non-invasive CIS bladder cancer, stage 0-1

Ron, I hope your cousin found all these clinical trials that I copied for you just in case.

Ongoing Trials

MPDL3280A, an anti-PD-L1 antibody made by Roche/Genentech, is undergoing a phase I trial, which showed that it shrank tumors in 13 out of 30 patients who had been previously treated for metastatic bladder cancer, and the responses were rapid and ongoing. The trial is continuing (NCT01375842) and there is a phase II trial in bladder cancer patients which just started (NCT02108652).

Nivolumab is an anti-PD-1 antibody and ipilimumab (Yervoy®) is an anti-CTLA-4 antibody, being produced by Bristol-Myers Squibb. They have a phase I/II trial of nivolumab or nivolumab and ipilimumab in several cancers, including bladder cancer. (NCT01928394)

Oncolytic viruses specifically kill cancer cells. CG0070, a product of Cold Genesys, Inc., is an oncolytic adenovirus that also expresses the immune stimulating cytokine GM-CSF to further enhance the anti-tumor immune response. A phase II/III study is testing intravesical CG0070 in patients with CIS of the bladder or with non-muscle invasive bladder cancer plus CIS of the bladder and who have failed BCG therapy (NCT01438112).

HS-410 is a therapeutic vaccine made from a human bladder cancer cell line that has been irradiated and engineered to express soluble gp96, a chaperone protein that can present multiple tumor antigens to the immune system and act as an adjuvant to enhance the immune response. A phase I/II trial sponsored by Heat Biologics testing HS-410 is currently enrolling patients with high-risk, non-muscle invasive bladder cancer who have completed surgery and intravesical BCG therapy (NCT02010203).

A phase I study at Roswell Park Cancer Institute is testing the DEC-205-NY-ESO-1 fusion protein vaccine with or without the biological therapy sirolimus in patients with a variety of solid tumors, including recurrent and metastatic bladder cancer. This vaccine may help build an immune response against tumor cells that express the cancer-testis antigen NY-ESO-1. The addition of sirolimus may enhance this immune response. (NCT01522820)

ALT-801, a product of Altor Bioscience Corporation, is a fusion of the cytokine interleukin-2 (IL-2) and an antibody that recognizes peptides on the surface of tumor cells. Treatment with IL-2 can enhance the activity of the immune system against tumors but can also cause many side effects. By linking IL-2 to the antibody, ALT-801 can target IL-2 to cancer cells. Two phase I/II trials are testing ALT-801 in combination with gemcitabine in patients with non-muscle invasive bladder cancer who have failed BCG therapy (NCT01625260) and in combination with gemcitabine and cisplatin in patients with muscle invasive bladder cancer (NCT01326871).

Ron,
I was doing some research too and I put interesting research papers in the Articles section on this forum. I think we need to actively add interesting articles in that section for everybody to easily find them. AnneH is also looking. If your cousin finds interesting research or clinical trials, anything that can be of interest to other people please give us links in the article section. And of course the moderators are looking too.
By the way, this is another link for the PD-L1 target drug that I wrote about some time ago. www.bbc.com/news/health-30206539

Fighterm, after my first six bcg treatments my first 3 month cysto result was atypical so there was some success. 4 months later the cancer was back in the next cysto. I guess that's why he wants to do bcg alone. But if it doesn't work this time it's RC. Right now I'm leaning toward the study though. My wifes cousin works at Albert Einstein and is extremely smart and is doing a lot of research for me. He believes that Sloan has identified the gene that needs help and the meds may work (if I'm explaining it correctly) and he thinks it's worth a try.

Alan, you also mentioned that somebody had their first BCG treatments for 6 weeks and it did not work from the start. Yes, it means refractory right away. For that case the combination with interferon was justified. It was the only option rather then remove the bladder. I know something about refractory cancers. My hematologist explained to me that when I stop responding to the drugs then it will be the end of me. I always save some good options for the next relapse. Options that I have not tried and have not developed resistance to. Good thing in the lymphoma world, we have a revolution there, so many new drugs are coming in the pipeline, that makes me hopeful. I am actually expecting a cure in the next 5 years for my type of lymphoma. Hopefully, the same will start happening for all cancers including BC.

Alan, after your comments I read some papers and I have some explanation for this discrepancy. BCG by itself is very good, but almost half the patients have recurrences. After several treatments with bcg it stops working. Such disease is called refractory. Then there is a need for something new. It was shown in clinical trials that in the case of a refractory disease (to bcg) they had better results with reduced BCG to which interferon-a was added. It is important to keep some good options available for a refractory BC.