Dr. Dawson also spent a while dialing back my expectations for the MPDL3280a drug. While she mentioned that the preliminary outcomes that were reported at the 2014 ASCO meeting showing a 50% response cost were very promising, she said that those facts didn't in construction her own individual competencies, or the experiences of other doctors that she had spoken with who were helping run the Phase II trial. She said that she had enrolled 13 patients in the Phase II trial, and of those 13, one had a entire response, and two had a partial response. The tumors of the other 10 patients continued to grow non-beat back. She said that other doctors had also told her that they were seeing a 20% response cost. Based upon that, she said that she would not be amazed if the Phase III trial showed that the response cost for MPDL3280a was about similar to for the taxene-based chemo.
We also discussed how the randomization would work if I was to join the Phase III trial. She said that, as soon as she qualified that I met the criteria, Hoffman-La Roche would enter my files, would conduct the computer-based randomization, and we would be told of the results. She genuinely beneficial me to be able to move because of with the trial regardless of the results — she didn't want me (or other patients) to keep for clinical trials, throwing in the towel if I don't get into the arm that I sought after. I recognize that from the perspective of the objective of the clinical trial, but from my own egocentric viewpoint, I'd as an selection get the anti-PL-L1 drug than the taxene.
Dr. Dawson asked even if I had taken into consideration Dr. Apolo's provide cabozanatinib clinical trial. I told her that Dr. Apolo and I had discussed it, and that the preliminary outcomes didn't appear to be as compelling as those for MPDL3280a, and the unwanted side effects were heaps more critical.
We discussed other clinical trials involving anti-PD-L1 drugs that were also manageable to me. She said that a host of businesses were studying those drugs: Merck has pembrolizumab (MK-3475) that may be in a Phase III trial for metastatic bladder cancer (No. NCT02256436). Bristol-Myers Squibb has nivolumab (BMS-936558) that may be in a Phase half of trial at Johns Hopkins for metastatic bladder cancer (No. NCT01928394). Dr. Apolo is planning a Phase I trial for nivolumab and cabozantinib on bladder cancer patients (No. NCT02308943), but that may be not very yet open. CureTech is engaged on pidilizumab, which is being studied for lymphoma and myeloma, but is not very in any clinical trials for metastatic bladder cancer.
Dr. Dawson said that she would email Dr. Rosen and MSKCC to decide even if he was actually running a trial on the subject material of PD-L1. I will email Drs. Apolo and Aragon-Ching and get their thoughts. My initial thoughts are that I'll roll the dice and with the MPDL3280a trial and see if I'm randomized into the immunotherapy arm. If so, I'll do it. If not, I'll decide even if to get the taxene chemo, or stall while I study either the Merck or Bristol-Myers trials on the subject material of PD-L1.
In essentially unrelated news, this afternoon I obtained an email from Dr. Agarwal's nurse, reporting on the result of the samples he took from my neobladder during the cystoscopy:
Good news, the pathology from your recent procedure looked quality no signal of tumor. Likewise, Dr. Agarwal didn't see any strictures, lesions, or any other obvious source of the bleeding youve been experiencing.If youd like to additional speak about the results with Dr. Agarwal or myself, basically let us know! Good news there, as a minimum.