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Revision as of 17:21, 4 May 2017

My Immune Therapy Plan

Nivolumab (Opdivo) and other immunotherapy drugs work by both boosting the immune system and targeting cancer using "checkpoint inhibitors". Some cancers put put a substance called PD-L1 that makes the adaptive immune system (T Cells) not be able to see the cancer. PD-L1 is an "I'm a friend - don't kill me" signal that hides the cancer from attack. Opdivo removes the mask allowing the immune system to see the cancer and attack it. In some cases even leading to a complete cure.

However ...

You can't unmask something that isn't masked in the first place so if you have PD-L1 then that's great. But I don't have it so a drug that removes a mask that isn't there isn't likely to work.

Nivolumab apparently does more that just remove the mask. Although the literature focuses on PD-L1, the list of possible side effects look similar to people who have autoimmune problems. In other words - it looks like it also stimulates the immune system to the point where it might attack your body's good cells. It appears that Nivolumab has more than one function - to unmask the cancer - and to stimulate the immune system and put it in learn mode so that the T cells can identify the cancer and attack it.

The Abscopal Effect

The Abscopal Effect is something that has been observed but, in my opinion, not got the attention it deserves. In some patients receiving radiation therapy, and often in combination with immunotherapy, the radiation kills cancer cells in a way that exposed the antigens (something that the adaptive immune system sees to identify cancer) to the T-cells, and causing the T cells to learn the cancer and attack it all over the body, not just where it was treated with radiation. This effect happens rarely and it is believed to be the result of a combination of events timed right to cause the immune system to "go to school" and learn the cancer's antigens. And it is this effect that I'm going to try to take advantage of to beat an unbeatable cancer.

It seems to me that even without PD-L1 - if the radiation can expose the cancer's antigens to the T-Cells, then radiation substitutes for PD-L1 unmasking allowing other properties of Nivolumab to go to work creating the immune response that makes Nivolumab work. But to do this, I have to get the sequence and timing right. And that is of course - the tricky part, I'm not a doctor - and I need to figure out stuff the doctors haven't yet figured out.

Important Assumptions in triggering the Abscopal Effect

I'll start with a list of what I know - or what I think I know.

1. The Abscopal Effect has the potential to take me to long life and possibly a total cure if it is successful.