› Forums › General Melanoma Community › Got CT results today
- This topic has 30 replies, 3 voices, and was last updated 10 years, 8 months ago by
JerryfromFauq.
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- September 6, 2013 at 6:30 pm
My husband did ILl-2, 14 doses… Has tumors in
Lymph nodes in chest and a mass on lung– went for
His CT scan today-all of the tumors grew, but
there are not any new ones anywhere else ..that they could see on the
Scan…. Now waiting to see if he has NRAS mutation
For a clinical trial… Also trying to get insurance to
Approve Ipi… So disappointed and frustrated…does anyone
Know the percentage of people that ipi helps??
For IL-2 it was 20%
Thank you so much,
NancyMy husband did ILl-2, 14 doses… Has tumors in
Lymph nodes in chest and a mass on lung– went for
His CT scan today-all of the tumors grew, but
there are not any new ones anywhere else ..that they could see on the
Scan…. Now waiting to see if he has NRAS mutation
For a clinical trial… Also trying to get insurance to
Approve Ipi… So disappointed and frustrated…does anyone
Know the percentage of people that ipi helps??
For IL-2 it was 20%
Thank you so much,
Nancy
- Replies
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- September 6, 2013 at 7:55 pm
Nancy:
The numbers generally accepted are that 4-5% of people have a complete response from IL-2 (all tumors go away) and another 10% or so get some benefit. ipi is somewhat better, with response rates around 18%.
The term "response" actually has a technical definition; I believe it is 30% reduction in the largest diameter of a tumor mass. Some people respond to these drugs but don't hit the definition of "response" per this criteria.
Regarding insurance, if you have problems you can either call the company or use the MRF toll-free help line: 1-877-673-6460 . We have trained social workers who can help deal with insurance issues.
Another option, unless he has brain metastases, is to look for a clinical trial testing an anti-PD1 drug. Two different companies are running trials now, and both drugs seem promising. Early data show better response rates and fewer side effects.
Tim–MRF
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- September 6, 2013 at 7:55 pm
Nancy:
The numbers generally accepted are that 4-5% of people have a complete response from IL-2 (all tumors go away) and another 10% or so get some benefit. ipi is somewhat better, with response rates around 18%.
The term "response" actually has a technical definition; I believe it is 30% reduction in the largest diameter of a tumor mass. Some people respond to these drugs but don't hit the definition of "response" per this criteria.
Regarding insurance, if you have problems you can either call the company or use the MRF toll-free help line: 1-877-673-6460 . We have trained social workers who can help deal with insurance issues.
Another option, unless he has brain metastases, is to look for a clinical trial testing an anti-PD1 drug. Two different companies are running trials now, and both drugs seem promising. Early data show better response rates and fewer side effects.
Tim–MRF
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- September 6, 2013 at 7:55 pm
Nancy:
The numbers generally accepted are that 4-5% of people have a complete response from IL-2 (all tumors go away) and another 10% or so get some benefit. ipi is somewhat better, with response rates around 18%.
The term "response" actually has a technical definition; I believe it is 30% reduction in the largest diameter of a tumor mass. Some people respond to these drugs but don't hit the definition of "response" per this criteria.
Regarding insurance, if you have problems you can either call the company or use the MRF toll-free help line: 1-877-673-6460 . We have trained social workers who can help deal with insurance issues.
Another option, unless he has brain metastases, is to look for a clinical trial testing an anti-PD1 drug. Two different companies are running trials now, and both drugs seem promising. Early data show better response rates and fewer side effects.
Tim–MRF
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- September 6, 2013 at 11:03 pm
Tim, Definitions can vary, especially in trials & also at what point in treatment. For a fast growing tumor, I have seen the figure of less than a 25% growth used used as response enough to go ahead with the 2nd round (weeks 3 & 4) of IL-2 administration. Less growth and no growth are considered as responding. I was considered as a responder when I went from no measurable tumors NED? in a Jan CT to innumerable tumors {some near 2 cm in 2 months time) and then, for 20 month I had essentially no growth and no new tumors. (So wound up being a partial responder). After my melanoma stopped responding to the IL-2 (20 Months later), I again developed innumerable new additional tumors in my lungs [how many is innumerable old plus innumerable new tumors?]. Some of the 2 year old tumors quadrupled in size, and I developed new tumors in my groin and on my neck. The liver tumors never resumed growth after week3 of theIL-2. In the 30 days after I talked my Onc into providing the non-FDA approved targeted chemo (for melanoma), all growth stopped again. In the 4 1/2 years since then, none of my tumors have grown. No new tumors have appeared. A few of the smaller tumors cannot now be seen on CT nor PET scans.
The 25% reduction has only recently been asked for as a hoped for target. I have never had a large reduction in tumor size, BUT over 6 1/2 years after being told I would have major breathing problems within 30 days (Feb 2007) and could go anytime then, I still have innumerable lung tumors and still spent time bugging my growing number of Grand children and now Great Grand children. As well as some older folks.
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- September 7, 2013 at 6:43 pm
Get the number correct! He earned IT.
So much FUn! What's the definition of that word ? -
- September 11, 2013 at 1:18 am
Do you know how much (% wise) the tumors grew?
Remember the definitions :
progressive disease—at least a 20% increase.
partial response—at least a 30% decrease.
Anything between the two is "Essentially Stable".
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- September 11, 2013 at 1:18 am
Do you know how much (% wise) the tumors grew?
Remember the definitions :
progressive disease—at least a 20% increase.
partial response—at least a 30% decrease.
Anything between the two is "Essentially Stable".
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- September 11, 2013 at 1:18 am
Do you know how much (% wise) the tumors grew?
Remember the definitions :
progressive disease—at least a 20% increase.
partial response—at least a 30% decrease.
Anything between the two is "Essentially Stable".
-
- September 6, 2013 at 11:03 pm
Tim, Definitions can vary, especially in trials & also at what point in treatment. For a fast growing tumor, I have seen the figure of less than a 25% growth used used as response enough to go ahead with the 2nd round (weeks 3 & 4) of IL-2 administration. Less growth and no growth are considered as responding. I was considered as a responder when I went from no measurable tumors NED? in a Jan CT to innumerable tumors {some near 2 cm in 2 months time) and then, for 20 month I had essentially no growth and no new tumors. (So wound up being a partial responder). After my melanoma stopped responding to the IL-2 (20 Months later), I again developed innumerable new additional tumors in my lungs [how many is innumerable old plus innumerable new tumors?]. Some of the 2 year old tumors quadrupled in size, and I developed new tumors in my groin and on my neck. The liver tumors never resumed growth after week3 of theIL-2. In the 30 days after I talked my Onc into providing the non-FDA approved targeted chemo (for melanoma), all growth stopped again. In the 4 1/2 years since then, none of my tumors have grown. No new tumors have appeared. A few of the smaller tumors cannot now be seen on CT nor PET scans.
The 25% reduction has only recently been asked for as a hoped for target. I have never had a large reduction in tumor size, BUT over 6 1/2 years after being told I would have major breathing problems within 30 days (Feb 2007) and could go anytime then, I still have innumerable lung tumors and still spent time bugging my growing number of Grand children and now Great Grand children. As well as some older folks.
-
- September 6, 2013 at 11:03 pm
Tim, Definitions can vary, especially in trials & also at what point in treatment. For a fast growing tumor, I have seen the figure of less than a 25% growth used used as response enough to go ahead with the 2nd round (weeks 3 & 4) of IL-2 administration. Less growth and no growth are considered as responding. I was considered as a responder when I went from no measurable tumors NED? in a Jan CT to innumerable tumors {some near 2 cm in 2 months time) and then, for 20 month I had essentially no growth and no new tumors. (So wound up being a partial responder). After my melanoma stopped responding to the IL-2 (20 Months later), I again developed innumerable new additional tumors in my lungs [how many is innumerable old plus innumerable new tumors?]. Some of the 2 year old tumors quadrupled in size, and I developed new tumors in my groin and on my neck. The liver tumors never resumed growth after week3 of theIL-2. In the 30 days after I talked my Onc into providing the non-FDA approved targeted chemo (for melanoma), all growth stopped again. In the 4 1/2 years since then, none of my tumors have grown. No new tumors have appeared. A few of the smaller tumors cannot now be seen on CT nor PET scans.
The 25% reduction has only recently been asked for as a hoped for target. I have never had a large reduction in tumor size, BUT over 6 1/2 years after being told I would have major breathing problems within 30 days (Feb 2007) and could go anytime then, I still have innumerable lung tumors and still spent time bugging my growing number of Grand children and now Great Grand children. As well as some older folks.
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- September 7, 2013 at 8:08 am
what is: ;Response ;Objective Tumor Response ; Complete Response ; Partial Response ; Progressive Disease ;Stable Disease (especially if previously rapidly progressing tumors) ;Pathological response
and for what purpose is the term tumor response being used?
http://www.eortc.be/Services/Doc/RECIST.pdf
.2.1. Evaluation of target lesions.
This section provides the definitions of the criteria used to determine objective tumor response for target lesions. The criteria have been adapted from the original WHO Handbook (3), taking into account the measurement of the longest diameter only for all target lesions:complete response—the disappearance of all target lesions;partial response—at least a 30% decrease in the sum of the longestdiameter of target lesions, taking as reference the baseline sumlongest diameter;progressive disease—at least a 20% increasein the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since thetreatment started or the appearance of one or more new lesions;stable disease—neither sufficient shrinkage to qualify for partialresponse nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter sincethe treatment started.. A sum of the longest diameter for all target lesions will be calculated and reported as the baseline sum longest diameter. The baseline sum longest diameter will be used as the reference by which to characterize the objective tumor response.
Tumor response associated with the administration of anticancer agents can be evaluated for at least three important purposes that are conceptually distinct:
• Tumor response as a prospective end point in early clinical trials. In this situation, objective tumor response is employed to determine whether the agent/regimen demonstrates sufficiently encouraging results to warrant further testing. These trials are typically phase II trials of investigational agents/regimens (see section 1.2), and it is for use in this precise context that these guidelines have been developed.
• Tumor response as a prospective end point in more definitive clinical trials designed to provide an estimate of benefit for a specific cohort of patients. These trials are often randomized comparative trials or single-arm comparisons of combinations of agents with historical control subjects. In this setting, objective tumor response is used as a surrogate end point for other measures of clinical benefit, including time to event (death or disease progression) and symptom control (see section 1.3).
• Tumor response as a guide for the clinician and patient or study subject in decisions about continuation of current therapy. This purpose is applicable both to clinical trials and to routine practice ( see section 1.1), but use in the context of decisions regarding continuation of therapy is not the primary focus of this document.
3.2.1. Evaluation of target lesions.
This section provides the definitions of the criteria used to determine objective tumor response for target lesions. The criteria have been adapted from the originalWHO Handbook (3), taking into account the measurement of the longest diameter only for all target lesions:
complete response—the disappearance of all target lesions;partial response—at least a 30% decrease in the sum of the longestdiameter of target lesions, taking as reference the baseline sumlongest diameter;
progressive disease—at least a 20% increasein the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions;
stable disease—neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter since the treatment started.
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- September 7, 2013 at 8:08 am
what is: ;Response ;Objective Tumor Response ; Complete Response ; Partial Response ; Progressive Disease ;Stable Disease (especially if previously rapidly progressing tumors) ;Pathological response
and for what purpose is the term tumor response being used?
http://www.eortc.be/Services/Doc/RECIST.pdf
.2.1. Evaluation of target lesions.
This section provides the definitions of the criteria used to determine objective tumor response for target lesions. The criteria have been adapted from the original WHO Handbook (3), taking into account the measurement of the longest diameter only for all target lesions:complete response—the disappearance of all target lesions;partial response—at least a 30% decrease in the sum of the longestdiameter of target lesions, taking as reference the baseline sumlongest diameter;progressive disease—at least a 20% increasein the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since thetreatment started or the appearance of one or more new lesions;stable disease—neither sufficient shrinkage to qualify for partialresponse nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter sincethe treatment started.. A sum of the longest diameter for all target lesions will be calculated and reported as the baseline sum longest diameter. The baseline sum longest diameter will be used as the reference by which to characterize the objective tumor response.
Tumor response associated with the administration of anticancer agents can be evaluated for at least three important purposes that are conceptually distinct:
• Tumor response as a prospective end point in early clinical trials. In this situation, objective tumor response is employed to determine whether the agent/regimen demonstrates sufficiently encouraging results to warrant further testing. These trials are typically phase II trials of investigational agents/regimens (see section 1.2), and it is for use in this precise context that these guidelines have been developed.
• Tumor response as a prospective end point in more definitive clinical trials designed to provide an estimate of benefit for a specific cohort of patients. These trials are often randomized comparative trials or single-arm comparisons of combinations of agents with historical control subjects. In this setting, objective tumor response is used as a surrogate end point for other measures of clinical benefit, including time to event (death or disease progression) and symptom control (see section 1.3).
• Tumor response as a guide for the clinician and patient or study subject in decisions about continuation of current therapy. This purpose is applicable both to clinical trials and to routine practice ( see section 1.1), but use in the context of decisions regarding continuation of therapy is not the primary focus of this document.
3.2.1. Evaluation of target lesions.
This section provides the definitions of the criteria used to determine objective tumor response for target lesions. The criteria have been adapted from the originalWHO Handbook (3), taking into account the measurement of the longest diameter only for all target lesions:
complete response—the disappearance of all target lesions;partial response—at least a 30% decrease in the sum of the longestdiameter of target lesions, taking as reference the baseline sumlongest diameter;
progressive disease—at least a 20% increasein the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions;
stable disease—neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter since the treatment started.
-
- September 7, 2013 at 8:08 am
what is: ;Response ;Objective Tumor Response ; Complete Response ; Partial Response ; Progressive Disease ;Stable Disease (especially if previously rapidly progressing tumors) ;Pathological response
and for what purpose is the term tumor response being used?
http://www.eortc.be/Services/Doc/RECIST.pdf
.2.1. Evaluation of target lesions.
This section provides the definitions of the criteria used to determine objective tumor response for target lesions. The criteria have been adapted from the original WHO Handbook (3), taking into account the measurement of the longest diameter only for all target lesions:complete response—the disappearance of all target lesions;partial response—at least a 30% decrease in the sum of the longestdiameter of target lesions, taking as reference the baseline sumlongest diameter;progressive disease—at least a 20% increasein the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since thetreatment started or the appearance of one or more new lesions;stable disease—neither sufficient shrinkage to qualify for partialresponse nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter sincethe treatment started.. A sum of the longest diameter for all target lesions will be calculated and reported as the baseline sum longest diameter. The baseline sum longest diameter will be used as the reference by which to characterize the objective tumor response.
Tumor response associated with the administration of anticancer agents can be evaluated for at least three important purposes that are conceptually distinct:
• Tumor response as a prospective end point in early clinical trials. In this situation, objective tumor response is employed to determine whether the agent/regimen demonstrates sufficiently encouraging results to warrant further testing. These trials are typically phase II trials of investigational agents/regimens (see section 1.2), and it is for use in this precise context that these guidelines have been developed.
• Tumor response as a prospective end point in more definitive clinical trials designed to provide an estimate of benefit for a specific cohort of patients. These trials are often randomized comparative trials or single-arm comparisons of combinations of agents with historical control subjects. In this setting, objective tumor response is used as a surrogate end point for other measures of clinical benefit, including time to event (death or disease progression) and symptom control (see section 1.3).
• Tumor response as a guide for the clinician and patient or study subject in decisions about continuation of current therapy. This purpose is applicable both to clinical trials and to routine practice ( see section 1.1), but use in the context of decisions regarding continuation of therapy is not the primary focus of this document.
3.2.1. Evaluation of target lesions.
This section provides the definitions of the criteria used to determine objective tumor response for target lesions. The criteria have been adapted from the originalWHO Handbook (3), taking into account the measurement of the longest diameter only for all target lesions:
complete response—the disappearance of all target lesions;partial response—at least a 30% decrease in the sum of the longestdiameter of target lesions, taking as reference the baseline sumlongest diameter;
progressive disease—at least a 20% increasein the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions;
stable disease—neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter since the treatment started.
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- September 7, 2013 at 6:43 pm
Get the number correct! He earned IT.
So much FUn! What's the definition of that word ? -
- September 7, 2013 at 6:43 pm
Get the number correct! He earned IT.
So much FUn! What's the definition of that word ?
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