I read an article in my newspaper this morning about the MANIFEST study, which caused me to delve a little deeper. It is recruiting small numbers of people who are being treated with immunotherapy - at the moment for melanoma, renal cell cancer, bladder cancer and triple negative breast cancer. My personal interest is I have metastatic tnbc and was treated earlier in my journey with the immunotherapy drug pembrolizumab. These drugs don’t work for all patients and they can also have high levels of toxicity. My own experience was the drug worked (I achieved a remission which has so far sustained), and I also experienced high levels of toxicity (an acute kidney injury leading to nephritis, pneumonitis, loss of thyroid function, plus a host of smaller things). There are patients who get hit with the toxicity but don’t reap benefits. The purpose of the study is to try to obtain a better understanding of why some people respond and others don’t. This could lead to better biomarkers than, say, the current eligibility test for pembrolizumab (10% or more of the cells in the sample express PD-L1). Really interesting and helpful.
If anyone reading this is recruited, please do post your experience. It looks like it is looking at a comprehensive set of things including gut biome.
Just to add I recently attended (remotely) a conference on secondary breast cancer. The oncologist who presented the section on TNBC was really keen to have them find better bio markers to indicate whether pembro is likely to work for the patient.
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I have metastatic Triple Negative Breast Cancer, in remission
