Thanks again for your interest in the Kasey Altman hackathon to find the best next treatments for this rare cancer patient. This is our last update (#19), summarizing the discussion in our last meeting on October 7, which both looked back at our conversations (reflections) over these last four months, and forward (next steps for Kasey and future hackathons). We greatly appreciate your attention and support. We have all learned a great deal.
The news from Kasey was disappointing: her cancer has returned, sooner and more aggressively than hoped. The recurrence (a small growth in her primary rectal site and a questionable nodule in her lung) happened five weeks after finishing her treatment, which had included 33 days of radiation. Her next step is surgery at Memorial Sloan Kettering to remove the growth in her primary site in a couple weeks. This will provide tumor tissue for additional genomic testing.
Delsee, Tessa Marcus, and Grace Cordovano noted that the hackathon has prepared Kasey and her family for this moment with a strategy and rational options on what to do next. The strategy that came out of the hackathon’s prioritization panel recommended immunotherapy and targeted treatments (e.g., with B7:H3 as a target, such as the Daiichi Sankyo trial of DS-7300, and BioAtla’s study with AXL). Kasey and her family are considering clinical trials that fit the strategy and the associated eligibility criteria. For example, some clinical trials require that Kasey has a recurrence with a growth of a particular size.
On the same day that they learned about the recurrence of Kasey’s cancer, Kasey and her family also learned that the personalized neoantigen clinical trial which they had been planning on (through Dr. Ezra Cohen at UCSD) for Kasey’s next treatment starting in October had been put on hold. The test of the identified peptides had a negligible response from Kasey’s immune system.
Fortuitously, Kasey and her family had an appointment with an expert in Kasey’s cancer (Dr. Leo Mascarenhas at UCLA) immediately after this development. He helped them think through Kasey’s next steps. He confirmed that one treatment recommendation (a clinical trial from UCLA of a combination of Mocetinostat, an HDAC inhibitor, and Vinorelbine, a chemotherapy drug) from the hackathon prioritization panel was a good option to consider.
Please see the recordings below for more details. For more on Kasey’s treatment options and priorities, please see the section on the CancerHacker Lab website under “Updates on Kasey’s Treatments”. There you will find the list of treatment options, the presentation that was used to structure the prioritization panel conversation, the minutes of that conversation, and the summary report.
In Closing: Our Request
If you haven’t done so already, please fill out the survey on the hackathon process from Tessa Marcus. (Tessa will tabulate and share the survey results.)
Kasey Altman, Delsee Altman, Lupe Montes, and Brad Power