A Novel Immunotherapy Approach for 'Cold' Cancers - Prostate, Breast, Pancreatic (Gary Onik, MD)
Channel: Cancer Patient Lab
Date: 11/03/2024

February 14, 2024
Discussion forum: community.cancerpatientlab.org

Full transcript: https://docs.google.com/document/d/1mPWTedVDUSnpfSRLs1rKhyp2efcsAsY5icWluAxd9MU/edit?usp=sharing

Cancer patient support and medical advice 00:03
Cancer treatment options with a focus on immunotherapy 01:03
Immunotherapy for hard-to-treat cancers 04:51
Cancer treatment outcomes and immunotherapy 11:49
Immunotherapy for cancer treatment with low side effects. 18:44
Prostate cancer treatment options and genetic testing. 25:27
Prostate cancer treatment with a focus on immunotherapy. 33:43
Immunotherapy for cancer, including cold cryoablation and systemic immune cocktails. 42:42
Immunotherapy customization for cancer treatment. 48:12

“It's an unusual treatment because it is unique in the history of cancer therapy, in that it is the first treatment that so far has worked on every tumor type we have tried it on.” – Gary Onik

“We're priming the immune system to react to the drugs that it didn't react to before and to unmask the tumor, so it can be recognized.” - Gary Onik

Meeting Summary
Advanced cancer patients with solid tumors which don’t respond to immunotherapies (“cold” tumors), such as prostate, breast, and pancreatic cancer patients, look with envy at blood cancer patients with "hot" tumors, who can access immunotherapies and often get amazing results. In traditional immunotherapy the medications are given “systemically” (into a patient’s vein). The tumors of a patient with a solid tumor can see minimal amounts of the medication, and the patient’s normal tissues are exposed to the same levels of medications as the cancer. The result is that many solid tumors don’t respond to the treatment, and there is a significant risk that the patient’s normal tissues can be damaged.
Gary Onik, MD, a physician, researcher, medical device inventor, and a cancer patient and survivor, has developed several innovative techniques and instrumentation to treat cancer, including an ultrasound-guided cryosurgery (freezing) tumor ablation procedure for the prostate and for the liver. He has also developed a unique approach to immunotherapy that creates a cancer vaccine within the patient’s body. The “Onik Method” stimulates the immune system to do what it is supposed to do: recognize and eliminate the tumor. This approach enables immunotherapy for "cold" tumors such as prostate, breast, and pancreatic tumors, that usually do not respond to traditional immunotherapy. He successfully treated his own terminal prostate cancer using this invention. 
What are the steps in this new internal cancer vaccine process?
1. Image the body (with PSMA, CT, or other techniques) to find a target tumor for the procedure.
2. Apply extreme cold with needle-like probes to freeze ("cryoablate") the target tumor, which damages the tumor, releasing proteins/antigens near the tumor.
3. Inject the tumor with immunologic medications that interact with the antigens from the dead tumors, which creates an internal vaccine, revving up the immune system to do its natural job of killing cancer cells. This vaccine circulates around the body and reaches other tumors to hopefully kill/shrink tumors elsewhere (the "abscopal effect").
Large volume tumors will sometimes need adjuvant traditional therapy, or systemic immunotherapy. Some patients will need other therapies later on.

What have been the results?

The results have been unique in the history of cancer therapy – it is the first treatment that so far has worked on every tumor type it has been tried on. In a published study, of 18 prostate cancer patients, 50% had a complete response. Patients with other cancers, such as pancreatic cancer, also showed encouraging results. Of six patients with non-prostate cancer: 33% that had a partial response. The side effects were more limited than expected or seen with systemic immunotherapy. Responses have been durable; in Dr. Onik’s case, five years, and others have lasted many years.

How can you access this internal cancer vaccine?
This approach is currently available under “off label use” – the drugs and techniques are safe, but they are not being applied in the same way as when the drug or technique was approved.

A clinical trial has been approved by the FDA with a focus on pancreatic cancer. They are looking for funding now. Three centers have joined the program. 

Until the trial is completed, a major limitation will be the cost to the patient.

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