely what the CDX trial researchers don't want to see. The CDX vaccine isn't merely preventative, but the researchers want to see how well the drug works, along with Temodar, to prevent tumor recurrence.

All of this was unclear in the WJLA news report, but it's now clear that Mom doesn't really fit the research profile. Still, there's no harm in asking the researcher in charge, Dr. Theodore Schwartz, whether his team might consider Mom. Dr. Schwartz is also based at NYP/Weill-Cornell, so it's likely he knows the doctors we'll be seeing on Tuesday (Drs. Boockvar and Riina, we hope). During our Tuesday visit to NYP/WC, we'll ask the docs to let Dr. Schwartz know about Mom. It may be that they'll be able to tell us, on the spot, whether there's even a slight chance that Mom could be a candidate for the CDX trial.

Final note: one commenter-- whose comment I didn't publish because it lacked any identification (please see the comments policy; links to the policy are all over this blog)-- wondered whether the term "vaccine" referred to something preventative. That's a good question. One of the above articles says this:

Cancer vaccines are intended either to treat existing cancers (therapeutic vaccines) or to prevent the development of cancer (prophylactic vaccines). Therapeutic vaccines, which are administered to cancer patients, are designed to treat cancer by stimulating the immune system to recognize and attack human cancer cells without harming normal cells. Prophylactic vaccines are given to healthy individuals to stimulate the immune system to attack cancer-causing viruses and prevent viral infection.

So a vaccine isn't always preventative; it can also assist in diminishing or curing a pathology.

UPDATE: The second article linked above, the September 25 one, makes it clear that Mom is ineligible:

Dr. Lai is aiming to recruit up to 20 patients in the trial, but added that the study has strict guidelines about who is eligible to enroll. "It's by no means a very easy trial to get into – we're very vigilant in our screening of patients," she said. Patients are not eligible if they have undergone chemotherapy and radiation and still have a tumor larger than 1 cm or have more than one tumor.

Timing issues are also important for entering this trial, Dr. Lai said. "The patient would probably have to be screened before they start chemo-radiation to have a chance to get into the trial because the study starts two weeks after the completion of chemo-radiation." The major criterion is that patients must have the tumor protein that is the vaccine's target.

We can only hope that the treatment will have moved from the trial phase to actual implementation while Mom still has a chance of benefiting from it.

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*"Recurrence" and "Occurring," it should be noted, do refer to two very different states of affairs. Frankly, I wonder whether the second article's title is appropriate, as it implies that people with no brain cancer might get an injection of the vaccine to prevent a first occurrence.


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