› Forums › General Melanoma Community › Yervoy and Radiation simultaneously
- This topic has 36 replies, 8 voices, and was last updated 10 years, 2 months ago by
_Paul_.
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- February 12, 2016 at 9:19 pm
My father started Yervoy today. Nice to get the ball rolling. When speaking to his onc last week she said radiation was in the treatment plan and I mentioned reading about doing immunotheraphy and radiation simultaneously. At the appt. this week she agreed that would be a good way to proceed. They are currently working on the mapping for radiation and as soon as that is done radiation will start. Does anyone have experience with combining the two treatments? Seems there are some good studies saying this could be a benefit.My father is stage 3C with extracapsular extention in 2 nodes, and micromets in 2.
Thanks!
Annie
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- February 12, 2016 at 9:41 pm
I have read that it has its benefits. But yervoy is sysmetic treatment to stop the spread around the body. The radiation is more for local. I think when radiation is done they just target the area that had the macro nodes. Ex armpit , groin, neck that was affected. I have my third yervoy infusion monday and wish your father good luck. Greg -
- February 12, 2016 at 9:41 pm
I have read that it has its benefits. But yervoy is sysmetic treatment to stop the spread around the body. The radiation is more for local. I think when radiation is done they just target the area that had the macro nodes. Ex armpit , groin, neck that was affected. I have my third yervoy infusion monday and wish your father good luck. Greg -
- February 12, 2016 at 9:41 pm
I have read that it has its benefits. But yervoy is sysmetic treatment to stop the spread around the body. The radiation is more for local. I think when radiation is done they just target the area that had the macro nodes. Ex armpit , groin, neck that was affected. I have my third yervoy infusion monday and wish your father good luck. Greg -
- February 12, 2016 at 9:46 pm
Annie,
I had SRS to a brain lesion prior to starting a 2 1/2 year trial with Nivo/Opdivo (anti-PD1) in 2010. I was given my last dose in June of 2013 and remain NED. There are many on the board who have utilized radiation simultaneous with various immnuotherapies as well as sequentially to good effect. Here is just one post (with several links within – some addressing radiation with ipi specifically) containing articles that demonstrate the benefit of the combination:
Wishing you and your father my best. Celeste
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- February 12, 2016 at 9:46 pm
Annie,
I had SRS to a brain lesion prior to starting a 2 1/2 year trial with Nivo/Opdivo (anti-PD1) in 2010. I was given my last dose in June of 2013 and remain NED. There are many on the board who have utilized radiation simultaneous with various immnuotherapies as well as sequentially to good effect. Here is just one post (with several links within – some addressing radiation with ipi specifically) containing articles that demonstrate the benefit of the combination:
Wishing you and your father my best. Celeste
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- February 13, 2016 at 3:41 pm
Yes – very exciting stuff going on with immunotherapries and traditional treatments. There has even been some attempts at chemo combinations.
http://www.uphs.upenn.edu/news/News_Releases/2015/03/minn/
There seems to be potential not just for ipi but combined and sequential treatments that finally unlock the immune system to attack the melanoma.
If the patient can stand the radiation and immunotherapy drugs, which most do well on, then I would strongly consider the ability to combine them.
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- February 13, 2016 at 3:41 pm
Yes – very exciting stuff going on with immunotherapries and traditional treatments. There has even been some attempts at chemo combinations.
http://www.uphs.upenn.edu/news/News_Releases/2015/03/minn/
There seems to be potential not just for ipi but combined and sequential treatments that finally unlock the immune system to attack the melanoma.
If the patient can stand the radiation and immunotherapy drugs, which most do well on, then I would strongly consider the ability to combine them.
-
- February 13, 2016 at 3:41 pm
Yes – very exciting stuff going on with immunotherapries and traditional treatments. There has even been some attempts at chemo combinations.
http://www.uphs.upenn.edu/news/News_Releases/2015/03/minn/
There seems to be potential not just for ipi but combined and sequential treatments that finally unlock the immune system to attack the melanoma.
If the patient can stand the radiation and immunotherapy drugs, which most do well on, then I would strongly consider the ability to combine them.
-
- February 12, 2016 at 9:46 pm
Annie,
I had SRS to a brain lesion prior to starting a 2 1/2 year trial with Nivo/Opdivo (anti-PD1) in 2010. I was given my last dose in June of 2013 and remain NED. There are many on the board who have utilized radiation simultaneous with various immnuotherapies as well as sequentially to good effect. Here is just one post (with several links within – some addressing radiation with ipi specifically) containing articles that demonstrate the benefit of the combination:
Wishing you and your father my best. Celeste
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- February 13, 2016 at 5:12 pm
When radiation is done. Is it done to the affected lymph nodes or the whole body. How does that work?-
- February 13, 2016 at 5:57 pm
If you take a look at the article above you will see that they use radiation on one single tumor and then used checkpoint inhibitors in this case Ipi (Yervoy) to treat the whole body. I have listen to a couple of different Oncologist talk about the Abscopal effect and the thinking is that when the radiation kills part of the tumor, it releases antigents into the blood and lymph system. When these antigens are brought to lymph nodes the t-cells will be programed to look for this specific tumor antigen. So by hitting one tumor you will in effect trigger the immune system to do the rest of the job,with the help of Ipi and or Pd-1 immunotherapy drugs. I have always wondered if my stereotatic brain radiation that I had previous to starting on the clinical trial checkmate 69 helped or in other words was there an ( abscopal effect). Hopefully more trials will prove this theory and make it standard of care!!! Ed
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- February 13, 2016 at 5:57 pm
If you take a look at the article above you will see that they use radiation on one single tumor and then used checkpoint inhibitors in this case Ipi (Yervoy) to treat the whole body. I have listen to a couple of different Oncologist talk about the Abscopal effect and the thinking is that when the radiation kills part of the tumor, it releases antigents into the blood and lymph system. When these antigens are brought to lymph nodes the t-cells will be programed to look for this specific tumor antigen. So by hitting one tumor you will in effect trigger the immune system to do the rest of the job,with the help of Ipi and or Pd-1 immunotherapy drugs. I have always wondered if my stereotatic brain radiation that I had previous to starting on the clinical trial checkmate 69 helped or in other words was there an ( abscopal effect). Hopefully more trials will prove this theory and make it standard of care!!! Ed
-
- February 13, 2016 at 5:57 pm
If you take a look at the article above you will see that they use radiation on one single tumor and then used checkpoint inhibitors in this case Ipi (Yervoy) to treat the whole body. I have listen to a couple of different Oncologist talk about the Abscopal effect and the thinking is that when the radiation kills part of the tumor, it releases antigents into the blood and lymph system. When these antigens are brought to lymph nodes the t-cells will be programed to look for this specific tumor antigen. So by hitting one tumor you will in effect trigger the immune system to do the rest of the job,with the help of Ipi and or Pd-1 immunotherapy drugs. I have always wondered if my stereotatic brain radiation that I had previous to starting on the clinical trial checkmate 69 helped or in other words was there an ( abscopal effect). Hopefully more trials will prove this theory and make it standard of care!!! Ed
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- February 13, 2016 at 6:42 pm
Thank you for all the feedback and interesting discussions and links. Seems it is called ABSCOPAL EFFECT and Ed explained it beautifully. I was encouraged by our Onc's willingness to try this, somewhat out-of-the-box combination. At least for Stage 3. One would think that if this is the effect it has, possible in-transit cancer cells would be more targeted as well. Not just excisting tumors.
Here is another link:
http://www.nejm.org/doi/full/10.1056/NEJMoa1112824
Annie
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- February 13, 2016 at 6:42 pm
Thank you for all the feedback and interesting discussions and links. Seems it is called ABSCOPAL EFFECT and Ed explained it beautifully. I was encouraged by our Onc's willingness to try this, somewhat out-of-the-box combination. At least for Stage 3. One would think that if this is the effect it has, possible in-transit cancer cells would be more targeted as well. Not just excisting tumors.
Here is another link:
http://www.nejm.org/doi/full/10.1056/NEJMoa1112824
Annie
-
- February 13, 2016 at 6:42 pm
Thank you for all the feedback and interesting discussions and links. Seems it is called ABSCOPAL EFFECT and Ed explained it beautifully. I was encouraged by our Onc's willingness to try this, somewhat out-of-the-box combination. At least for Stage 3. One would think that if this is the effect it has, possible in-transit cancer cells would be more targeted as well. Not just excisting tumors.
Here is another link:
http://www.nejm.org/doi/full/10.1056/NEJMoa1112824
Annie
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- February 14, 2016 at 1:40 am
Hi Annie,
I was a participant in the RAD-VAX trial at the SCCA in Seattle. This combined the standard ipi protocol of 4 3mg/kg infusions with SRS to one of my tumors (not the largest one). I was only able to complete 3 doses of ipi due to side effects, and at the end did see progression in my largest tumor, but the rest remained stable.
I wish I could say for certain whether the addition of the SRS to the ipi had an effect, but I guess we need to wait for the trial results. What I do know was that the decision was a no brainer for me given that ipi was the standard of care anyway. Why not give it an extra (hopeful) boost?
– Paul
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- February 14, 2016 at 1:40 am
Hi Annie,
I was a participant in the RAD-VAX trial at the SCCA in Seattle. This combined the standard ipi protocol of 4 3mg/kg infusions with SRS to one of my tumors (not the largest one). I was only able to complete 3 doses of ipi due to side effects, and at the end did see progression in my largest tumor, but the rest remained stable.
I wish I could say for certain whether the addition of the SRS to the ipi had an effect, but I guess we need to wait for the trial results. What I do know was that the decision was a no brainer for me given that ipi was the standard of care anyway. Why not give it an extra (hopeful) boost?
– Paul
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- February 14, 2016 at 3:27 pm
Thanks Paul. Yes, that is what I am thinking. It can’t hurt, and who knows if some time from now they will figure out that it is actually extremely beneficial. Since he has to have radiation therapy because of the extra capsular extension anyway, might as well follow this protocol for some hopefully positive benefits. -
- February 14, 2016 at 3:27 pm
Thanks Paul. Yes, that is what I am thinking. It can’t hurt, and who knows if some time from now they will figure out that it is actually extremely beneficial. Since he has to have radiation therapy because of the extra capsular extension anyway, might as well follow this protocol for some hopefully positive benefits. -
- February 14, 2016 at 3:27 pm
Thanks Paul. Yes, that is what I am thinking. It can’t hurt, and who knows if some time from now they will figure out that it is actually extremely beneficial. Since he has to have radiation therapy because of the extra capsular extension anyway, might as well follow this protocol for some hopefully positive benefits.
-
- February 14, 2016 at 1:40 am
Hi Annie,
I was a participant in the RAD-VAX trial at the SCCA in Seattle. This combined the standard ipi protocol of 4 3mg/kg infusions with SRS to one of my tumors (not the largest one). I was only able to complete 3 doses of ipi due to side effects, and at the end did see progression in my largest tumor, but the rest remained stable.
I wish I could say for certain whether the addition of the SRS to the ipi had an effect, but I guess we need to wait for the trial results. What I do know was that the decision was a no brainer for me given that ipi was the standard of care anyway. Why not give it an extra (hopeful) boost?
– Paul
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- February 15, 2016 at 3:49 pm
I was not offered radiation because I had microscopic cells in one node. I wonder if it would have any benefit on people like me. Greg
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