Friday, December 5, 2014

Colonoscopy done, feeling a bit better, and...Inhaled IL-2 for lung mets??!!!


Arthralgias and mouth ulcers continue to wax and wane in their random fashion, but decreasing overall.  REALLY wishing my lungs would improve more rapidly!!!  Tired of coughing and lack of sleep, but I think that is slowly getting better as well.  But....as I sit here with my albuterol/pulmicort hooka (as the kids call it)....I found this:

Low-dose inhalation of interleukin-2 bio-chemotherapy for the treatment of pulmonary metastasis in melanoma patients.  Posch, Weihsengruber, Bartsch, et al.  British Journal of Cancer. March 2014.

Interleukin-2 (IL-2) treatment for...metastatic melanoma has shown remarkable durable responses.  Systemic administration of IL-2 may cause severe side-effects, whereas local administration is considered to be a safe alternative.

20 patients with Stage IV melanoma were treated with 3X3 million IU inhalative IL-2 once daily with monthly dacarbazine bolus injections.  5 (prophy group) were treated after surgical resection of lung mets, 15 (treatment group) had active disease.  Radiographic follow-up was done every 3 months.

9 in the treatment group had clinical benefit with partial regression (27%) or stable disease (33%).  4 had progression of lung mets and 2 were not evaluable.  In the prophy group, none of the patients developed new lung mets during the inhalation therapy.  Median f/u was 7.8 months in the treatment group and 25.7 months in the prophy group.  Treatment was well tolerated in most.  Therefore, IL-2 inhalation might offer an effective and safe treatment option for lung mets and may have a prophylactic potential to prevent recurrence in the lungs after pulmonary melanoma metastasectomy.  Can easily be performed in the outpatient setting.

Sounds like a plan to me!  Albeit with small numbers and limited responses.... Perhaps inhaled IL-2 will be investigated further and be at least part of a successful comprehensive treatment plan.  Not sure about pairing it with dacarbazine, but with other systemic treatments like immunotherapies it may hold real promise.

In news from the other end...colonoscopy was completed.  The day of starvation and "other" sundry activities was not too bad.  All was well within.  No sign of colitis at the moment...perhaps never was.  One 3mm polyp was removed and sent to pathology for review, but it was not ominous looking and is gone now.   In the midst of all that, B did let it be known that 50-60% of all melanoma patients are found to have melanoma in their gut on autopsy. [Clinical Study - Emergency Surgery for Metastatic Melanoma.  Mantas, Tsaparas, Charalampoudis, et al.  International Journal of Surgical Oncology  June 2014  "At autopsy, metastatic deposits are reportedly present in 50 to 60 percent of patients with melanoma; however less than 4 percent of patients are found to have gastrointestinal metastasis during the course of their disease..."]  Hmmmm...  The factoids that man keeps close to his chest.  I'm thinking the next time I do any gut checking, beyond the occasional emotional one, should perhaps wait til MY autopsy!!!  What 'cha think?

From Dinotopia (and folks doing inhaled drugs everywhere) - Breathe deep. Seek peace!  -  c


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