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Brain mets

Forums General Melanoma Community Brain mets

  • Post
    RGal
    Participant

      Do any studies allow patients w brain mets?  Does yervoy alone ever work on them or do they need to be radiated or gamma knife?

    Viewing 8 reply threads
    • Replies
        Julie in SoCal
        Participant

          Hi, each clinical trial is different regarding brain mets, so you'll need to check them.

          Regarding yervoy and the other immunotherapies, they all pass the blood brain barrier and so if they work for you,  they could work on brain mets.

          julie

          Julie in SoCal
          Participant

            Hi, each clinical trial is different regarding brain mets, so you'll need to check them.

            Regarding yervoy and the other immunotherapies, they all pass the blood brain barrier and so if they work for you,  they could work on brain mets.

            julie

            Julie in SoCal
            Participant

              Hi, each clinical trial is different regarding brain mets, so you'll need to check them.

              Regarding yervoy and the other immunotherapies, they all pass the blood brain barrier and so if they work for you,  they could work on brain mets.

              julie

                jpg
                Participant

                  That's great that these pass the blood brain barrier.  Did your doctor tell you that? Mine said that what can happen is that your immune system revs up from the IPI or Keytruda and that helps the brain.  But he said he didn't know of anything that crosses the barrier.  So I'm getting radiation for now (SRS I think)

                  Mat
                  Participant

                    The T cells cross the barrier.  Also, a radiated tumor can provide a better target so combining radiation with immunotherapy is thought to be a good idea (currently in trials).  SRS is often an easy procedure.

                    jpg
                    Participant

                      Mat, I think you are onto something. It is the tcells that cross not the actual drug.  that makes sense to me.  I know that I had brain mets happen after being on the combo braf/mek for one year.  Then I had another pop up when I was doing optivo.  So my doctor says that the drugs don't get up there.

                      jpg
                      Participant

                        Mat, I think you are onto something. It is the tcells that cross not the actual drug.  that makes sense to me.  I know that I had brain mets happen after being on the combo braf/mek for one year.  Then I had another pop up when I was doing optivo.  So my doctor says that the drugs don't get up there.

                        jpg
                        Participant

                          Mat, I think you are onto something. It is the tcells that cross not the actual drug.  that makes sense to me.  I know that I had brain mets happen after being on the combo braf/mek for one year.  Then I had another pop up when I was doing optivo.  So my doctor says that the drugs don't get up there.

                          Mat
                          Participant

                            The T cells cross the barrier.  Also, a radiated tumor can provide a better target so combining radiation with immunotherapy is thought to be a good idea (currently in trials).  SRS is often an easy procedure.

                            Mat
                            Participant

                              The T cells cross the barrier.  Also, a radiated tumor can provide a better target so combining radiation with immunotherapy is thought to be a good idea (currently in trials).  SRS is often an easy procedure.

                              jpg
                              Participant

                                That's great that these pass the blood brain barrier.  Did your doctor tell you that? Mine said that what can happen is that your immune system revs up from the IPI or Keytruda and that helps the brain.  But he said he didn't know of anything that crosses the barrier.  So I'm getting radiation for now (SRS I think)

                                jpg
                                Participant

                                  That's great that these pass the blood brain barrier.  Did your doctor tell you that? Mine said that what can happen is that your immune system revs up from the IPI or Keytruda and that helps the brain.  But he said he didn't know of anything that crosses the barrier.  So I'm getting radiation for now (SRS I think)

                                Bubbles
                                Participant

                                  Most trials require that brain mets be under control post surgery or SRS…but it varies.  Here is a post I made when patients with brain met WERE admitted in a new arm of my anti-PD1 (nivo/opdivo) trial – (look toward the bottom…I don't know if all the slots have been filled or not): http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/03/9-months-after-nivolumab-trialstats-fu.html 

                                  Here is a post discussing that very thing….Should patients with melanoma brain mets be allowed in trials?  (The answer is:  YES!!!):  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/03/should-melanoma-brain-met-patients-be.html

                                  Here is a link to a post I have provided many times.  Yes, immunotherapies (ipi and anti-PD1) work in the brain. In fact, many studies are noting that BRAF inhibitors (for BRAF positive patients) work as well.  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/06/anti-pd1-in-melanoma-t-cells-brain-and.html

                                  Here's an overview:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/02/overview-of-treatments-for-melanoma.html

                                  And how ipi combined with radiation can be especially effective:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/02/ipi-nivo-combo-and-radiation-for.html

                                  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/01/ipi-and-radiationa-good-combo-for.html

                                  Hope that helps.  I wish you well.  Celeste

                                  Bubbles
                                  Participant

                                    Most trials require that brain mets be under control post surgery or SRS…but it varies.  Here is a post I made when patients with brain met WERE admitted in a new arm of my anti-PD1 (nivo/opdivo) trial – (look toward the bottom…I don't know if all the slots have been filled or not): http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/03/9-months-after-nivolumab-trialstats-fu.html 

                                    Here is a post discussing that very thing….Should patients with melanoma brain mets be allowed in trials?  (The answer is:  YES!!!):  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/03/should-melanoma-brain-met-patients-be.html

                                    Here is a link to a post I have provided many times.  Yes, immunotherapies (ipi and anti-PD1) work in the brain. In fact, many studies are noting that BRAF inhibitors (for BRAF positive patients) work as well.  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/06/anti-pd1-in-melanoma-t-cells-brain-and.html

                                    Here's an overview:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/02/overview-of-treatments-for-melanoma.html

                                    And how ipi combined with radiation can be especially effective:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/02/ipi-nivo-combo-and-radiation-for.html

                                    http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/01/ipi-and-radiationa-good-combo-for.html

                                    Hope that helps.  I wish you well.  Celeste

                                    Bubbles
                                    Participant

                                      Most trials require that brain mets be under control post surgery or SRS…but it varies.  Here is a post I made when patients with brain met WERE admitted in a new arm of my anti-PD1 (nivo/opdivo) trial – (look toward the bottom…I don't know if all the slots have been filled or not): http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/03/9-months-after-nivolumab-trialstats-fu.html 

                                      Here is a post discussing that very thing….Should patients with melanoma brain mets be allowed in trials?  (The answer is:  YES!!!):  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/03/should-melanoma-brain-met-patients-be.html

                                      Here is a link to a post I have provided many times.  Yes, immunotherapies (ipi and anti-PD1) work in the brain. In fact, many studies are noting that BRAF inhibitors (for BRAF positive patients) work as well.  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/06/anti-pd1-in-melanoma-t-cells-brain-and.html

                                      Here's an overview:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/02/overview-of-treatments-for-melanoma.html

                                      And how ipi combined with radiation can be especially effective:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/02/ipi-nivo-combo-and-radiation-for.html

                                      http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/01/ipi-and-radiationa-good-combo-for.html

                                      Hope that helps.  I wish you well.  Celeste

                                      Patina
                                      Participant

                                        Most studies require that they be treated before hand.  You should be talking to a melanomoa specialist if you have melanoma. It is a tricky disease and a typical cancer doctor is not who you should be seeing.  

                                        My Mother had 25 brain tumors treated with gamma knife radiation. Whole Brain Radiation was never discussed. – I think the doctors felt WBRT was not as beneficial long term compared to gamma knife radiation.

                                        She started Yervoy 4 days after the first gamma knife treatment in December (2013) for 8 of 9 (Doctor in Beverly Hills MISSED 1!) and had her last infusion at the end of March (2014) about 3 weeks before the 2nd gamma knife radiation treatment where 17 were treated at USC in Los Angeles (USC has hands down BEST Doctors!).

                                        It has been mentioned to us that Yervoy seems to work "last" on the brain.  It does pass the blood brain barrier which is why we went with this option.  I do not however know if there is evidence that it works on the brain last or not. However, the tumors my Mom had on her scalp and elsewhere were gone or significantly reduced but she had new growth after treatment with Yervoy in the brain. (Could be because of the screw up by the doctor in Beverly Hills who missed 1 brain tumor.)  I do know that she has had NO no new growth since the 2nd successful treatment by Dr. Chang and his team at USC. 

                                        Since we discovered my Mom had brain cancer she had been taking  Cibdex, it is a natural source of cannabinoids. There is a article below that indicates this can be beneficial for brain cancer with gamma knife radiation. 

                                         

                                        Read these studies:

                                        http://www.elekta.com/press/9381f384-ff4a-4561-80c7-5175f5e0f381/study-finds-gamma-knife-radiosurgery-alone-yields-equal-survival-outcomes-for-patients-with-two-to-10-tumors.html

                                        “The essential criticism of employing Gamma Knife radiosurgery without WBRT for patients with several lesions is that microscopic tumors might go untreated, necessitating salvage stereotactic radiosurgery or an alternative therapy,” he adds. “Thus, WBRT is widely advocated. However, a recent study showed that WBRT is only able to prevent the emergence of new tumors for no more than six months post-treatment. Many patients with brain mets can survive for more than a year, thereby outliving the effects of WBRT.”

                                        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3892394/

                                        Study finds marijana drastically shrinks brain cancer

                                        http://www.huffingtonpost.com/2014/11/18/marijuana-brain-cancer_n_6181060.html?ir=Healthy+Living

                                        Patina
                                        Participant

                                          Most studies require that they be treated before hand.  You should be talking to a melanomoa specialist if you have melanoma. It is a tricky disease and a typical cancer doctor is not who you should be seeing.  

                                          My Mother had 25 brain tumors treated with gamma knife radiation. Whole Brain Radiation was never discussed. – I think the doctors felt WBRT was not as beneficial long term compared to gamma knife radiation.

                                          She started Yervoy 4 days after the first gamma knife treatment in December (2013) for 8 of 9 (Doctor in Beverly Hills MISSED 1!) and had her last infusion at the end of March (2014) about 3 weeks before the 2nd gamma knife radiation treatment where 17 were treated at USC in Los Angeles (USC has hands down BEST Doctors!).

                                          It has been mentioned to us that Yervoy seems to work "last" on the brain.  It does pass the blood brain barrier which is why we went with this option.  I do not however know if there is evidence that it works on the brain last or not. However, the tumors my Mom had on her scalp and elsewhere were gone or significantly reduced but she had new growth after treatment with Yervoy in the brain. (Could be because of the screw up by the doctor in Beverly Hills who missed 1 brain tumor.)  I do know that she has had NO no new growth since the 2nd successful treatment by Dr. Chang and his team at USC. 

                                          Since we discovered my Mom had brain cancer she had been taking  Cibdex, it is a natural source of cannabinoids. There is a article below that indicates this can be beneficial for brain cancer with gamma knife radiation. 

                                           

                                          Read these studies:

                                          http://www.elekta.com/press/9381f384-ff4a-4561-80c7-5175f5e0f381/study-finds-gamma-knife-radiosurgery-alone-yields-equal-survival-outcomes-for-patients-with-two-to-10-tumors.html

                                          “The essential criticism of employing Gamma Knife radiosurgery without WBRT for patients with several lesions is that microscopic tumors might go untreated, necessitating salvage stereotactic radiosurgery or an alternative therapy,” he adds. “Thus, WBRT is widely advocated. However, a recent study showed that WBRT is only able to prevent the emergence of new tumors for no more than six months post-treatment. Many patients with brain mets can survive for more than a year, thereby outliving the effects of WBRT.”

                                          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3892394/

                                          Study finds marijana drastically shrinks brain cancer

                                          http://www.huffingtonpost.com/2014/11/18/marijuana-brain-cancer_n_6181060.html?ir=Healthy+Living

                                            jpg
                                            Participant

                                              Is there a study that shows Yervoy goes through the blood brain barrier?  I heard that only if it is broken can that happen.

                                              jpg
                                              Participant

                                                Is there a study that shows Yervoy goes through the blood brain barrier?  I heard that only if it is broken can that happen.

                                                jpg
                                                Participant

                                                  Is there a study that shows Yervoy goes through the blood brain barrier?  I heard that only if it is broken can that happen.

                                                Patina
                                                Participant

                                                  Most studies require that they be treated before hand.  You should be talking to a melanomoa specialist if you have melanoma. It is a tricky disease and a typical cancer doctor is not who you should be seeing.  

                                                  My Mother had 25 brain tumors treated with gamma knife radiation. Whole Brain Radiation was never discussed. – I think the doctors felt WBRT was not as beneficial long term compared to gamma knife radiation.

                                                  She started Yervoy 4 days after the first gamma knife treatment in December (2013) for 8 of 9 (Doctor in Beverly Hills MISSED 1!) and had her last infusion at the end of March (2014) about 3 weeks before the 2nd gamma knife radiation treatment where 17 were treated at USC in Los Angeles (USC has hands down BEST Doctors!).

                                                  It has been mentioned to us that Yervoy seems to work "last" on the brain.  It does pass the blood brain barrier which is why we went with this option.  I do not however know if there is evidence that it works on the brain last or not. However, the tumors my Mom had on her scalp and elsewhere were gone or significantly reduced but she had new growth after treatment with Yervoy in the brain. (Could be because of the screw up by the doctor in Beverly Hills who missed 1 brain tumor.)  I do know that she has had NO no new growth since the 2nd successful treatment by Dr. Chang and his team at USC. 

                                                  Since we discovered my Mom had brain cancer she had been taking  Cibdex, it is a natural source of cannabinoids. There is a article below that indicates this can be beneficial for brain cancer with gamma knife radiation. 

                                                   

                                                  Read these studies:

                                                  http://www.elekta.com/press/9381f384-ff4a-4561-80c7-5175f5e0f381/study-finds-gamma-knife-radiosurgery-alone-yields-equal-survival-outcomes-for-patients-with-two-to-10-tumors.html

                                                  “The essential criticism of employing Gamma Knife radiosurgery without WBRT for patients with several lesions is that microscopic tumors might go untreated, necessitating salvage stereotactic radiosurgery or an alternative therapy,” he adds. “Thus, WBRT is widely advocated. However, a recent study showed that WBRT is only able to prevent the emergence of new tumors for no more than six months post-treatment. Many patients with brain mets can survive for more than a year, thereby outliving the effects of WBRT.”

                                                  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3892394/

                                                  Study finds marijana drastically shrinks brain cancer

                                                  http://www.huffingtonpost.com/2014/11/18/marijuana-brain-cancer_n_6181060.html?ir=Healthy+Living

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