› Forums › General Melanoma Community › BRAF for brain mets
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shellebrownies.
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- June 19, 2011 at 5:21 pm
Hello – my husband had a craniotomy last month for a tumor causing weakness on the left side, the surgery was a success, two weeks later he had 10 sessions of whole brain radiation and tomotherapy for the remaining 4 smaller tumors. Now that he is finished the radiation he is tired and nauseated and has a rash across his forehead, he just lost his hair the other day. His doc wants him to wait a month to "recover" and then restage him.
Hello – my husband had a craniotomy last month for a tumor causing weakness on the left side, the surgery was a success, two weeks later he had 10 sessions of whole brain radiation and tomotherapy for the remaining 4 smaller tumors. Now that he is finished the radiation he is tired and nauseated and has a rash across his forehead, he just lost his hair the other day. His doc wants him to wait a month to "recover" and then restage him. The nurse said the doc is excited about a new drug starting with a "V" which I believe is for BRAF. Apparently there is a study starting soon. Has anyone experienced the rash from the radiation and what are people' results with BRAF? Thank You.
s
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- June 19, 2011 at 5:37 pm
Below is the drug he was probably talking about. Although this article does not reference whether or not they tested it on brain cancer patents. Many trials will not accept them.
Patients with advanced melanoma may live longer with Ipilimumab, and have a better likelihood of surviving longer on Vemurafenib than chemotherapy, scientists revealed in the Annual Meeting of the American Society of Clinical Oncology (ASCO).
In a phase three clinical trial, Vemurafenib was tested on 675 participants, all with advanced melanoma. 84% of those on Vemurafenib pills taken twice daily were alive six months later, compared to 64% of those on standard chemotherapy.
48% of those on Vemurafenib had significant tumor shrinkage.
Half of all advanced skin cancer patients have a faulty gene – BRAF. Vemurafenib works on this faulty gene by targeting and blocking this protein at the cellular level. Those running the study were so impressed with the results that it was stopped early, so that the participants on chemotherapy could switch to Vemurafenib.
Compared to those on chemotherapy, Vemurafenib was also found to lower the risk of worsening disease by 74%.
Vemurafenib is being developed by Genentech (Roche) and Plexxikon Inc.
Study leader, Dr. Paul Chapman, of the Memorial Sloan-Kettering Cancer Center's Melanoma and Sarcoma service, said:
"This is the beginning of personalized medicine in melanoma," said Dr. Chapman. We have seen tumors shrink rapidly, and in some patients, quality of life improved dramatically. It has been a very exciting year."
Trials are currently underway to determine whether Vemurafenib might help patients with other types of cancers.
Another clinical trial demonstrated that Ipilimumab (Yervoy) can help patients with advanced melanoma live longer (extends survival time).
502 patients were involved in a double-blind, randomized clinical trial which examined the response of patients who had just been diagnosed and had not had prior treatment for their disease. Half of them were on dacarbazine (standard chemotherapy treatment), while the other half were on ipilimumab plus standard chemotherapy.
A considerable number of patients who would usually have been expected to have died within a few months lived for years, the researchers explained. Researchers said that Yervoy almost doubled the number of patients who survived three years or more.
Study leader, Jedd Wolchok MD, PhD, also of the Memorial Sloan-Kettering Cancer Center's Melanoma and Sarcoma service, said:
"Ipilimumab blocks a very critical brake that the immune system uses to hold itself back from attacking normal tissues. By temporarily blocking this brake, ipilimumab allows the immune system to become more robustly activated than it otherwise would and, therefore, in some people causes the production of antibodies and T-cells that can recognize melanoma leading to control of the disease."
Yervoy was created by Bristol-Myers Squibb Co.
National regulatory bodies, such as NICE (National Institute for Clinical Excellence) in the UK, EMA (European Medicines Agency) and the FDA are currently assessing both treatments. UK media believes they could become available in the UK by the end of this year. In March 2011 the FDA (Food and Drug Administration) approved ipilimumab as a treatment for advanced melanoma.
Dr. Allen Lichter, chief executive of the American Society of Clinical Oncology, said:
"Melanoma has just seen a
renaissance of new agents."68,000 patients in the USA were diagnosed with melanoma in 2010. There were 8,700 deaths caused by melanoma last year in the USA in the same year.
Written by Christian Nordqvist
View drug information on Yervoy. -
- June 19, 2011 at 5:37 pm
Below is the drug he was probably talking about. Although this article does not reference whether or not they tested it on brain cancer patents. Many trials will not accept them.
Patients with advanced melanoma may live longer with Ipilimumab, and have a better likelihood of surviving longer on Vemurafenib than chemotherapy, scientists revealed in the Annual Meeting of the American Society of Clinical Oncology (ASCO).
In a phase three clinical trial, Vemurafenib was tested on 675 participants, all with advanced melanoma. 84% of those on Vemurafenib pills taken twice daily were alive six months later, compared to 64% of those on standard chemotherapy.
48% of those on Vemurafenib had significant tumor shrinkage.
Half of all advanced skin cancer patients have a faulty gene – BRAF. Vemurafenib works on this faulty gene by targeting and blocking this protein at the cellular level. Those running the study were so impressed with the results that it was stopped early, so that the participants on chemotherapy could switch to Vemurafenib.
Compared to those on chemotherapy, Vemurafenib was also found to lower the risk of worsening disease by 74%.
Vemurafenib is being developed by Genentech (Roche) and Plexxikon Inc.
Study leader, Dr. Paul Chapman, of the Memorial Sloan-Kettering Cancer Center's Melanoma and Sarcoma service, said:
"This is the beginning of personalized medicine in melanoma," said Dr. Chapman. We have seen tumors shrink rapidly, and in some patients, quality of life improved dramatically. It has been a very exciting year."
Trials are currently underway to determine whether Vemurafenib might help patients with other types of cancers.
Another clinical trial demonstrated that Ipilimumab (Yervoy) can help patients with advanced melanoma live longer (extends survival time).
502 patients were involved in a double-blind, randomized clinical trial which examined the response of patients who had just been diagnosed and had not had prior treatment for their disease. Half of them were on dacarbazine (standard chemotherapy treatment), while the other half were on ipilimumab plus standard chemotherapy.
A considerable number of patients who would usually have been expected to have died within a few months lived for years, the researchers explained. Researchers said that Yervoy almost doubled the number of patients who survived three years or more.
Study leader, Jedd Wolchok MD, PhD, also of the Memorial Sloan-Kettering Cancer Center's Melanoma and Sarcoma service, said:
"Ipilimumab blocks a very critical brake that the immune system uses to hold itself back from attacking normal tissues. By temporarily blocking this brake, ipilimumab allows the immune system to become more robustly activated than it otherwise would and, therefore, in some people causes the production of antibodies and T-cells that can recognize melanoma leading to control of the disease."
Yervoy was created by Bristol-Myers Squibb Co.
National regulatory bodies, such as NICE (National Institute for Clinical Excellence) in the UK, EMA (European Medicines Agency) and the FDA are currently assessing both treatments. UK media believes they could become available in the UK by the end of this year. In March 2011 the FDA (Food and Drug Administration) approved ipilimumab as a treatment for advanced melanoma.
Dr. Allen Lichter, chief executive of the American Society of Clinical Oncology, said:
"Melanoma has just seen a
renaissance of new agents."68,000 patients in the USA were diagnosed with melanoma in 2010. There were 8,700 deaths caused by melanoma last year in the USA in the same year.
Written by Christian Nordqvist
View drug information on Yervoy. -
- June 19, 2011 at 6:00 pm
Vemurafenib (also known as also known as PLX4032, RG7204 or RO5185426) may be to what you are referring. This drug is what is called a BRAF inhibitor. Your husband must have a tumor tested and be positive for the BRAF V600E mutation to qualify for a BRAF inhibitor drug trial. The results and success will vary from person.
PubMed states that Phase 1 and 2 clinical trials of the BRAF kinase inhibitor vemurafenib (PLX4032) have shown response rates of more than 50% in patients with metastatic melanoma with the BRAF V600E mutation. If your husband is positive for the mutation, research and have your next plan of attact ready as melanoma may find another pathway around the BRAF inhibitor and begin to grow again.
http://www.ncbi.nlm.nih.gov/pubmed/21639808
I believe another trial by Roche stated a response rate of 48.4%. (This drug is developed by Plexxikon and Hoffmann-La Roche)
I am not sure as to what you mean by the re-staging question as I believe he will still be stage 4, and with any luck NED (no evidence of disease) at some point.
Michael
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- June 19, 2011 at 6:08 pm
Forgot to mention, that of the trails I have seen, brain mets are excluded. In the trials it is referred as acitve CNS (central nervous system) metastases. You may wish to discuss with the doctor if he qualifies as he had WBR and other therapy.
Michael
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- June 19, 2011 at 6:08 pm
Forgot to mention, that of the trails I have seen, brain mets are excluded. In the trials it is referred as acitve CNS (central nervous system) metastases. You may wish to discuss with the doctor if he qualifies as he had WBR and other therapy.
Michael
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- June 19, 2011 at 6:00 pm
Vemurafenib (also known as also known as PLX4032, RG7204 or RO5185426) may be to what you are referring. This drug is what is called a BRAF inhibitor. Your husband must have a tumor tested and be positive for the BRAF V600E mutation to qualify for a BRAF inhibitor drug trial. The results and success will vary from person.
PubMed states that Phase 1 and 2 clinical trials of the BRAF kinase inhibitor vemurafenib (PLX4032) have shown response rates of more than 50% in patients with metastatic melanoma with the BRAF V600E mutation. If your husband is positive for the mutation, research and have your next plan of attact ready as melanoma may find another pathway around the BRAF inhibitor and begin to grow again.
http://www.ncbi.nlm.nih.gov/pubmed/21639808
I believe another trial by Roche stated a response rate of 48.4%. (This drug is developed by Plexxikon and Hoffmann-La Roche)
I am not sure as to what you mean by the re-staging question as I believe he will still be stage 4, and with any luck NED (no evidence of disease) at some point.
Michael
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- June 19, 2011 at 6:07 pm
If you look below there is a post from Nic from Oz. She is on a Braf trial that includes brain mets and is having an incredible response. But, as others have said, he has to have the correct mutations for those trials.
I am stage IV and have been NED for several times, unfortunately always recurring. However, I have never been restaged. With melanoma once stage IV always stage IV. Now, I've seen paperwork for insurance to have additional scans and it always says restaging. When I asked about it I was told it was just insurance terminology.
Hope your husband continues to do well. I would call the Radiologist and ask what you could put on the rash. I am about to have radiation and was told that I should expect a rash/irritation/sensitive skin and would be given something.
Linda,
Stage IV since 06 currently 2 weeks NED!
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- June 19, 2011 at 6:07 pm
If you look below there is a post from Nic from Oz. She is on a Braf trial that includes brain mets and is having an incredible response. But, as others have said, he has to have the correct mutations for those trials.
I am stage IV and have been NED for several times, unfortunately always recurring. However, I have never been restaged. With melanoma once stage IV always stage IV. Now, I've seen paperwork for insurance to have additional scans and it always says restaging. When I asked about it I was told it was just insurance terminology.
Hope your husband continues to do well. I would call the Radiologist and ask what you could put on the rash. I am about to have radiation and was told that I should expect a rash/irritation/sensitive skin and would be given something.
Linda,
Stage IV since 06 currently 2 weeks NED!
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- June 20, 2011 at 2:17 am
Hoffman-La Roche has a BRAF trial for brain mets opening up.
However, it doesn't appear it's available in US right now. Perhaps there is a new one or this one is coming out?
Michelle, wife of Don
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- June 20, 2011 at 2:22 am
Wait, here's another one: http://www.clinicaltrials.gov/ct2/show/NCT01266967?term=melanoma+brain&recr=Open&rank=1
Currently open in: LA, SF, NYC, Ann Arbor, MI, Pittsburgh, PA, Nashville, TN, Houston, TX, Seattle, WA
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- June 20, 2011 at 2:22 am
Wait, here's another one: http://www.clinicaltrials.gov/ct2/show/NCT01266967?term=melanoma+brain&recr=Open&rank=1
Currently open in: LA, SF, NYC, Ann Arbor, MI, Pittsburgh, PA, Nashville, TN, Houston, TX, Seattle, WA
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- June 20, 2011 at 2:17 am
Hoffman-La Roche has a BRAF trial for brain mets opening up.
However, it doesn't appear it's available in US right now. Perhaps there is a new one or this one is coming out?
Michelle, wife of Don
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