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#3 - A Personalized Neoantigen Vaccine [Kasey Altman Hackathon]

Thanks again for your interest in the Kasey Altman hackathon to find the best next treatment for this rare cancer patient. This is our weekly update (#3), especially for those who were unable to join us in person on Thursday (June 17). Each call has its own flavor, and this one turned into a tutorial/education session with the crowd experts helping us (the lay people/patients/caregivers) understand the science and the choices Kasey faces, especially for her plan to get a personalized cancer vaccine.


Kasey’s Update: In the Hospital Due to Chemo Side Effects


Kasey joined our call from Memorial Sloan Kettering. She was hospitalized at midnight on Wednesday with a fever (over 102) and neutropenia (low neutrophil count) before her Neulasta shot could augment her numbers. (Unfortunately, she missed Tuesday night’s Nets playoff game. She had surprised her dad with tickets for Father’s Day.) It is typical to reach a low ebb 8-10 days after heavy chemotherapy. She got labs, cultures, and IV antibiotics. 


Kasey is scheduled to get scans (PET/MRI and CT) on Monday (June 21). We should have results by our next update on Thursday. Hopefully “No Evidence of Disease”!


Delsee’s Update: Worried about Bridging Kasey to Her Immunotherapy Trial


Delsee reported that Dr. Ezra Cohen’s projections for the availability of a personalized cancer vaccine for Kasey is estimated to be 16 weeks out (which works out to be in early October). This timing creates a possible coverage gap between the end of Kasey’s 9-month frontline treatment (which is coming up in a week) and the beginning of the cancer vaccine. While Kasey’s cancer is responsive to front line treatment, it is known to be aggressive. The challenge is keeping a possible recurrence at bay.


Delsee also updated us on Kasey’s tests: Tempus is performing whole exome sequencing (WES) on the March biopsy tissue, per Dr. Cohen’s request, to provide a complement to the RNA sequencing done on the same tissue sample.


Roundtable Discussion: The Science of Targeted Immunotherapies


The majority of our roundtable discussion revolved around questions, explanations, and suggestions relating to immunotherapy: from differentiating typical vaccines from cancer vaccines and CAR-T cell therapy from precision immunotherapy treatment. Elena Brin (CSO of Athae Bio) helped shed light on these concepts fundamental to Kasey’s current plan and options. For example, among options for patients who express the B7-H3 antigen (which Kasey’s cells highly express), there is a CAR-T clinical trial, eligible to those who experience recurrence or who are refractory (not responding to treatment.)


Data Gathering Update: Recommendations for Potential Tests and Treatment Options


The conversation last meeting and at this meeting reinforced the importance of having working documents that capture the discussion around things like best tests and best treatments. We now have shared docs drafted on tests and treatments for Kasey. Besides a simple spreadsheet, we are also capturing the rationale or explanation that underlies some of the diagnostics and the treatments. At your convenience, please review and comment on these working documents:


In Closing: Our Requests


  • Please review the working documents on Kasey’s possible tests and treatments and edit and comment.

  • Please check out the online conversation (on Slack) and add your comments, questions, and suggestions.

  • For more details, please reference the recording below.


Best,


Kasey Altman, Delsee Altman, Lupe Montes, and Brad Power

 

Status Update - In The Hospital With Fever And Low Immune System (3 Mins)


Discussion - Transitioning To A Personalized Cancer Vaccine Clinical Trial (53 Mins)


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