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  • Dendritic Cell Cancer Treatment for Urotherial Carcinoma

    Posted by Erza5 on October 18, 2024 at 7:05 pm

    Hello, my father 62 years old was diagnosed with non-invasive bladder tumor in 2019, he had several non-invasive laser surgeries that were not effective and the tumor regrew. The biopsy showed it was non-invasive, low grade tumor. In 2020 he had bladder removal surgery and a neo bladder put in, and he had post-op chemotherapy treatment. He was cancer free for 2 years and then it reappeared in the right kidney ureter. He had kidney removal surgery and one year later it reappeared in the left kidney ureter. It was diagnosed as Urotherial Carcinoma and he was advised to have his other kidney removed for the best success rate. My father is against living with hemodialysis so we decided against surgery. First we tried immunotherapy “pembrolizumab” which was not effective, then he had 4 rounds of chemotherapy (cis-platinum and gemcitabine?!) . He recently had another MRI which showed the chemotherapy is not working so we are now looking into other treatments. I came across ‘ Dendritic cell cancer treatment” and tried to research it but although some websites praise it others say it has only around a 15% rate of success which is not very promising for a treatment that costs thousands of euros.

    I am hoping to find someone who has tried this treatment or who knows more about it.

    • This discussion was modified 2 weeks, 6 days ago by Inspry Inspry.
    • This discussion was modified 2 weeks, 6 days ago by Inspry Inspry.
    Erza5 replied 2 weeks, 2 days ago 2 Members · 2 Replies
  • 2 Replies
  • Erza5

    Member
    October 25, 2024 at 7:45 pm

    Thank you very much for your reply and for the treatment option you mentioned. I will definitely look more into it because the option our doctors are giving is kidney removal which would leave my father in hemodialysis for the rest of his life and that is something he really doesn’t want.

  • joea73

    Member
    October 21, 2024 at 12:21 am

    In the US, the FDA approved most promising treatment for metastatic bladder cancer is the combination of PADCEV and Keytruda. The combo treatment is more effective than PADCEV alone or Keytruda alone. The European Commission recently approved the combo drug/treatment to be sold in EU. So, you may be able to access to the treatment. I am not sure if NHS/UK has yet approved or not. Before this combo treatment was approved by FDA, PADCEV was the next line treatment when gemcitabine/cisplatin chemotherapy and immunotherapy ,e.g. Keytruda was not effective. PADCEV is also chemotherapy but its mechanism of action is different from gemcitabine or cisplatin in such way that PADCEV is targeted chemotherapy aiming at cells which express NECTIN-4 protein on cell membrane, and advanced bladder cancer tends to express high NECTIN-4 on its cell membrane. In the clinical trial, which led to the FDA approval, PADCEV+Keytruda combo extended life double compared systemic chemotherapy, i.e. gemcitabine + cisplatin.

    In terms of Dendritic therapy, it is not still main stream treatment. Dendric cell (DC) is known an important antigen presentation cells (APC). DC picks antigen, i.e. small pieces of cancer, and present it to T-helper cell (CD4+), then T-helper cells stimulate T-Killer cells (CD8+) and help producing millions of T-Killer cells targeting to the specific cancer which matches to the presented cancer antigen. I do not exactly what dendritic cell therapy does, but I expect that they try to produce many dendritic cells with the antigens from your dad’s cancer and inject those dendritic cells back to the body, hoping they will increase the production of T-killer cells to attack the cancer. Well, that is the theory, but as you mentioned, the effectiveness is about 15%. I have not seen any clinical trial being conducted by FDA governed clinical trial yet. So, first I would try to get PADCEV+Keytruda combination.

    https://www.onclive.com/view/enfortumab-vedotin-plus-pembrolizumab-approved-in-europe-for-metastatic-urothelial-cancer

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