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Tuesday, November 01, 2016 6:20:17 PM
well now we seem to be making some progress as we are no longer talking about electroporating PD1 inhibitors, but instead taking about ep of DNA encoding for PD1 inhibitors. However, no compelling explanation of the reason for doing this has been offered. thanks
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Original message:
"I tend to engage in a lot of thought experiments...
Absolutely no one is talking about electroporating checkpoint inhibitors, as they are administered systemically. For metastatic diseases, this wide administration makes a lot of sense, as tumors are found in more than one place in the body.
But what were to happen if you were to electroporate a combination of genes including IL-12 and GP96/OX40L with checkpoint inhibitor(s)?
In non-metastatic solid tumors, I think complimentary pathways would be triggered to allow complete tumor regressions. This would theoretically benefit patients with both resectable and non-resectable tumors. In patients who would normally have tumors surgically removed, you could build immunity to tumor associated antigens, thus preventing recurrences. You tend to see maintenance chemo therapy in patients with surgically removed tumors;this combination EP approach would replace the chemos and would be performed prior to hypothetical surgical removal. I even think surgery will ultimately become unnecessary in most patients - that is how effective I think a combination EP version of IL-12/GP96/OX40L/checkpoint inhibitors would prove to be. I think non-resectable tumors will be dealt the same death blow, leading to long term immunity and recurrence free outcomes.
I even see a situation where the same EP combination could be used in metastatic cancers. I think an electroporated combination of IL-12, GP96/OX40L, and checkpoint inhibitor(s) would serve to immediately annihilate a solid tumor, and using the OX40L co-stimulatory pathway, you would observe significant polyclonal expansion of activated and tumor specific CD8 tcells. The resulting abscopal effect would then serve to prime metastatic tumors for systemic checkpoint inhibitor use.
I seriously believe checkpoint inhibitor genes can be electroporated and expressed intratumorally with other complimentary genes like those I listed. There would still be a reason to use systemic anti-pd-1, anti-ctla-4, and other checkpoint inhibitors in metastatic disease; however, an electroporated version of those genes would become the more universal application."
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