Ärztlicher direktor dr. ursula jacob

Ärztlicher Direktor

Dr. Ursula Jacob

Köln 2011

Therapiekonzepte in der Onkologie

ONCOTRACE

ONCOTRAIL

ONCOCOUNT

TU profile +

Case studies

• Case report for hypertheramia treatment and sensitivity testing:

• Patient C.O., born 13.10.72

• Diagnosis: 01/00 Hodgkin’s disease (nodular sclerotic).• Until 08/00 multiple chemotherapies and radiation with partial remission.• 10/00 recurrence right axilla. No therapy.• 02/01 progressive disease, chemotherapy with ESHAP.• Progressive disease.• 03/01 change of chemotherapy.• 06/01 progressive disease, high dosage chemotherapy, full remission.• 02/02 progressive disease lymph node right axillary region. Radiotherapy.• 08/03 progressive disease mediastinal, hilar lymph nodes, bilateral. CD30 antibody

treatment, without effect. • 05/04 massive progressive disease in PET CT and clinically.

Start of Gemzar mono without effect. High-dosed Prednisolone.• 08/04 in our treatment – chemosensitivity test showed Vinblastin in combination with

Procarbazin in combination with CD20 antibody Mabthera until 12/04.Start of local chemotherapy plus systemic chemo, whole-body hyperthermia every few months until now.PET scan and MRI: full remission until now.

• 12/08 microtumor testing showed cells under the norm.• 11/10 microtumor test: again cells under the normal limit.• Full remission

2007

ONCOTRACE

2008ONCOTRACE

2010ONCOTRACE

• History Patient female

D.F. dob.: 28.01.1947• 2006: Abnormal mammogram then MRI diagnosed stage IV

breast cancer with bone, liver and lymph node metastases. Therapy – bilateral mastectomy (ER+, HER2 –ve) then monthly Zometa, Femara

• 2008: Hepatic recurrence, therapy changed from Femara to Xeloda plus Herceptin (now HER2 +)

• 2009: Progressive disease. Xeloda increased. Tycarb commenced with initial beneficial effect but then further progression. Therapy changed to Abraxane plus Carboplatin (but reduced blood count)

• 9/2010Markedly progressive disease on CT with massive increase in hepatic tumour mass, therapy changed to Abraxane, Zometa and Herceptin with partial remission

• 29.9.10-4.11.10

Treatment in the clinic• Chemosensitivity test performed• Local therapy – chemoperfusion/chemoembolisation

(Prof Vogl, Uniklinik Frankfurt), x3 (28.9.2010 Mitomycin C + Avastin, 12.10.2010 Mitomycin C + Avastin, 29.10.2010 Gemcitabine + Avastin)

• Systemic chemotherapy – 2.10.2010 Navelbine 50 mg (together with whole body hyperthermia )

• Antibody therapy – Thalidomide • Anti-hormone therapy – Faslodex• Other therapies – Zometa, Bondronate• Supportive therapies – whole body hyperthermia (2.10.2010

[39.0], 8.10.2010 [39.1], 1.11.2011 [39.1]), photophoresis

• Given Medication

• Oral – quercetin, Immune plus, vitamin D• Infusion – HepaMerz, vitamin C, selenium, Neurium,

ProNeuroplus, Tationil• Parenteral – thymus/spleen extract,

mesenchymal growth factors

• Ongoing therapy at home

• Chemotherapy – Navelbine 50 mg 2-3 weekly (dependent on blood picture)

• Antibody therapy – Thalidomide• Anti-hormone therapy – Faslodex 250 mg fortnightly• Oral – quercetin, vitamin D, Bondronate, Immune plus, Kwai

(garlic extract), Chlorella, selenium, Hepamerz, CoQ10, probiotics, fish oil, B complex, Viromax

• Parenteral – Lektinol, thymus, mesenchymal growth factors

• 25.1.2011-7.2.2011

Treatment in the clinic

• Local therapy – chemoembolisation/chemoperfusion (Prof Vogl, Uniklinik Frankfurt) with Mitomycin C + Avastin (31.1.2011)

• Systemic chemotherapy 27.1.2011 Navelbine 50 mg (together with whole body hyperthermia )

• Antibody therapy – Thalidomide (ceased 25.1.2011) replaced with Herceptin (3 weekly)

• Anti-hormone therapy – Faslodex• Other therapies – Zometa, Bondronate• Supportive therapies – whole body hyperthermia (27.1.2011

[39.7], 3.2.2011 [39.0], photophoresis


• Oral – quercetin, Immune plus, vitamin D plus Vayara (Boswellia), CoQ10, melatonin, Bactoflor,

• Infusion – HepaMerz, vitamin C, selenium, Neurium, ProNeuroplus, Tationil plus Artemesinin, Agaricus phalloides D4

• Parenteral – thymus/spleen extract, lektinol

Ongoing therapy at home


• Antibody therapy – Herceptin 3 weekly• Anti-hormone therapy – Faslodex 250 mg fortnightly• Oral – vitamin D, Bondronate, Immune plus, selenium,

Hepamerz, CoQ10, probiotics, fish oil, B complex plus Detoxolite, Agaricus phalloides D4, melatonin, Vayara (Boswellia), Aniflazyme, Nattokinase

• Parenteral – Lektinol, thymus, mesenchymal growth factors

• 10.3.2011- 8.4.2011



• Antibody therapy – Removab 16.3.2011 (5 mcg), 21.3.2011 (10 mcg), 28.3.2011 (10 mcg)

• Anti-hormone therapy – Faslodex• Other therapies – Zometa,

Given Medication

• Oral – Immune plus, vitamin D, Vayara (Boswellia), CoQ10, melatonin, Bactoflor, Detoxolite

• Infusion – HepaMerz, vitamin C, selenium, Neurium, ProNeuroplus, Tationil plus Artemesinin, Agaricus phalloides D4

• Parenteral – thymus/spleen extract, lektinol, mesenchyme growth factors

Staging – PET CT – 6.4.2011 total remission in bones and lungs, good partial remission in liver



• Antibody therapy – Herceptin 3 weekly• Anti-hormone therapy – Faslodex 250 mg fortnightly• Oral – vitamin D, Immune plus, Hepamerz, CoQ10, fish oil, B

complex, Agaricus phalloides D4, Vayara (Boswellia), Aniflazyme, Nattokinase

• Parenteral – Lektinol, mesenchymal growth factors

• 20.5.2011-28.5.2011



• Systemic chemotherapy 27.1.2011 Navelbine 50 mg (together with whole body hyperthermia )

• tumour specific targeted antibody therapy on 22.5.11• Anti-hormone therapy – Faslodex• Other therapies – Zometa, Bondronate• Supportive therapies – whole body hyperthermia

(23.5.2011), photophoresis

Given Medication

• Oral –Immune plus, vitamin D, Vayara (Boswellia), CoQ10, melatonin plus Biobran

• Infusion – HepaMerz, vitamin C, selenium, Neurium, ProNeuroplus, Tationil, Artemesinin, Agaricus phalloides D4

• Parenteral – mesenchymal growth factors, lektinol



• Antibody therapy – Herceptin 3 weekly• Anti-hormone therapy – Faslodex 250 mg fortnightly• Oral – vitamin D, Bondronate, Immune plus, Hepamerz,

CoQ10, fish oil, Agaricus phalloides D4, melatonin, Vayara (Boswellia), Aniflazyme, Nattokinase

• Parenteral – Lektinol, mesenchymal growth factors

• 10.09.2011 – 06.10.2011

Treatment in the clinic• Local therapy – chemoembolisation/chemoperfusion

(Prof Vogl, Uniklinik Frankfurt) with Mitomycin C + Avastin (13.9.2011) and 23.9.11 (with Gemcitabine) – initial MRI shows progressive hepatic disease

• Antibody therapy – Removab (5 mcg 18.9.11, 10 mcg 28.9.11)• tumour specific targeted antibody therapy 7/11 and 09/11• Anti-hormone therapy – Faslodex, changed to Tamoxifen

22.9.11• Other therapies – Zometa, Bondronate, Pantozol• Supportive therapies – whole body hyperthermia (15.9.2011

[38,7], 26.9 [39,2]),

Given Medication

• Oral –Immune plus, vitamin D, Vayara (Boswellia), CoQ10, Nattokinase, Aniflazyme, Arcoxia (changed to Arthrotec), Membrain, glycine, Venalot, Cimetidine

• Infusion – HepaMerz, vitamin C, selenium, Neurium, ProNeuroplus, Tationil, Artemesinin, Agaricus phalloides D4, DCA, zinc

• Parenteral – thymus extract, lektinol, methylcobalamin, Iecur growth factors

• Staging PET CT (5.10.11)

full remission

22.11.2010* 01.12.2010* 13.12.2010* 03.01.2011* 12.1.11* 26.01.2011 09.02.2011*119 107 121 132 149 197 107

285 286385 369 341 309 298 265

14.03.2011 20.04.2011* 09.05.2011* 24.05.2011 01.06.2011* 10.06.2011 20.06.2011169 137 167 243 164 163 195288 379

299 355 378 364 36413,8 13,6

11.07.2011 27.07.2011 13.09.2011208 235 369

676433 421

17,7

Tumour markersCEACA15-3CA27,29CA125




05.01.2010* 22.07.2010* 04.08.2010* 21.09.2010* 02.11.2010 17.11.2010*510 494 676 943 360 1301812 1516 2394 951 5241222 1040 1437 1927 377

24,1

CST comparisons(Antibody therapy 22.5.11)Genes 16.09.2010 03.06.2011 28.06.2011 20.09.2011CES1&2 (carboxylase) Normal Normal Normal NormalE2F1 Normal Normal Normal Normalp180 30% over control 30% over control 30% over control 25% over controlp27 35% over control 35% over control 35% over control 30% over controlDPD Normal Normal Normal NormalUP Normal Normal Normal NormalNP Normal Normal Normal NormalTP Normal Normal Normal NormalGamma GC Normal Normal Normal Normalp53 35% over control 40% over control 40% over control 40% over controlp16 50% over control 65% over control 65% over control 65% over controlVEGF 60% over control 60% over control 45% over control 65 % over controlFGF 45% over control 40% over control 25% over control 30% over controlPDGF 40% over control 55% over control 40% over control 30% over controlCOX2 Normal Normal Normal Normal5-LOX Normal Normal Normal NormalMMP 60% over control 40% over control 45% over control 40% over controlTS Normal Normal Normal NormalDHFR Normal Normal Normal NormalSHMT Normal Normal Normal NormalGARFT Normal Normal Normal NormalNFκB 30% over control 30% over control 30% over control 35% over controlIκB (a,d,e) 35% below control 35% below control 45% below control 50% below controlRibonuclease reductase Normal Normal Normal NormalDNA methyltransferase I 30% over control 30% over control 15% over control 20% over controlDNA methylase 20% below control 25% below control 20% below control 20% below controlO6-methylguanin-DNA-tran. Normal Normal Normal NormalTGF-b 35% over control 40% over control 25% over control 30% over controlEGF 45% over control 50% over control 40% over control 55% over controlIGF Normal Normal Normal NormalHistone deacylase-dispeptide Normal Normal Normal NormalBcl-2 Normal Normal Normal NormalKISS-1-r 45% below control 65% below control 25% below control 30% below controlNm23 20% below control 40% below control 15 % below control 10% below controlRas/Raf/MEK/Erk 50% over control 40% over control 30% over control 35% over controlmTOR Normal Normal Normal Normalc-erb-B2 Normal Normal Normal Normalc-erb-B1 Normal Normal Normal NormalBcr-abl Normal Normal Normal Normalh-TERT (Human telomerase) 20% over control 15% over control 15% over control 10% over control

16.09.2010 03.02.2011 03.06.2011 28.06.2011 20.09.2011

CTC (cells/7,5 ml) 6,1 5,8 6,6 4,8 4,5

ONCOTRACE

• History Patient female V.B. dob.: 18.12.1957

• 11/2010: Diagnosed with ovarian cancer with peritoneal carcinomatosis (Figo IIc).

• Treated with debulking surgery and hysterectomy (with reduction in CA125) followed by 6 cycles of Taxol plus carboplatin with further reduction of tumour marker.

• 1/2011 Chemosensitivity test performed

ONCOCOUNT14.06.2011

• 16.06.2011 – 06.07.2011


• Staging PET CT 15.6.2011. ‘discrete residual activity of the peritoneal carcinosis’ and 2 small liver metastases in left liver lobe’

• Antibody therapy – Thalidomide, Removab (5 mcg 17.6.11, 10 mcg 22.6.2011 and 28.6.2011)

• Supportive therapies – whole body hyperthermia (13.6.2011 [39.7]), photophoresis

• Given Medication• Oral – quercetin, Immune plus, vitamin D, Boswellia, CoQ10,

Detoxylite, Nattokinase, Aniflazyme• Infusion – HepaMerz, vitamin C, selenium, Neurium,

ProNeuroplus, Tationil, Faktor AF2, Viromax, B12/folate. Pantozol, Periplasmal

• Parenteral – thymus extract, mesenchymal growth factors, bone marrow extract, Abnoba pini, filgastrim, erythropoetin

• Ongoing therapy at home• Antibody therapy – Thalidomide• Oral – quercetin, Boswellia, vitamin D, Immune plus,

selenium, Hepamerz, fish oil, Nattokinase, Aniflazyme, chlorella, Detoxylite, Ribomunyl, Delimmun

• Parenteral –mesenchymal growth factors, Faktor AF2, • Abnoba pini• Intravenous- vitamin C, glutathione

ONCOCOUNT16.09.2011

• 13.09.2011 – 06.10.2011

Treatment in the clinicRemains well

• Noted to have elevated TSH (4.70) and subsequently elevated TPO (141), though vitamin D levels optimised

• Staging PET CT 16.9.2011. ‘previously described peritoneal and hepatic changes are no longer traceable. Present activity level does not differ from the surrounding, so that one can speak of a complete remission’

• Antibody therapy – Thalidomide, Removab (5 mcg 17.9.2011, 10 mcg 26.9.2011)

• Dendritic cell vaccination – 22.9.2011• Supportive therapies – whole body hyperthermia

(14.9.2011 [40.2]), photophoresis


• Oral – quercetin, Immune plus, vitamin D, Boswellia, CoQ10, Detoxylite, Nattokinase, Aniflazyme, glycine, Membrain, Kreon

• Infusion – HepaMerz, vitamin C, selenium, Neurium, ProNeuroplus, Tationil, zinc, Agaricus, Artesunate, Periplasmal

• Parenteral – thymus extract, mesenchymal growth factors, thyroid extract, Abnoba pini, filgastrim, erythropoetin


• Antibody therapy – Thalidomide

• Oral – quercetin, Boswellia, vitamin D, Immune plus, selenium, Hepamerz, fish oil, Nattokinase, Aniflazyme, glycine, Membrain, Delimmun, Labolife 2HERP, Labolife 2EBV

• Parenteral –mesenchymal growth factors, thyroid extract,

Abnoba pini, Zylexis

RGCC ONCOTRAIL 28.01.2011 08.06.2011 14.09.2011

CTC (cells/ml) 5,7 4,8 3,6

Viral activity and cancer

What can we learn from this?

CFS Test

• History Patient male

M.M. dob.: 29.07.1968

• Diagnosis:. 07/08 Lennert’s lymphoma (Hodgkin’s disease), stage IV, diagnosed through a lymph node biopsy left cervical region, with multiple mediastinal, abdominal and retroperitoneal lymph nodes, as well as hepato- and splenomegaly. (Histologically lymphoma Popema-Lennert, CD 20 positive, CD 30 negative.)

• 04/2009: Full remission in PET CT. Thalidomide from 04-06/09.


• 10/08-12/08 chemotherapy with BEACOPP-14 plus Mabthera with full remission ( 4 cycles )

• 12/08 consolidation therapy with Mabthera until 03/09• 03/09 Thalidomide until 08/09• 08/09 Finished Thalidomide and Mabthera• Microtumor test showed an decrease of the tumor cell

amount• CFS Panel showed an increased RT-PCR for EBV virus in the

cell• The autoimmune panel showed no signs of autoimmune

disease

Tumour markers 15.09.2008 18.11.2008 27.02.2009 09.12.2009 05.11.2010

Thymidine kinase (<7) 8,9 12,4 13 7,9 4,7

β-2 microglobulin (0,7-1,8) 2 2,2 2,3 1,1 1,6

09.03.2009 17.08.2009 30.09.2009 11.05.2010 10.11.2010 18.08.2011

CTC (cells/ml) 3,7 2,9 2,2 0 0 <1

24.08.2009

CLINICAL RESULTS • The scientific base of micro-arrays analysis of gene

expression is confirmed by the clinical data that we collect from our patients. This information has been organized into

DATA TABLES OF CANCER PATIENTS’ RESPONSE TO SUGGESTED SCHEMES THROUGH CHEMO-SENSITIVITY – CHEMO-RESISTANCE TESTING

Ärztlicher direktor dr. ursula jacob

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