GM-CSF ... PLEASE read

Selizabeth12

My mom just started the Neuvax trial yesterday.

https://clinicaltrials.gov/ct2/show/NCT01570036?te...

I am really excited for her to be getting Herceptin due to research I have seen that it seem works for breast cancer stem cells for patients that express low amounts of HER2. I am also excited about the data collected from previous Neuvax trials. HOWEVER, I have been doing research on GM-CSF and it seems to have more cons than pros. Can anyone tell me what they think about GM-CSF? What does your oncologist think about it? If this has such negative effects and actually induces tumor growth I do not want my mom to continue to continue this trial.

Here are summaries of the negative studies I have found:

"Hematopoietic growth factors are used to reverse chemotherapy-induced leukopenia. However some factors such as GM-CSF induce osteoclast-mediated bone resorption that can promote cancer growth in bone." : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC288885...

"Though in some of these studies GM-CSF appeared to help in generating an immune response, in others no effect or even a suppressive effect was reported" and "As a consequence of such analysis, we conclude that GM-CSF may increase the vaccine-induced immune response when administered repeatedly at relatively low doses (range 40–80 μg for 1–5 days) whereas an opposite effect was often reported at dosages of 100–500 μg" ( In the Neuvax trial it will be adminstered at dosages of 250 every month for 6 months) : http://annonc.oxfordjournals.org/content/18/2/226....

"A drug used to counteract low white blood cell counts in individuals with breast cancer may also be inducing bone metastases" : http://www.nature.com/nm/journal/v13/n1/full/nm010...

"Lastly, the concomitant increase of GM-CSF and pDC was significantly associated with relatively more aggressive breast cancer subtypes." : http://hwmaint.cancerres.aacrjournals.org/cgi/cont...

What do you think? Now I'm really nervous about her continueing with the trial..

Moderators

Hi Selizabeth!

If it helps, here is what you'll find about GM-CSF in the main BC.org site: Experimental Vaccine May Help Reduce Recurrence Risk of HER2-Positive Disease

Best,

The Mods

JohnSmith

Despite being ILC, your Mom is on a different treatment path than my wife, so I can't answer your questions directly, especially since I'm unfamiliar with GM-CSF. In fact, a simple search for "GM-CSF" on this forum generated ~20 comments.
I think SpecialK participated in a trial with GM-CSF, per this thread. I'd reach out to her.

I'm not sure if this addresses your questions, but I've been reading about bone mestastisis prevention.
Her MO might frown on this, but perhaps look into MAF gene testing, per this thread: "MAF" gene responsible for breast cancer bone metastasis". More importantly, there's also a number of discussions on Bisphosphonates (assuming she's post-menopause), which are used for Osteoporosis and can slow down or prevent bone damage due to cancer.

Off topic, it's nice to see a HER2- ILC patient getting Herceptin, given the understudied nature of ILC (compared to other subtypes).
The Herceptin studies for the HER2- (low Her2) cohort are very intriguing and many look forward to next years results from the NSABP-B-47 trial

I appreciate the thoroughness of your research. Please contribute to the ILC section of the forum.

Selizabeth12

Thanks so much for your response John!

I did do a search last night and found those exact treads you mentioned I reached out to SpecialK but haven't heard back just yet.

My mom is getting Zometa every 6 months to help prevent bone mets. I'm definitely going to look into MAF gene testing, thanks! Her oncologist doesn't necessarily frown upon any information I bring to him.. But I do have to do ALL of the research and ask for anything "extra" like the Zometa.. He has never mentioned anything other than the standard protocol (surgery, chemo, rads, AI) so I'm always looking for new things to bring to him that could have potential benefits.