› Forums › General Melanoma Community › IL-2 versus MEK Inhibitor
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Jim in Denver.
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- October 18, 2010 at 11:30 pm
Hello – we are currently in the process of comparing IL-2 versus MEK inhibitor as a treatment for my husbands melanoma. He had tumours on his leg and had isolated limb perfusion and infusions. Now the cancer has spread to a few tumours located in his abodomen. Does anyone have any experience with IL-2? We are currently receiving conflicting advice from the US v our Canadian doctors. thank you, donswife.
Hello – we are currently in the process of comparing IL-2 versus MEK inhibitor as a treatment for my husbands melanoma. He had tumours on his leg and had isolated limb perfusion and infusions. Now the cancer has spread to a few tumours located in his abodomen. Does anyone have any experience with IL-2? We are currently receiving conflicting advice from the US v our Canadian doctors. thank you, donswife.
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- October 19, 2010 at 2:02 am
Most likely he will have to fail an approved systemic treatment to be eligible for a trial drug like MEK. In the US it pretty much comes down to either a chemo like dacarbazine or IL-2. (I don't know about Canada.) I did IL-2; when it works, it can be a home run with potential for durable, long-term response. The chances of that are admittedly low, but they are real. IL-2 is tough and there are plenty of side effects, but they do fade pretty quickly for most people. You can search on IL-2 on the archives and find lots of people with experience.
Good luck with whatever you decide!
KatyWI
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- October 20, 2010 at 10:16 pm
This information is not accurate. To "fail an approved systemic treatment to be eligible for a trial drug like MEK" is inaccurate. Look at the trial information itself:
http://clinicaltrials.gov/ct2/show/NCT01037127
There are at least two types of treatments available currently that go beyond conventional chemotherapy (i.e. dacrabazine) – targeted and systemic. Targeted treatments focus on blocking genetic pathways through whihc the disease spreads (BRAF, MEK, and others), while systemic treatments try to augment and/or enable the body's immune system to attack the disease (IL2, Ipilimumab). Il2 is FDA approved, while the others are in clinical trials. I cannot address the Canadian situation, so that adds another layer of complexity.
BRAF and MEK inhibitors are similar in approach biologically, but the actual available trials themselves differ in whether they enable the patient to actually receive the drug under study. There are Phase I, II, and III trials, and I will not go into the differences between them here, but you can do your own research to lear more about the diffferenced among them and the entire FDA approval process. It is worth pinting out, however, that the Phase III trials involve ramdomization, which means the participants may or may not get the drug under study since they are ramdomly assigned to a study group. Whether this is good or bad depends on your point of view – many patients have issues with the system that requires randomization, even though there are good scientific reasons to do so. That said, the BRAF inhibitor that is mentioned here often is a Phase III trial while the MEK inhibitor trial is Phase II. Both require presence of the specific BRAF mutation that the trial sponsors (drug companies) seek to study, and they do their own tests to determine eligibility. First, it must be determined if you are eligible.
Hope that helps. Not offense meant to you, Katy, but I felt that your well intentioned information should be amended.
Best Wishes,
Jim
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- October 20, 2010 at 10:16 pm
This information is not accurate. To "fail an approved systemic treatment to be eligible for a trial drug like MEK" is inaccurate. Look at the trial information itself:
http://clinicaltrials.gov/ct2/show/NCT01037127
There are at least two types of treatments available currently that go beyond conventional chemotherapy (i.e. dacrabazine) – targeted and systemic. Targeted treatments focus on blocking genetic pathways through whihc the disease spreads (BRAF, MEK, and others), while systemic treatments try to augment and/or enable the body's immune system to attack the disease (IL2, Ipilimumab). Il2 is FDA approved, while the others are in clinical trials. I cannot address the Canadian situation, so that adds another layer of complexity.
BRAF and MEK inhibitors are similar in approach biologically, but the actual available trials themselves differ in whether they enable the patient to actually receive the drug under study. There are Phase I, II, and III trials, and I will not go into the differences between them here, but you can do your own research to lear more about the diffferenced among them and the entire FDA approval process. It is worth pinting out, however, that the Phase III trials involve ramdomization, which means the participants may or may not get the drug under study since they are ramdomly assigned to a study group. Whether this is good or bad depends on your point of view – many patients have issues with the system that requires randomization, even though there are good scientific reasons to do so. That said, the BRAF inhibitor that is mentioned here often is a Phase III trial while the MEK inhibitor trial is Phase II. Both require presence of the specific BRAF mutation that the trial sponsors (drug companies) seek to study, and they do their own tests to determine eligibility. First, it must be determined if you are eligible.
Hope that helps. Not offense meant to you, Katy, but I felt that your well intentioned information should be amended.
Best Wishes,
Jim
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- October 19, 2010 at 2:02 am
Most likely he will have to fail an approved systemic treatment to be eligible for a trial drug like MEK. In the US it pretty much comes down to either a chemo like dacarbazine or IL-2. (I don't know about Canada.) I did IL-2; when it works, it can be a home run with potential for durable, long-term response. The chances of that are admittedly low, but they are real. IL-2 is tough and there are plenty of side effects, but they do fade pretty quickly for most people. You can search on IL-2 on the archives and find lots of people with experience.
Good luck with whatever you decide!
KatyWI
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- October 19, 2010 at 9:25 pm
Hi,
We had conflicting advice from our Canadian and US doctors as well and chose to do a combo MEK and P13K inhibitor combo. http://clinicaltrials.gov/ct2/show/NCT01155453
Our doctors here in Canada never even brought up IL-2 they thought that this trial offered a better chance.
After 1 month the results have been astounding…
Feel free to email me off board if you like.
Em
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- October 19, 2010 at 9:25 pm
Hi,
We had conflicting advice from our Canadian and US doctors as well and chose to do a combo MEK and P13K inhibitor combo. http://clinicaltrials.gov/ct2/show/NCT01155453
Our doctors here in Canada never even brought up IL-2 they thought that this trial offered a better chance.
After 1 month the results have been astounding…
Feel free to email me off board if you like.
Em
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- October 19, 2010 at 9:50 pm
While many treatments work for a very few people, Il-2 has the most proven record for helpiing melanoma patients of any treatment other than surgery.
My personal opinion is that too many patients are scared off by doctors negative comments on IL-2. I researched the statistics and talked to people whose spouses had saved Il-2 as a last resort and never recovered from the chemo's they tried first, in time to try the IL-2. The statistics I found showed that approximately 20% of general melanoma patients will be at least partial responders. Ipi is the only other treatment that seems to be approaching this record, especially when used in conjunction with IL-2. It's extremely long term effects aare not yet known.
I jumped first to IL-2 with Dr Weiss at UVA. He is an IL-2 pioneer that highly understands how to use the IL-2 to get the best benefit for the patient. HE also stays involved with the full treatment and does not pass things off to assistants, even though he is head of the department at UVA. My IL-2 saga in in my profile here and in M VCarepages. I was a partial responder for 20 months. During that time my lung mets stabilized and the liver mets went away. When the IL-2 ceased hold the melanoma table, I had been lookiing at a plan B. Though not a standard plan B, it seemed tohold the best possibility for me. Dr. Weiss agreed to try my wishes and I have been stable agin for the last 19 months.
My logic was that with the short recovery time for the worst of IL-2 side effects (one week-10 days) I could move on quickly if needed.
What discussions I have had had with a couple of Oncologist's consider MEK a step that will slow down the spead of Melanoma growth, but is not likely to compleatly end the life of melanoma. it would appear to me that somewhere down the line MEK will likely be used in conjunction with other target drugs to stop more than one of the signaling paths involved with melanoma. Time will tell. Currently mixing treatments has trouble with approval unless they are all approved treatments. i suspect that several target treatments will be necessary to cut enough signalling paths. The MRF is looking into getting some multile drug tests accomplished.
The above is personal opinion based on my own experience and discussions with others. No one knows in advance what will will work for any of us.
JerryfromFauq
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- October 20, 2010 at 1:07 am
Thank you so much for this invaluable information. We have just started all of our appointments and information gathering. It seems to be a troublesome decision between the two. I am just new at this so any information is the beginning of our learing and hopeful recovery.
donswife
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- October 20, 2010 at 1:07 am
Thank you so much for this invaluable information. We have just started all of our appointments and information gathering. It seems to be a troublesome decision between the two. I am just new at this so any information is the beginning of our learing and hopeful recovery.
donswife
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- October 20, 2010 at 1:11 am
Jerry,
Good to see you back on the board and good to hear you are still holding stable.
Take care of yourself!
Rebecca and Bob
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- October 20, 2010 at 1:11 am
Jerry,
Good to see you back on the board and good to hear you are still holding stable.
Take care of yourself!
Rebecca and Bob
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- October 19, 2010 at 9:50 pm
While many treatments work for a very few people, Il-2 has the most proven record for helpiing melanoma patients of any treatment other than surgery.
My personal opinion is that too many patients are scared off by doctors negative comments on IL-2. I researched the statistics and talked to people whose spouses had saved Il-2 as a last resort and never recovered from the chemo's they tried first, in time to try the IL-2. The statistics I found showed that approximately 20% of general melanoma patients will be at least partial responders. Ipi is the only other treatment that seems to be approaching this record, especially when used in conjunction with IL-2. It's extremely long term effects aare not yet known.
I jumped first to IL-2 with Dr Weiss at UVA. He is an IL-2 pioneer that highly understands how to use the IL-2 to get the best benefit for the patient. HE also stays involved with the full treatment and does not pass things off to assistants, even though he is head of the department at UVA. My IL-2 saga in in my profile here and in M VCarepages. I was a partial responder for 20 months. During that time my lung mets stabilized and the liver mets went away. When the IL-2 ceased hold the melanoma table, I had been lookiing at a plan B. Though not a standard plan B, it seemed tohold the best possibility for me. Dr. Weiss agreed to try my wishes and I have been stable agin for the last 19 months.
My logic was that with the short recovery time for the worst of IL-2 side effects (one week-10 days) I could move on quickly if needed.
What discussions I have had had with a couple of Oncologist's consider MEK a step that will slow down the spead of Melanoma growth, but is not likely to compleatly end the life of melanoma. it would appear to me that somewhere down the line MEK will likely be used in conjunction with other target drugs to stop more than one of the signaling paths involved with melanoma. Time will tell. Currently mixing treatments has trouble with approval unless they are all approved treatments. i suspect that several target treatments will be necessary to cut enough signalling paths. The MRF is looking into getting some multile drug tests accomplished.
The above is personal opinion based on my own experience and discussions with others. No one knows in advance what will will work for any of us.
JerryfromFauq
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