Dear coolesgu, final last recent inASCO، ASCO 2016 promises to reveal exciting clinical data in GU malignancies. I will highlight some of these data with downloadable slidesets and an online activity where I will discuss the clinical implications of the data with Daniel M. Geynisman, MD, after the ASCO annual meeting. Chief among them—and on the heels of the recent FDA approval—are updated data from IMvigor210 investigating the anti–PD-L1 checkpoint inhibitor atezolizumab in advanced urothelial cancer, both in cisplatin-refractory and cisplatin-ineligible patients that will be presented. In addition, predictive biomarker data from these trials are being generated. The anti–PD-1 checkpoint inhibitor nivolumab is now approved in refractory RCC, and phase III data from CheckMate 025 will be presented, as well as a phase III trial comparing nivolumab head to head with everolimus, both evaluating treatment beyond progression, a scenario that we encounter frequently in practice. Finally, data exploring chemotherapy in CRPC with cabazitaxel in the first-line setting and intermittent vs continuous docetaxel, as well as the androgen receptor splice variant AR-V7, a potential predictive marker for novel hormonal therapy, are awaited.

We have a limited experience (7 cases of RCC metastatic cancer) treated with the triple approach:

1) Very high dose of proton pump inhibitors like pantoprazol or even better lanzoprazol

2) Ciprofloxacine

3) Metformin

4) Carbonic anhydrase inhibitor acetazolamide

5) Sodium difenylhydantoinate.

6) Sylimarin

Four patients show stable disease without progression after 9 month.

One patient died two month after initiating treatment due to cerebral metastasis.

Two patients are still alive but with disease progression.

This treatment is absolutely unexpensive and lacks toxicity.

The data mentioned here has not been published yet.

If you are interested in the fundamentals of this approach you may read it at

https://www.ncbi.nlm.nih.gov/pubmed/28122261

and also a similar articular I published in Researchgate.

Dear Tomas Koltai

It is very interesting about the concept of triple therapy to treat the cancer. I think it's a new information that become a very good field to do some research. Do you have any suggestion of basic research using RCC cell line to support the hipotesis using triple therapy in RCC?

Thank you

Dear Andiko

All the patients I described in my previous comment (7 patients) were cases of advanced metastatic RCC. We added silimarin to the triple edged protocol because there are two japanese researches that have shown interesting results with this drug in RCC.

We have not performed basic research on RCC cells. We could not find a sponsor for such a plan, mainly because we are dealing with repurposed drugs that are not under patent protection.

Just to complete my previous comment, I have to add that the four surviving patients recently went beyond one year survival without disease progression. One of them is alive and well after 4 and a half years after treatment initiation.

In all the cases, the treatment was not interrupted at any time and have been well tolerated.

I think that it would be very interesting to test the triple approach at basic level, on cells. Now we are going precisely against basic research rules.

We have acceptable results in patients without having performed the basic cellular research.

This subversion of the rules was born out of need but if you are interested in the issue I encourage you to make the basic experiments that we could not accomplish.

You may count with my full cooperation.

For an easier link my mails are

[email protected]

and

[email protected]

Best regards

Tomas 

People have been trying cytotoxic chemotherapy for decades and nothing works worth describing. Some products that do work are interferon especially with VGEF inhibitors, IL-2, some TKI's, and the PD-1 PD-L1 checkpoint inhibitors.

Think of VHL isoforms and apoptotic resistance

http://www.nature.com/articles/cddiscovery201723