Pembrolizumab (Keytruda) as well as Nivolizumab (Opdivo) are both anti-PD-1 agents that are categorized as immunotherapy, or check point inhibitors, as is Ipilimumab (yervoy). Here is a primer I put together that breaks them down regarding side effects, response rates, etc.:
https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melanoma-intel-primer-for-current.html
Many here have taken all of these drugs as adjuvant (after radiation or surgical removal of tumors) and with active disease. The new ta-dah in melanoma is “neo-adjuvant” treatment. Exactly what your docs have proposed for you. Which is taking the med before surgical removal, both to shrink the lesion and to train the immune system. Basically, in melanoma we have three methods of attacking melanoma with medicine. The immunotherapies noted above. Targeted therapy (a combination of a BRAF inhibitor and a MEK inhibitor) if the lesions are BRAF positive. Or intralesional treatments that are injected into the tumor directly. Immunotherapy is recognized to work well but more slowly. Targeted therapy is known to work rapidly, though later tumors can learn to “work around” the effect. (All of this is covered in the primer.) Both targeted and immunotherapy are being tried as neo-adjuvants. Here are some reports:
On immunotherapy: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2018/12/neoadjuvant-immunotherapy-vs-adjuvant.html
On targeted therapy: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2018/03/brafmek-before-surgery-as-well-as-after.html
Since targeted therapy is known to act much more rapidly, I would make sure that my lesion was tested for BRAF status and if it was positive, I would ask the docs why they are recommending immunotherapy rather than a BRAF/MEK combo. (Though you may have already worked through this.)
Hope this helps. You can use the search bubble here to look for folks who are utilizing neoadjuvant treatment….though it is relatively new in melanoma world. Hope this helps. Celeste
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