Immunotherapy

Hi SS89 

I don’t have oesophageal cancer but I have been treated with immunotherapy, hence I am replying to your post. Immunotherapy drugs are a class of drugs called checkpoint inhibitors. They target a particular protein on cancer cells and therefore have strict eligibility criteria. If the cancer doesn’t have the relevant protein target there is no possibility of the drug working so it won’t be offered. It might be that immunotherapy is offered to some people with oesophageal cancer (I don’t know as it’s not my cancer) but if so it will be because their cancer has whatever the drug is targeted to address. The most common class of immunotherapy drugs are PD-1 inhibitors such as pembrolizumab and they only work on cancer that express PD-L1. 

 Coddfish thank you, very much appreciated as I did not understand why I couldn’t have it.

 Coddfish sorry to ask again but do you know much about targeted therapy and what the similarities or differences are with targeted and immunotherapy?

https://www.cancerresearchuk.org/about-cancer/treatment/targeted-cancer-drugs-immunotherapy

hope this helps

Hi SS89

I was originally going down the route of chemo /surgery/ chemo even having a planning meeting with surgeon and after laparoscopy no spread. However had to have an ultrasound on my thyroid (am hypothyroid) day after the surgery planning meeting as the Pet scan had shown activity by thyroid and ultrasound found small suspicious nodule . Plan changed to neo adjuvant immuno + chemo.

I’d already queried before if I could have immuno before any surgery as I am dmmr deficient (and HER-) and read it can be very successful for this group but I was told originally it would only be possible according to NICE guidelines if there was mets found or after surgery it returned. Think it’s a funding issue. However after the suspicious nodule was found I was switched to immuno+ chemo as then considered as having a metastasis.

Worth asking more about your own bio markers … good luck

Hi SS89, 

I have Stage 4 GOJ and have been put on to a clinical trial under the Royal Marsden for Immunotherapy. As PP's have said it's all about the proteins - I am HER2+ but they're also targeting another weird little protein that runs alongside the HER2 and is only present in my Blob, so I get infusions of Herceptin and another of the Immunotherapy drug. 

Everyone I have spoken to in the various hospitals I'm under are all hailing Immunotherapy as a total game changer and there seem to be so many trials that are focusing on bringing this into mainstream use in the UK. I would certainly ask your Oncology team if they could look around for you, apparently the Trials frequently send out emails to Oncology Teams across the Country looking for candidates. 

The only thing I would say is it's also timing. I was called at 5pm on the day before my first chemo session was due asking if I wanted to be put forwards as had I started treatment I wouldn't have been eligible for this particular trial. 

Good luck, it's a really fast moving field and the money being currently thrown at this particular area is astonishing. Keeping everything crossed that you get the same ducks put in a row that I did! 

Sam xx

Hi DollyParsnip 

Thank you so much for the info and sharing. It’s been a possibility Iv been contemplating but now I’m definitely going to ask for more information.

Good luck and all the best to you too xx