If your lung cancer is a met from your oral/oropharyngeal cancer, the answer is yes you are a candidate. You need to have failed primary treatment with radiation and cisplatin to get into any on going trials. For the limited approval of the drug from FDA, you still need to have already had cisplatin. I watched this go through trials at the NCI oversight committee that I am on, and there are now 4 companies with variants of this idea in the market this was just the first. This got fast tracked from the FDA before the clinical trials were done because the results were so positive.

But not for everyone, and there are still many questions about the side effects and dosing levels to be answered in trials. So while immune checkpoint inhibitors (pd-1 pathway) are an amazing thing for turning your own immune system on, actually allowing it to see something that it was not recognizing as a threat before, there have been a few cases where the immune system attacked more than the tumor with a negative result to the patient.

This is an amazing breakthrough. My Xmas donation ask letter is partly written around this, this year that I will be sending out to thousands of OCF supporters in a week, as OCF was a financial funder along with the NCI and private sector in the idea. We also referred a bunch of patients into the trials. That portion of the patients that did respond have had long durable remissions. Remember that these were patients I was talking to had no hope, and the doctors had pretty much told them to go home and get their affairs in order.

People here on this board are probably the only ones who understand how this impacted me personally, as I talk to these kinds of patients every week, and it is one of the hardest parts of what I do for OCF. But today many of those patients are alive because of immune checkpoint inhibitors. It has completely changed the optimism that I can express to them, and where I can point them compared to just a year ago. The first out was from BMS, then Merck, then Astra Zeneca, and more companies are following as there are slightly different means to approach the idea.

I can see a point in the future where this will become part of the cocktail of things that are done in primary treatment. While we have epidermal grow factor monoclonal antibodies, which have been around for awhile; now we have one designed around the programed death immune checkpoint signaling pathway, and more mechanisms like this are being currently explored. The next step will be careful proteomic and genetic profiling of patients to determine which combination of these things will work for them, as we have seen with the EGFR attack, it does not work on every patient from every etiology.