Is Yervoy for brain mets? Your help is greatly appreciated
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Is Yervoy for brain mets? Your help is greatly appreciated

› Forums › General Melanoma Community › Is Yervoy for brain mets? Your help is greatly appreciated

  • Post
    • February 5, 2012 at 1:30 pm
    davidfromsingapore
    Participant

    Had some scans last week that came back somewhat inconclusive.  MRI showed a few spots in the thalamus and some areas near the tumors that were removed from my brain that were "enhanced" after the injection of the dye, but PET/CT said "No suspicious hypermetobolic lesions detected".  If it is cancer, I would like to know if any of you out there have used Yervoy (ipi) for brain mets?  Is Yervoy being administered only in clinical trials or can I get it from my oncologist?

    Had some scans last week that came back somewhat inconclusive.  MRI showed a few spots in the thalamus and some areas near the tumors that were removed from my brain that were "enhanced" after the injection of the dye, but PET/CT said "No suspicious hypermetobolic lesions detected".  If it is cancer, I would like to know if any of you out there have used Yervoy (ipi) for brain mets?  Is Yervoy being administered only in clinical trials or can I get it from my oncologist?

    I've read that Yervoy is a large molecule  (and thus won't pass the blood brain barrier), but then again I see that it has been used with some success for some people with brain mets.  Apparently the white blood cells are still able to cross the blood/brain barrier.  

    Your thoughts are greatly appreciated.  Going through some hard times not knowing.  

     

    Thanks, David

Viewing 14 reply threads
  • Replies
      • February 5, 2012 at 2:22 pm
      FormerCaregiver
      Participant

      David, Yervoy can be used in patients with brain mets. However, I don't know if it would
      be suitable in your situation and you would need to consult an oncologist about it.

      Yervoy works by acting on the immune system and therefore has the ability to treat
      tumours anywhere in the body. See: http://en.wikipedia.org/wiki/Ipilimumab and
      http://www.yervoy.com/patient/about-yervoy.aspx

      An oncologist can prescribe it for you, but that would depend if it is approved and
      available in your location.

      Hope this helps.

      Frank from Australia

      • February 5, 2012 at 2:22 pm
      FormerCaregiver
      Participant

      David, Yervoy can be used in patients with brain mets. However, I don't know if it would
      be suitable in your situation and you would need to consult an oncologist about it.

      Yervoy works by acting on the immune system and therefore has the ability to treat
      tumours anywhere in the body. See: http://en.wikipedia.org/wiki/Ipilimumab and
      http://www.yervoy.com/patient/about-yervoy.aspx

      An oncologist can prescribe it for you, but that would depend if it is approved and
      available in your location.

      Hope this helps.

      Frank from Australia

      • February 5, 2012 at 2:22 pm
      FormerCaregiver
      Participant

      David, Yervoy can be used in patients with brain mets. However, I don't know if it would
      be suitable in your situation and you would need to consult an oncologist about it.

      Yervoy works by acting on the immune system and therefore has the ability to treat
      tumours anywhere in the body. See: http://en.wikipedia.org/wiki/Ipilimumab and
      http://www.yervoy.com/patient/about-yervoy.aspx

      An oncologist can prescribe it for you, but that would depend if it is approved and
      available in your location.

      Hope this helps.

      Frank from Australia

      • February 5, 2012 at 2:25 pm
      nikolaos
      Participant

      Hello David. Ipilimumab does not attack tumors itself. It stimulates immune system so that it recognize melanoma and produces lymphocytes that attack tumors. Those lymphocytes can hopefully cross the brain barrier and do the job. At early trials there have been no study references to agree with that statement- however most of them (i think all of them) did not include in the study patients with brain metastases..

      However i have come across one study which suggests that ipilimumab has the same level (or at least almost the same) of activity in central nervous system like in extracranial sites.. Here is the link to the study. Look at the conclusion.

      http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=74&abstractID=50834

       

      Conclusions: Ipi has a similar level of activity in brain and non-CNS lesions. This is the first study to prospectively evaluate Ipi in advanced melanoma pts with brain mets, and the data support its potential use as a treatment for these pts. The analyses are ongoing and final data will be presented.

      • February 5, 2012 at 2:25 pm
      nikolaos
      Participant

      Hello David. Ipilimumab does not attack tumors itself. It stimulates immune system so that it recognize melanoma and produces lymphocytes that attack tumors. Those lymphocytes can hopefully cross the brain barrier and do the job. At early trials there have been no study references to agree with that statement- however most of them (i think all of them) did not include in the study patients with brain metastases..

      However i have come across one study which suggests that ipilimumab has the same level (or at least almost the same) of activity in central nervous system like in extracranial sites.. Here is the link to the study. Look at the conclusion.

      http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=74&abstractID=50834

       

      Conclusions: Ipi has a similar level of activity in brain and non-CNS lesions. This is the first study to prospectively evaluate Ipi in advanced melanoma pts with brain mets, and the data support its potential use as a treatment for these pts. The analyses are ongoing and final data will be presented.

      • February 5, 2012 at 2:25 pm
      nikolaos
      Participant

      Hello David. Ipilimumab does not attack tumors itself. It stimulates immune system so that it recognize melanoma and produces lymphocytes that attack tumors. Those lymphocytes can hopefully cross the brain barrier and do the job. At early trials there have been no study references to agree with that statement- however most of them (i think all of them) did not include in the study patients with brain metastases..

      However i have come across one study which suggests that ipilimumab has the same level (or at least almost the same) of activity in central nervous system like in extracranial sites.. Here is the link to the study. Look at the conclusion.

      http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=74&abstractID=50834

       

      Conclusions: Ipi has a similar level of activity in brain and non-CNS lesions. This is the first study to prospectively evaluate Ipi in advanced melanoma pts with brain mets, and the data support its potential use as a treatment for these pts. The analyses are ongoing and final data will be presented.

      • February 6, 2012 at 3:34 pm
      fdess056
      Participant

      Hi David  Good to hear from you again.  I was scheduled to start IPI in January for lung mets.  Onc ordered a brain MRI just to have an updated base line.  MRI showed leptomeningeal metastasis, which I believe you've had also.  Onc decided to stick with IPI anyway since it does break the brain barrier.  I have my 3rd infusion scheduled for this Thursday.   I also  just had a set of 4 MRIs done on Saturday……brain and complete spine..   Once I get results I'll take CD and report  to a new neuro-oncologist for consultation.  I'll let you know how it al works out  Best of luck to you!

      frankd  brooklyn NY 

        • February 8, 2012 at 2:37 pm
        davidfromsingapore
        Participant

         

        Frank

         

        Thanks so much for your reply.  I do have a question about the Yervoy (ipi).  My oncologist has said it is a large molecule drug and thus does not cross the bb barrier.  But he did say that the white blood cells that it creates will cross the BBB.  Are you certain that Yervoy crosses the BBB?  That would be good news for sure.  Do you think that ipi can give you a long term or complete response for the leptomeningeal melanoma?  What is your next step?  I think I'm headed down the ipi trail. 

        David 

        • February 8, 2012 at 2:37 pm
        davidfromsingapore
        Participant

         

        Frank

         

        Thanks so much for your reply.  I do have a question about the Yervoy (ipi).  My oncologist has said it is a large molecule drug and thus does not cross the bb barrier.  But he did say that the white blood cells that it creates will cross the BBB.  Are you certain that Yervoy crosses the BBB?  That would be good news for sure.  Do you think that ipi can give you a long term or complete response for the leptomeningeal melanoma?  What is your next step?  I think I'm headed down the ipi trail. 

        David 

        • February 8, 2012 at 4:03 pm
        fdess056
        Participant

        David, good timing on your question.  I just got back from seeing a neuro-oncologist at Mt Sinaiin Manhattan.  He confirmed the opinion of my head onc  that Yervoy does penetrate the brain barrier.  However, he did note that it is not approved in the US by the Food & Drug Admin for that purpose, so there is some controversy about this subject.   Since i also have a met on my left lung, they were able to get clearance to  use the yervoy.  My latest brain MRIs show a  small decrease in size of the original brain met….(possibly due to yervoy?) with no further spread to the brain or spinal column.     This is after 2 yervoy infusions. I have my 3rd one on Thursday.  He  wants to try  Gamma Knife surgery in conjunction with the yervoy.  I'm waiting to hear back from radiology on their insight.  I hope this helps and wish you all the best  You'll continue to be in my thoughts.

        FrankD

        • February 8, 2012 at 4:03 pm
        fdess056
        Participant

        David, good timing on your question.  I just got back from seeing a neuro-oncologist at Mt Sinaiin Manhattan.  He confirmed the opinion of my head onc  that Yervoy does penetrate the brain barrier.  However, he did note that it is not approved in the US by the Food & Drug Admin for that purpose, so there is some controversy about this subject.   Since i also have a met on my left lung, they were able to get clearance to  use the yervoy.  My latest brain MRIs show a  small decrease in size of the original brain met….(possibly due to yervoy?) with no further spread to the brain or spinal column.     This is after 2 yervoy infusions. I have my 3rd one on Thursday.  He  wants to try  Gamma Knife surgery in conjunction with the yervoy.  I'm waiting to hear back from radiology on their insight.  I hope this helps and wish you all the best  You'll continue to be in my thoughts.

        FrankD

        • February 8, 2012 at 4:03 pm
        fdess056
        Participant

        David, good timing on your question.  I just got back from seeing a neuro-oncologist at Mt Sinaiin Manhattan.  He confirmed the opinion of my head onc  that Yervoy does penetrate the brain barrier.  However, he did note that it is not approved in the US by the Food & Drug Admin for that purpose, so there is some controversy about this subject.   Since i also have a met on my left lung, they were able to get clearance to  use the yervoy.  My latest brain MRIs show a  small decrease in size of the original brain met….(possibly due to yervoy?) with no further spread to the brain or spinal column.     This is after 2 yervoy infusions. I have my 3rd one on Thursday.  He  wants to try  Gamma Knife surgery in conjunction with the yervoy.  I'm waiting to hear back from radiology on their insight.  I hope this helps and wish you all the best  You'll continue to be in my thoughts.

        FrankD

        • February 8, 2012 at 2:37 pm
        davidfromsingapore
        Participant

         

        Frank

         

        Thanks so much for your reply.  I do have a question about the Yervoy (ipi).  My oncologist has said it is a large molecule drug and thus does not cross the bb barrier.  But he did say that the white blood cells that it creates will cross the BBB.  Are you certain that Yervoy crosses the BBB?  That would be good news for sure.  Do you think that ipi can give you a long term or complete response for the leptomeningeal melanoma?  What is your next step?  I think I'm headed down the ipi trail. 

        David 

      • February 6, 2012 at 3:34 pm
      fdess056
      Participant

      Hi David  Good to hear from you again.  I was scheduled to start IPI in January for lung mets.  Onc ordered a brain MRI just to have an updated base line.  MRI showed leptomeningeal metastasis, which I believe you've had also.  Onc decided to stick with IPI anyway since it does break the brain barrier.  I have my 3rd infusion scheduled for this Thursday.   I also  just had a set of 4 MRIs done on Saturday……brain and complete spine..   Once I get results I'll take CD and report  to a new neuro-oncologist for consultation.  I'll let you know how it al works out  Best of luck to you!

      frankd  brooklyn NY 

      • February 6, 2012 at 3:34 pm
      fdess056
      Participant

      Hi David  Good to hear from you again.  I was scheduled to start IPI in January for lung mets.  Onc ordered a brain MRI just to have an updated base line.  MRI showed leptomeningeal metastasis, which I believe you've had also.  Onc decided to stick with IPI anyway since it does break the brain barrier.  I have my 3rd infusion scheduled for this Thursday.   I also  just had a set of 4 MRIs done on Saturday……brain and complete spine..   Once I get results I'll take CD and report  to a new neuro-oncologist for consultation.  I'll let you know how it al works out  Best of luck to you!

      frankd  brooklyn NY 

      • February 7, 2012 at 3:40 am
      NancyGM
      Participant

      David, I do know that Temodar (temozolamide) crosses the blood brain barrier. Have your doctors considered this chemo pill? I did 10 rounds in 2007 and have been clear now for 4 years. I didn't have brain mets. I had a pretty good size lung met which could not be surgically removed.

      Very best of luck to you.You have a beautiful family. I think life is full of miracles..who is to say you might not just be one?

        • February 8, 2012 at 2:49 pm
        davidfromsingapore
        Participant

        Nancy

        Thanks for the helpful advice and the kind words.  Temodar is indeed one of my options.  I think it is the drug my oncologist prefer actually.  Hearing your success definitely helps.  

         

        All the best, David

        • February 8, 2012 at 2:49 pm
        davidfromsingapore
        Participant

        Nancy

        Thanks for the helpful advice and the kind words.  Temodar is indeed one of my options.  I think it is the drug my oncologist prefer actually.  Hearing your success definitely helps.  

         

        All the best, David

        • February 8, 2012 at 2:49 pm
        davidfromsingapore
        Participant

        Nancy

        Thanks for the helpful advice and the kind words.  Temodar is indeed one of my options.  I think it is the drug my oncologist prefer actually.  Hearing your success definitely helps.  

         

        All the best, David

      • February 7, 2012 at 3:40 am
      NancyGM
      Participant

      David, I do know that Temodar (temozolamide) crosses the blood brain barrier. Have your doctors considered this chemo pill? I did 10 rounds in 2007 and have been clear now for 4 years. I didn't have brain mets. I had a pretty good size lung met which could not be surgically removed.

      Very best of luck to you.You have a beautiful family. I think life is full of miracles..who is to say you might not just be one?

      • February 7, 2012 at 3:40 am
      NancyGM
      Participant

      David, I do know that Temodar (temozolamide) crosses the blood brain barrier. Have your doctors considered this chemo pill? I did 10 rounds in 2007 and have been clear now for 4 years. I didn't have brain mets. I had a pretty good size lung met which could not be surgically removed.

      Very best of luck to you.You have a beautiful family. I think life is full of miracles..who is to say you might not just be one?

      • February 7, 2012 at 3:43 am
      NancyGM
      Participant

      David, I do know that Temodar (temozolamide) crosses the blood brain barrier. Have your doctors considered this chemo pill? I did 10 rounds in 2007 and have been clear now for 4 years. I didn't have brain mets. I had a pretty good size lung met which could not be surgically removed.

      Very best of luck to you.You have a beautiful family. I think life is full of miracles..who is to say you might not just be one?

      • February 7, 2012 at 3:43 am
      NancyGM
      Participant

      David, I do know that Temodar (temozolamide) crosses the blood brain barrier. Have your doctors considered this chemo pill? I did 10 rounds in 2007 and have been clear now for 4 years. I didn't have brain mets. I had a pretty good size lung met which could not be surgically removed.

      Very best of luck to you.You have a beautiful family. I think life is full of miracles..who is to say you might not just be one?

      • February 7, 2012 at 3:43 am
      NancyGM
      Participant

      David, I do know that Temodar (temozolamide) crosses the blood brain barrier. Have your doctors considered this chemo pill? I did 10 rounds in 2007 and have been clear now for 4 years. I didn't have brain mets. I had a pretty good size lung met which could not be surgically removed.

      Very best of luck to you.You have a beautiful family. I think life is full of miracles..who is to say you might not just be one?

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