A Busy Day

Life – Terror. Ecstasy. Fight. Denial. Flight. Failure. PAIN. Forgiveness. Reconciliation. Hope. Love. Peace – Death.

“Scanxiety.”

A word that has featured in several of my posts. For people who have had a cancer diagnosis, undergoing imaging scans, prostate cancer PSA tests, can lead to a variety of emotions. It is common to feel stress or worry in the period before a medical test, during the test, and while waiting for test results. We call these feelings “scanxiety.”

Three (four)? Appointments, a busy day – A PSA ‘results day’.

1. My first PSA after a recent round of Stereotactic Ablative Radiotherapy (SABR), to destroy a, recently discovered by a PSMA PET Scan, new, 9 mm tumour, located in my pelvic bed. 2. My first physiotherapy appointment post corrective surgery, right hand, Dupuytren’s Contracture plus, 3. A re-dressing appointment for same.

The truth? Today, I wasn’t feeling that anxious.

On a scale of most v least scanxiety, probably the least anxious I have ever been on a results day? After my first SABR session (2019), I was extremely anxious. This turned to frustration, extreme disappointment finally, devastation, on hearing ‘no change’. My PSA, ergo my cancer), had not reduced at all, as was expected, after intense radiation therapy. Fuck me, can nothing beat this cunty disease?

16th September 2022, 10.00am. Appointment 1 (telephone consultation)

Calling me at work, I missed him the first time (9.55). He called back, just after 10.00. Dr Eswar, oncological, radiologist. My sights were set low. I was not expecting any radical news, all I can think about is my hand that is fucking killing me!

Unexpectedly, he seemed genuinely pleased to inform me of a PSA drop! From 2.0 to 1.9 (-5%). Great news. Worse case increase would be 30%, typically, my recent profile has been +13-17% increase. In real terms we are looking at an 18-21% reduction, if you are a fan of statistics, dam lies and statistics, that is?

A great start, considering the (my) aim for this consultation is to prime Dr Eswar for my planned escalation, in the pursuit of securing, relevant cancer clinical trials.

I am extremely proactive in this area and have been planning my next assault to be based upon, this latest, post SABR, treatment prognosis. I have made another, valuable, contact at the Royal Marsden Hospital, Professor De Bono, head of experimental prostate cancer medicine, who has offered ‘to see me’ after I had written to him expressing interest in Cancer Vaccine treatments. Any such ‘consultation’ would require a referral from Dr Eswar.

We went there, we have been there before. Eswar explained that any such referral should (had to) come from my GP. We have done this merry dance before, for another genetics/DNA trial I was interested in.

On that occasion, reluctantly, after numerous requests, Eswar provided a ‘one line’ referral (a note) and I was enrolled on the trial. Suddenly, he remembered our previous encounter, this time he chose to explain. ‘It’s all about the money, I cannot refer you unless it is related to something specific, a condition, a treatment that you might benefit from, an additional intervention…. unless the De Bono consultation is ‘Private’?

I ‘got it’ immediately, admittedly, last time I just thought he was a lazy bastard, this time he told me the truth, as far as he is concerned, his hands are tied by protocol. I thanked him for his honesty and reiterated ‘I get it’ and ‘I don’t want to get you into trouble’.

No choice, we would have to do the budget dance between him, my GP (via his secretary) once I had identified a specific avenue (e.g. a new trial). Little did I know that that would turn out to be today!

Second and third appointments – Redressing of my hand (52 stitches) was easy. The previous dressing had already fallen off. [Nurse], ‘This is fine, it does not need any additional dressings’. [Me],‘ but it’s fucking killing me, is it alright?’ [Nurse], ‘YES, it’s fine [grow a set]. I have been rotating 2 x paracetamol then 2 ibuprofen, 24 seven, every two hours for the past two weeks.

Physiotherapy – [Me], ‘it’s fucking killing me’. ‘YES, it’s infected’ [Me], ‘the nurse has just said it’s alright’? [OH], ‘it must be alright then’. ‘I will make you a splint for night-time’ (to wear in bed, to keep my hand straight). It was too painful to do any actual physiotherapy.

On the way home I called into the local health clinic (My GP), appointment 4? To collect blood test forms ahead of a practice Nurse’s Annual Review (diabetes/high blood pressure/raised cholesterol), also, to be booked as soon as blood tests could be arranged (the earliest available turned out to be November), finally, under the advice of the NHS, to make an appointment for a Flu jab and my 5th Covid Jab (Autunm Booster).

When I checked my emails at home, coincidentally, Dr Thomas Morris, Chief Medical Examiner, Oxford Vacmedix, had emailed with some, highly anticipated, exciting, news that the Christie, Manchester had, finally, began clinical trials for a Cancer Vaccine!

Oxford Vacmedix, a U.K.-based bio company specialising in cancer vaccines and partner of Korea’s CancerRop, won the regulatory approval to conduct a phase 1 trial of vaccine candidate OVM-200.

Although we usually think of vaccines as preventing diseases, the term can also be applied to drugs that harness the power of the immune system to treat them.

Our immune system is constantly destroying small cancers as they develop. But cancer cells have a variety of strategies to avoid being attacked, allowing the disease to grow and spread. These include making a protein called Survivin. Found on the surface of the cells of many cancers in large quantities, it helps the cancer hide from the immune system.

Exactly how it does this isn’t clear.

One theory is that because it is also found on some healthy cells, albeit in much smaller amounts, the immune system doesn’t realise the cancer cells are dangerous and so doesn’t attack them.

A Phase 1, Multicentre, Open-label, Nonrandomised, First-in-human Study of OVM-200 as a Therapeutic Vaccine in Patients with Locally Advanced or Metastatic Non-Small Cell Lung Cancer, Ovarian Cancer, and Prostate Cancer has been granted approval.

A prototype cancer vaccine, OVM-200 will be tested in humans for the first time in Study OVM-200-100.  I first became aware of the study, the first of its kind, in-human trials in the UK. I enquired about participation eligibility criteria in 2019.

The pandemic has meant severe delays rolling this trail out to the selected clinics. I made friends with the Chief Medical Officer at ‘Oxford Vacmedix’ Dr Thomas Morris. He advised me to wait for the Christie rollout. 2 years on this has now happened and I am doing my best to get onto the trial.

Sadly, (for me) clinical trials are more often than not, reserved as a last chance saloon option for terminally ill, (6 – 12 months life expectancy), patients. My cancer, although Stage 4, advanced, (no cure) is not (often) considered eligible for most trials, or specifically, not as eligible as other, further, down the line patients.

Up to 52 patients aged 18-75 with prostate, lung or ovarian cancer will be enrolled in the Study to find out if OVM-200 is safe to continue studying it in patients with cancer. The Study consists of 2 parts: a dose escalation part and a dose expansion part. In the dose escalation part, up to 4 increasing doses of OVM-200 will be evaluated in small groups of cancer patients to find the recommended dose for the expansion part.

The recommended dose of OVM-200 will then be given to cancer patients in the dose expansion part to confirm safety and understand how effective it is against their disease and if there are any side effects.

Patients who agree to participate in the Study and pass screening will receive 3 doses of OVM-200 in total at 2-week intervals as an injection under the skin. After completing treatment with OVM-200 patients will be followed up for side effects and to monitor changes in their cancer. Patients will stay on the Study for about 6 months in total during which they will have 10 hospital visits.

The Study will run at around 5 sites in the UK.

The U.K. Medicines and Healthcare products Regulatory Authority (MHRA) gave the go-ahead based on the company’s plan to focus on safety and establishing immune response in patients with non-small-cell lung cancer (NSCLC), prostate cancer, and ovarian cancer in the study, according to Oxford Vacmedix.

The study, run by LabCorp, formerly known as Covance, at five sites in the U.K., including University College Hospital (UCH) London, the cancer hospital of the Oxford University Hospitals Foundation Trust (OUHFT), and the Christie in Manchester.

CancerRop, a domestic company specialising in molecular diagnostics and cancer drugs, holds the largest shares of Oxford Vacmedix. CancerRop jumped into developing cancer vaccines after taking over its U.K. partner.

OVM-200 is a cancer vaccine developed by using the company’s novel recombinant overlapping peptide (ROP) platform. It targets the protein Survivin overexpressed in cancer cells and prevents the immune system from attacking malignant cells.

Professor Martin Forster is leading the phase 1 study at UCH. The study is testing OVM-200 and ROP-based technology for the first time in clinical trials.

“We were very pleased to receive both Ethics approval and MHRA’s regulatory approval for the phase 1 trial of OVM-200,” said Dr. Tom Morris, chief medical officer of Oxford Vacmedix. “With this trial, we are looking at three cancers with high unmet clinical need, and we see the potential benefits of a vaccination approach both in stimulating the immune system to attack cancer and enhance the efficacy of immune-oncology agents in the future.”

Dr. Morris added that the study would be the first step towards having an effective vaccine for cancers.

Oxford Vacmedix CEO William Finch also said, “I am delighted that we have reached the significant milestone, and the ROP technology pioneered by Dr. Shisong Jiang has been developed from an initial concept in the laboratory to now being tested as a treatment for critically ill patients.”

The advancements have been made due to the team’s great efforts at OVM, building on the advice from both our Scientific Advisory Council and from the Clinical Advisory Board for OVM-200, Finch said.

The Oxford Vacmedix CEO added that the ROP technology offers hope for cancer patients for longer and better lives with safe and effective therapies.

For me (and others) this could be a complete game changer.

From no cure to cure.

Thanks for Reading

Hope

출처 : KBR(http://www.koreabiomed.com)