The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

Ipi and bone mets?

Forums General Melanoma Community Ipi and bone mets?

  • Post
    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
        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.

          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.

            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.

                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.  

                  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.  

                    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.

                       

                      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.

                         

                        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.

                           

                          JerryfromFauq
                          Participant

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

                            JerryfromFauq
                            Participant

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

                              JerryfromFauq
                              Participant

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

                                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.

                                  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.

                                    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.

                                      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!"

                                         

                                        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!"

                                           

                                          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!"

                                             

                                            Michelem
                                            Participant

                                              Thanks, Jerry. Fingers crossed! 

                                              Michelem
                                              Participant

                                                Thanks, Jerry. Fingers crossed! 

                                                Michelem
                                                Participant

                                                  Thanks, Jerry. Fingers crossed! 

                                                  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!

                                                    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!

                                                      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!

                                                        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

                                                          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

                                                            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

                                                              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. 

                                                                Michelem
                                                                Participant

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

                                                                  Michelem
                                                                  Participant

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

                                                                    Michelem
                                                                    Participant

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

                                                                      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. 

                                                                        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. 

                                                                          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.  

                                                                          Bruce Davis
                                                                          Participant

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

                                                                            Bruce Davis
                                                                            Participant

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

                                                                              Bruce Davis
                                                                              Participant

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

                                                                            Viewing 5 reply threads
                                                                            • You must be logged in to reply to this topic.
                                                                            About the MRF Patient Forum

                                                                            The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                                                                            The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.