Ipi and bone mets?
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Ipi and bone mets?

› Forums › General Melanoma Community › Ipi and bone mets?

  • Post
    • February 11, 2014 at 2:24 pm
    Michelem
    Participant

    Does anyone have experience with ipi being effective on bone mets? My husbands melanoma has now spread to liver and bone, and he has just had his first ipi treatment.

Viewing 5 reply threads
  • Replies
      • February 11, 2014 at 4:01 pm
      Mat
      Participant

      Folks seem to be talking about the synergies between radiation and ipi, so you might consider discussing with your doc adding radiation to the bone met while you're doing ipi.

      • February 11, 2014 at 4:01 pm
      Mat
      Participant

      Folks seem to be talking about the synergies between radiation and ipi, so you might consider discussing with your doc adding radiation to the bone met while you're doing ipi.

      • February 11, 2014 at 4:01 pm
      Mat
      Participant

      Folks seem to be talking about the synergies between radiation and ipi, so you might consider discussing with your doc adding radiation to the bone met while you're doing ipi.

        • February 11, 2014 at 9:22 pm
        Michelem
        Participant

        Hubby was set for radiation to the abdominal area – he has had lymph nodes removed but they know there is more melanoma in the surrounding tissue – but now that melanoma has spread to liver and bone we are told radiation is not a very good option as the spread is throughout too large an area.  

        • February 11, 2014 at 9:22 pm
        Michelem
        Participant

        Hubby was set for radiation to the abdominal area – he has had lymph nodes removed but they know there is more melanoma in the surrounding tissue – but now that melanoma has spread to liver and bone we are told radiation is not a very good option as the spread is throughout too large an area.  

        • February 12, 2014 at 11:39 am
        JerryfromFauq
        Participant

        If they radiate the abdominal area then there is a chance that the Synergistic effects would help fight it in the bone or vice versa.  Normaly radiation will not destroy melanoma tumors completely by itself to any large degree.  As you probably know I am not in favor of heavy radiation to the abdominal area.  But it would be interesting to see if radiationg the bone tumor after administering Ipi would help enhance the effect of the Ipi on the remaining organ tumors.

         

        • February 12, 2014 at 11:39 am
        JerryfromFauq
        Participant

        If they radiate the abdominal area then there is a chance that the Synergistic effects would help fight it in the bone or vice versa.  Normaly radiation will not destroy melanoma tumors completely by itself to any large degree.  As you probably know I am not in favor of heavy radiation to the abdominal area.  But it would be interesting to see if radiationg the bone tumor after administering Ipi would help enhance the effect of the Ipi on the remaining organ tumors.

         

        • February 12, 2014 at 11:39 am
        JerryfromFauq
        Participant

        If they radiate the abdominal area then there is a chance that the Synergistic effects would help fight it in the bone or vice versa.  Normaly radiation will not destroy melanoma tumors completely by itself to any large degree.  As you probably know I am not in favor of heavy radiation to the abdominal area.  But it would be interesting to see if radiationg the bone tumor after administering Ipi would help enhance the effect of the Ipi on the remaining organ tumors.

         

        • February 12, 2014 at 11:41 am
        JerryfromFauq
        Participant

        I am intrested in what Dr Minor has to say on this possibility, if you discuss it with him.

        • February 12, 2014 at 11:41 am
        JerryfromFauq
        Participant

        I am intrested in what Dr Minor has to say on this possibility, if you discuss it with him.

        • February 12, 2014 at 11:41 am
        JerryfromFauq
        Participant

        I am intrested in what Dr Minor has to say on this possibility, if you discuss it with him.

        • February 12, 2014 at 5:25 pm
        Michelem
        Participant

        At this point Minor has recommended against radiation. The purpose was to eliminate the groin cancer and percent further spread. But now that there are mets in the liver and bone he feels this strategy does not apply. For now the treatment is 3mg/kilo ipi at three week intervals.

        MRI this week may make a difference, ie if there are brain mets they may do something further.

        • February 12, 2014 at 5:25 pm
        Michelem
        Participant

        At this point Minor has recommended against radiation. The purpose was to eliminate the groin cancer and percent further spread. But now that there are mets in the liver and bone he feels this strategy does not apply. For now the treatment is 3mg/kilo ipi at three week intervals.

        MRI this week may make a difference, ie if there are brain mets they may do something further.

        • February 12, 2014 at 5:25 pm
        Michelem
        Participant

        At this point Minor has recommended against radiation. The purpose was to eliminate the groin cancer and percent further spread. But now that there are mets in the liver and bone he feels this strategy does not apply. For now the treatment is 3mg/kilo ipi at three week intervals.

        MRI this week may make a difference, ie if there are brain mets they may do something further.

        • February 14, 2014 at 7:17 am
        JerryfromFauq
        Participant

        Makes sense, time for systemic acrion now.  The Ipi is certainly within the guidelines.  Either Ipi, IL-2 or one of the Clinical trials.

        Hope they say what I was told my MRI showed:  I.E. "NOTHING there!"

         

        • February 14, 2014 at 7:17 am
        JerryfromFauq
        Participant

        Makes sense, time for systemic acrion now.  The Ipi is certainly within the guidelines.  Either Ipi, IL-2 or one of the Clinical trials.

        Hope they say what I was told my MRI showed:  I.E. "NOTHING there!"

         

        • February 14, 2014 at 7:17 am
        JerryfromFauq
        Participant

        Makes sense, time for systemic acrion now.  The Ipi is certainly within the guidelines.  Either Ipi, IL-2 or one of the Clinical trials.

        Hope they say what I was told my MRI showed:  I.E. "NOTHING there!"

         

        • February 14, 2014 at 2:14 pm
        Michelem
        Participant

        Thanks, Jerry. Fingers crossed! 

        • February 14, 2014 at 2:14 pm
        Michelem
        Participant

        Thanks, Jerry. Fingers crossed! 

        • February 14, 2014 at 2:14 pm
        Michelem
        Participant

        Thanks, Jerry. Fingers crossed! 

        • February 14, 2014 at 3:25 pm
        POW
        Participant

        Michele, as you have said yourself, your husband's melanoma seems to be pretty aggressive. While the ipi by itself might work, we are seeing more and more melanoma doctors who are recommending treating melanoma with a combination of treatments. BRAF+MEK, or ipi + IL-2 or any one of a number of other combinations. There are a lot of clinical trials now or being proposed to test such combo treatments. 

        One of the combos that has been suggested but is getting little attention is radiataion + ipi. Jerry mentioned that a couple of days ago and I really think you should consider it. I agree that wide-area radiation to the abdomen might cause more harm than good. But some institutions can now do stereotactic (highly  focused) radiation to internal organs with good results.

        Here is a paper in the New England Journal of Medicine about combining radiaiton to liver mets with ipilumimab ( http://www.nejm.org/doi/full/10.1056/NEJMc1203984 ) Yes, it only talks about one patient, but the authors were clearly excited by the result. They are now conducting a clinical trial for this combo and they are located in Stanford. I strongly suggest that you contact them and discuss the possibilities. 

        Even if Don does not qualify for the clinical trial, or if he doesn't want to participate in the clinical trial, he could get SRS to the liver (or other organ) independent of a trial. Note that these authors gave the patient two ipi infusions before doing the radiotherapy, so you have time to do some research about the combo.

        Good luck!

        • February 14, 2014 at 3:25 pm
        POW
        Participant

        Michele, as you have said yourself, your husband's melanoma seems to be pretty aggressive. While the ipi by itself might work, we are seeing more and more melanoma doctors who are recommending treating melanoma with a combination of treatments. BRAF+MEK, or ipi + IL-2 or any one of a number of other combinations. There are a lot of clinical trials now or being proposed to test such combo treatments. 

        One of the combos that has been suggested but is getting little attention is radiataion + ipi. Jerry mentioned that a couple of days ago and I really think you should consider it. I agree that wide-area radiation to the abdomen might cause more harm than good. But some institutions can now do stereotactic (highly  focused) radiation to internal organs with good results.

        Here is a paper in the New England Journal of Medicine about combining radiaiton to liver mets with ipilumimab ( http://www.nejm.org/doi/full/10.1056/NEJMc1203984 ) Yes, it only talks about one patient, but the authors were clearly excited by the result. They are now conducting a clinical trial for this combo and they are located in Stanford. I strongly suggest that you contact them and discuss the possibilities. 

        Even if Don does not qualify for the clinical trial, or if he doesn't want to participate in the clinical trial, he could get SRS to the liver (or other organ) independent of a trial. Note that these authors gave the patient two ipi infusions before doing the radiotherapy, so you have time to do some research about the combo.

        Good luck!

        • February 14, 2014 at 3:25 pm
        POW
        Participant

        Michele, as you have said yourself, your husband's melanoma seems to be pretty aggressive. While the ipi by itself might work, we are seeing more and more melanoma doctors who are recommending treating melanoma with a combination of treatments. BRAF+MEK, or ipi + IL-2 or any one of a number of other combinations. There are a lot of clinical trials now or being proposed to test such combo treatments. 

        One of the combos that has been suggested but is getting little attention is radiataion + ipi. Jerry mentioned that a couple of days ago and I really think you should consider it. I agree that wide-area radiation to the abdomen might cause more harm than good. But some institutions can now do stereotactic (highly  focused) radiation to internal organs with good results.

        Here is a paper in the New England Journal of Medicine about combining radiaiton to liver mets with ipilumimab ( http://www.nejm.org/doi/full/10.1056/NEJMc1203984 ) Yes, it only talks about one patient, but the authors were clearly excited by the result. They are now conducting a clinical trial for this combo and they are located in Stanford. I strongly suggest that you contact them and discuss the possibilities. 

        Even if Don does not qualify for the clinical trial, or if he doesn't want to participate in the clinical trial, he could get SRS to the liver (or other organ) independent of a trial. Note that these authors gave the patient two ipi infusions before doing the radiotherapy, so you have time to do some research about the combo.

        Good luck!

        • February 15, 2014 at 2:35 am
        Michelem
        Participant

        Thank you, POW!  This is good info and I will ask our doctor about it on Wednesday. What I can't tell from reading this is whether it's addressing a significant tumor . . . . one of my husband's issues is that he has numerous small mets spread throughout his liver, spleen, bones and general groin area.  Can radiation be addressed to such a generalized widespread situation?  I don't know, but I will ask.

        They had planned on doing radiation to the groin area, but when the PET scan showed the broader spread, this plan was cancelled.

        My husband has been tested for BRAF, but does not have the mutation.  mm

        • February 15, 2014 at 2:35 am
        Michelem
        Participant

        Thank you, POW!  This is good info and I will ask our doctor about it on Wednesday. What I can't tell from reading this is whether it's addressing a significant tumor . . . . one of my husband's issues is that he has numerous small mets spread throughout his liver, spleen, bones and general groin area.  Can radiation be addressed to such a generalized widespread situation?  I don't know, but I will ask.

        They had planned on doing radiation to the groin area, but when the PET scan showed the broader spread, this plan was cancelled.

        My husband has been tested for BRAF, but does not have the mutation.  mm

        • February 15, 2014 at 2:35 am
        Michelem
        Participant

        Thank you, POW!  This is good info and I will ask our doctor about it on Wednesday. What I can't tell from reading this is whether it's addressing a significant tumor . . . . one of my husband's issues is that he has numerous small mets spread throughout his liver, spleen, bones and general groin area.  Can radiation be addressed to such a generalized widespread situation?  I don't know, but I will ask.

        They had planned on doing radiation to the groin area, but when the PET scan showed the broader spread, this plan was cancelled.

        My husband has been tested for BRAF, but does not have the mutation.  mm

        • February 15, 2014 at 3:51 am
        POW
        Participant

        If it was me, I would contact Dr. Susan Knox, one of the authors of this paper, before you go to see your doctor on Wednesday. Her contact info is:

        Susan J. Knox, M.D., Ph.D. 

        Stanford University Medical Center, Stanford, CA 

        Get your questions answered and get a sense of what Dr. Knox thinks is possible. You might or might not want to make an appointment to see her together with Don. If you have more solid information about this thing they call "radioimmunotherapy" before you talk to your doctor, you will be able to have a more fruitful and satisfying conversation with him. 

        • February 15, 2014 at 6:07 am
        Michelem
        Participant

        I will send her a message and see what she has to say.  Every resource is a treasure!  mm

        • February 15, 2014 at 6:07 am
        Michelem
        Participant

        I will send her a message and see what she has to say.  Every resource is a treasure!  mm

        • February 15, 2014 at 6:07 am
        Michelem
        Participant

        I will send her a message and see what she has to say.  Every resource is a treasure!  mm

        • February 15, 2014 at 3:51 am
        POW
        Participant

        If it was me, I would contact Dr. Susan Knox, one of the authors of this paper, before you go to see your doctor on Wednesday. Her contact info is:

        Susan J. Knox, M.D., Ph.D. 

        Stanford University Medical Center, Stanford, CA 

        Get your questions answered and get a sense of what Dr. Knox thinks is possible. You might or might not want to make an appointment to see her together with Don. If you have more solid information about this thing they call "radioimmunotherapy" before you talk to your doctor, you will be able to have a more fruitful and satisfying conversation with him. 

        • February 15, 2014 at 3:51 am
        POW
        Participant

        If it was me, I would contact Dr. Susan Knox, one of the authors of this paper, before you go to see your doctor on Wednesday. Her contact info is:

        Susan J. Knox, M.D., Ph.D. 

        Stanford University Medical Center, Stanford, CA 

        Get your questions answered and get a sense of what Dr. Knox thinks is possible. You might or might not want to make an appointment to see her together with Don. If you have more solid information about this thing they call "radioimmunotherapy" before you talk to your doctor, you will be able to have a more fruitful and satisfying conversation with him. 

        • February 11, 2014 at 9:22 pm
        Michelem
        Participant

        Hubby was set for radiation to the abdominal area – he has had lymph nodes removed but they know there is more melanoma in the surrounding tissue – but now that melanoma has spread to liver and bone we are told radiation is not a very good option as the spread is throughout too large an area.  

      • March 3, 2014 at 6:27 am
      Bruce Davis
      Participant

      So sorry to hear of your loss.  Praying for family and friends.

      • March 3, 2014 at 6:27 am
      Bruce Davis
      Participant

      So sorry to hear of your loss.  Praying for family and friends.

      • March 3, 2014 at 6:27 am
      Bruce Davis
      Participant

      So sorry to hear of your loss.  Praying for family and friends.

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