Thursday, July 7, 2022

Cancer Procedures: Ultrasound guided breast mass cryoablation with injection of immunotherapy

Cancer Procedures: Ultrasound guided breast mass cryoablation with injection of immunotherapy




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Tuesday, July 5, 2022

AblationVax™: The Cancer Ablation “Vaccine”

AblationVax™: The Cancer Ablation “Vaccine”





We often use either Montanide ISA 51 or a hydrogel to achieve a depot effect in the tumor microenvironment. If you inject just a water-soluble drug, especially in a non-ablated tumor, much of the drug may exit the tumor microenvironment due to the increased blood flow often found with tumors, creating a wash out effect. This is less of an issue injecting into an ablated tumor, as usually the blood flow has been cut off or reduced by the ablation process. This is another advantage offered by ablation. However, I still feel it is good to use an agent that will cause a slow release and keep the medication for an extended period of time within the tumor environment.
Without going into too much detail of the science behind these findings (which you can find in the References), the basic process involves killing the tumor with cryoablation that will simultaneously stimulate the immune system, and adding vaccine adjuvants and immune checkpoint inhibitor drugs directly at the ablation site so that the typical aspects that will inhibit an effective immune response are blocked. This process creates an effective tumor “vaccine” which, while not technically a vaccine against cancer that healthy people can use to protect against cancer cells forming in the first place, does act in the same way as a vaccine for those who already have cancer cells proliferating in their bodies. The effect is not just the elimination of cancer at the ablation site, but also the stimulation of a complete response against all of that cancer cell type in the body.
Essentially, the patient’s own tumor has created a vaccine response in the body. Different than most vaccines, a vaccine made from your own tumor in your body is specific for you. It may also target numerous tumor antigens, giving the immune system antigen diversity.
This way even if a cancer tries to hide, by mutating and disguising an antigen, this technique of AblationVax™ can have multiple targets, so the cancer typically would have to hide numerous antigens at once, which is far less likely to happen.
–
Jason R Williams, MD DABR
Chief of Interventional Oncology
In order to read more you can download a free copy of my book in the following link

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How does Immunotherapy Work?

How does Immunotherapy Work?Hello




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Thursday, June 30, 2022

Hardly anyone, including doctors who perform this procedure

Hardly anyone, including doctors who perform this procedure





“Hardly anyone, including doctors who perform this procedure, realize that cryoablation can be used to generate a powerful immune response leading to one of the most successful cancer treatments that exist, particularly for patients with Stage III or IV cancer, where the options for treatment are most limited. Each year there are approximately 600,000 advanced cancers diagnosed in the U.S., which would otherwise be practically hopeless cases. But with this ablation technique, combined with immunotherapy, we now have the chance to save many of those lives. Moreover, patients with earlier stages of cancer who would otherwise suffer through toxic chemotherapy and radiation now have more effective choices of treatment with far fewer side effects. I like to call this combination therapy AblationVax™ because of how it optimizes the body’s immune system, similar to how vaccines do.
When I was in medical school and early residency and learned about the potential of this technique to treat cancer, I thought it was the most amazing thing I had heard and assumed word of this new strategy would spread quickly and all oncologists would jump on board. I recognized that the future of cancer treatment would be to target the tumor directly using minimally invasive techniques and image guidance, but I have since discovered that these ablation techniques have been slow to catch on. Even now, years later, the techniques are vastly under-utilized.
It is for these reasons, I believe, that this procedure may not take off until the oncologists themselves learn to do it.”
–
Jason R Williams, MD DABR
Chief of Interventional Oncology
–
In order to read more you can download a free copy of my book in the following link

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Tuesday, June 28, 2022

Combination immunotherapy is generally more effective than any single agent.

Combination immunotherapy is generally more effective than any single agent.





“The anti-cancer immune response is as complex as is cancer itself. It is highly unlikely that one agent alone is sufficient to generate an effective anti-cancer immune response. Not only does CTLA-4 help tumors to suppress the immune response against them, PD-1 also plays an important role.
It has already been shown in clinical trials that the combination of anti-CTLA-4 and anti-PD-1 inhibitors is significantly more effective than either one alone. Just recently the FDA has added approvals of this combination for certain melanoma, kidney and colon cancers. Unfortunately, just as success increases, so does the cost and side effects of the two drugs just as significantly. This is one reason that we inject the medications into the tumor microenvironment, where they need to be. You want the immune response to be directed against the tumor, and where that is more likely to occur is at the tumor site. Once the immune system “learns” how to respond in one location, it is better able to attack cancer elsewhere in the body.
In addition, a treatment such as cryoablation, which is the direct freezing of the tumor, has its own immune-stimulating properties. It can be considered an additional form of immunotherapy to be used with immune checkpoint inhibitors. And because ablation is minimally invasive and tumors are treated with a needle under image guidance, it is the perfect opportunity to administer other immune agents, such as the checkpoint inhibitor drugs, directly into the tumor, at the same time, in one procedure.
Throughout the history of modern medicine, we have found many remarkable powerhouse treatment combinations. A great example is the treatment of HIV/AIDS. Just a few decades ago, an HIV diagnosis was a terminal one. But the current medications used today in combination have had great success and patients can live long, relatively normal lives with their disease. But when these same drugs are used alone, there is only a modest survival increase. Hence, the lessons we have learned in treating HIV patients supports the importance of combination therapy in treating disease, and cancer is no different.
Immune checkpoint inhibitors not only help unlock a natural immune response, they can be essential for helping other immune therapies turn from bust to boom. It’s that synergistic immune response that enables cancer treatments to become far more effective than ever before. While our knowledge of immunotherapy is still developing, we have finally reached a point where cancer patients—like former President Jimmy Carter—can recover from malignant and fast-growing tumors previously thought hopeless. And when I talk about hope, I’m not talking about just passively sitting back and hoping for a cure. I’m talking about taking charge of the recovery process by doing everything possible to give the immune system a fighting chance against cancer.”
Jason R Williams, MD DABR
Chief of Interventional Oncology
In order to read more you can download a free copy of my book in the following link

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Friday, June 24, 2022

Typically your health insurance will not cover the costs of the drugs without FDA approval for your specific form of cancer, but combining immunotherapy with cryoablation or directly injecting the drugs into the tumor can drastically reduce the costs of medications.

HelloTypically your health insurance will not cover the costs of the drugs without FDA approval for your specific form of cancer, but combining immunotherapy with cryoablation or directly injecting the drugs into the tumor can drastically reduce the costs of medications.





“Unfortunately, insurance carriers will almost never provide coverage for a drug used to treat a condition that the FDA hasn’t approved it to treat. That means that if the drug your physician prescribes has not been approved by the FDA to treat the specific form of cancer you have, it may be almost impossible for him or her to offer you a standard immunotherapy treatment that is not directly covered by insurance, even if it may work. Yervoy, for example, may be covered by your insurance carrier for treating certain cases of melanoma, but not for treating other cancers. With a price tag at over $30,000 per infusion—and a course of treatment requiring a minimum of four infusions—it remains a treatment that many patients cannot afford. Bristol-Myers Squibb, the makers of Yervoy, does offer a patient-assistance program that may reduce cost, but it may still be such a steep price beyond the reach of many. There is also the difficulty of finding doctors who may be willing to offer these medications “off-label.” Also keep in mind that we are mainly discussing advanced, Stage IV patients, for which standard therapies may have failed or been of limited success.
Even though the drugs are available outside the United States, where in most cases they would be much less expensive than they are in the U.S., immunotherapy pricing remains fairly steep throughout the world.
But don’t let the price of these drugs discourage you. The key aspect to injecting the drugs directly into the tumor, rather than into the bloodstream, means that even without ablation, it may be possible to achieve the same or better results with a fraction of the dose—and at a fraction of the costs.34 In other words, whereas standard immunotherapy treatment involves infusing the drugs into the bloodstream, by combining immunotherapy with cryoablation or directly injecting these medications into the tumor, the effectiveness of the treatment may be enhanced while the price of that treatment is dramatically reduced.”
Jason R Williams, MD DABR
Chief of Interventional Oncology
In order to read more you can download a free copy of my book in the following link

The post Typically your health insurance will not cover the costs of the drugs without FDA approval for your specific form of cancer, but combining immunotherapy with cryoablation or directly injecting the drugs into the tumor can drastically reduce the costs of medications. appeared first on Williams Cancer Institute.



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Wednesday, June 22, 2022

What You Need to Know to Get Started: The Basics of Cancer Immunotherapy

What You Need to Know to Get Started: The Basics of Cancer Immunotherapy





“In essence, as powerful as the immune system is, cancer  has been even more intelligent. It is not just the fact that the  immune system fails to recognize cancer that has made cancer  so challenging to treat effectively, but also the fact that cancer  is actively able to avoid the immune system.
In simple terms, you can think of the immune system  as having two main divisions, one designed to attack  harmful foreign substances and the other to protect against  an overzealous immune response, acting as defense against  “autoimmunity”—the process of immune cells misperceiving  cells in the body as foreign invaders and attacking them by  mistake. I stress this again because it is important: The division
designed to protect the body from a mistaken immune attack  is known as the regulatory immune system. The regulatory  immune system is obviously critical to reduce the risk of  autoimmune diseases which arise when the immune system  thinks the body’s own cells are foreign ones and must be  destroyed. The regulatory immune system helps prevent these  mistaken attacks on the body’s own cells. You can think of  the protective, regulatory side of the immune system as being  the “brakes” and the attacking side as being the “gas pedal.”  No matter how much you push the gas, if the brakes are fully  applied you will go nowhere. Unfortunately, what that means  when it comes to cancer is that the regulatory portion of the  immune system prevents the rest of the immune system from  attacking cancer cells because those cells are masquerading  as normal, natural cells that belong there. Thus, failing to  recognize the cancer cells for what they are, the regulatory  immune system is an important protector of cancer.
Despite these challenges, the concept of teaching the  immune system to recognize cancer and destroy it has seemed  like the best chance to create a cure in a high percentage of  cancer patients. The immune system has its own intelligence  and it has memory, both of which are crucial to seek out  and kill cancer. A good immune response recognizes many  targets on a cancer, so-called cancer antigens, making it  harder for the cancer to hide. This is the weakness with some  of the one-dimensional treatments, which includes some  vaccines and original versions of CAR-T, which generally  target one antigen. Later in this book, I will discuss in more  detail how intra-tumoral immunotherapy, the injection of  immunotherapy directly into a cancer, may be a good solution  to this problem.”

In order to read more you can download a free copy of my book in the following link
 
Jason R Williams, MD, DABR

The post What You Need to Know to Get Started: The Basics of Cancer Immunotherapy appeared first on Williams Cancer Institute.



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