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Ipi/Nivo, or Nivo/Ipi??? What is the “right” sequence
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Ipi/Nivo, or Nivo/Ipi??? What is the “right” sequence

› Forums › General Melanoma Community › Ipi/Nivo, or Nivo/Ipi??? What is the “right” sequence

  • Post
    • July 10, 2019 at 10:56 pm
    NewEra
    Participant
      My first immuno treatment today. I got Nivo (Opdivo/Nivolumab) ( first (30 mins) then Ipi (Yervoy/Ipilimumab)). I recall seeing a study on the efficacy of the sequence of these drugs, with one sequence having better results, but of course it’s now lost in the ether and, despite 30 minutes of searching, I can’t find it again!

      Any thoughts/input?

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    • Replies
        • July 10, 2019 at 11:31 pm
        ed williams
        Participant
          Hi there Newera, the short answer is the concept of which drug should come first is not related to should you get ipi or nivo first at the chemo ward when getting the combination IV but rather back in the old days of early trials, was it better to start patients on ipi and if they progress or not respond to ipi to then switch to nivo or vice versa. Usually a scan was required to confirm progression before switching. Here is a link to checkmate 064 one of the early trials that looked at this concept, this was before checkmate 067 trial which lead to the the approval of ipi+ nivo together at the same time which most here call the combination and what you are getting as a treatment approach. Best Wishes!!!Ed https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30126-7/fulltext
            • July 11, 2019 at 1:52 pm
            NewEra
            Participant
              OK, if I’m understanding you correctly, then a “sequence” is a series of weeks/treatments on one drug, then a series on another. The order of the two had differences in outcome in past studies.

              Now both are delivered in the same session for one series of weeks (for checkpoint inhibitors) and the “which one first” in this “combined” approach doesn’t really matter.

              RiGHT???

              So sorry! Total “Newbie” aleart! Where’s that link to the lingo when I need it? GRRRR!)

              • July 11, 2019 at 2:07 pm
              Bubbles
              Participant
                You got it! And no worries! We were all “newbies” once. Old timers like Ed and myself are just glad that “newbies” these days have legit melanoma treatment options. Still, melanoma and its treatments are confusing beasts. Continue to ask questions as you need to. And if you need a glossary of terms, we got that too!

                Here is a link to a primer regarding melanoma treatment that I put together: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melanoma-intel-primer-for-current.html

                A link to a list of abbreviations related to melanoma is included at the bottom of that post, but here it is from my blog with a link to the thread on this forum where it was posted originally: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2016/03/melanoma-abbreviations-and-random.html

                c

              • July 10, 2019 at 11:42 pm
              Bubbles
              Participant
                Ed is exactly right. You are getting the combo….30 minutes does not a sequence make. c
                • July 12, 2019 at 6:09 pm
                MelanomaMike
                Participant
                  Ha! Now that i try and think about, i cant remember what was given to me first the ipi or nivo! I wanna say i got the Ipi first, then the Nivo bag…i called it my “Shot & a Beer back!”….sorry for the silly chime in…lol
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