› Forums › General Melanoma Community › Keytruda – efficacy for brain mets following targeted therapy?
- This topic has 18 replies, 5 voices, and was last updated 7 years, 2 months ago by
zfishberg.
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- February 12, 2017 at 9:55 am
Hey,
First time posting, although I've been reading the forum for years.
My wife is Stage IV – primary site in thigh, now with multiple brain mets – all of which as have been zapped with SRS.
She had 8 months of PFS with Tafinlar/Mekinist but that's over. Tomorrow she starts Keytruda, and will transition off Taf/Mek.
Our onco is being a bit vague about the efficacy of Keytruda with brain mets, esepcially given the previous Taf/Mek treatment. Same question regarding side effects.
Anyone have experience and/or knowledge?
Thanks,
Steven
- Replies
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- February 12, 2017 at 11:06 am
Hi Steven, as I understand it she has developed resistance to targeted therapy and you are now switching to Pd-1. The most recent data that I can find is from ESMO ,fall of 2016. Here is a link https://m.youtube.com/watch?v=NE2KL43UtiA I will look for some data for treating brain mets, may be Celeste will post something for you! Best wishes!!! Ed
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- February 12, 2017 at 11:06 am
Hi Steven, as I understand it she has developed resistance to targeted therapy and you are now switching to Pd-1. The most recent data that I can find is from ESMO ,fall of 2016. Here is a link https://m.youtube.com/watch?v=NE2KL43UtiA I will look for some data for treating brain mets, may be Celeste will post something for you! Best wishes!!! Ed
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- February 12, 2017 at 11:06 am
Hi Steven, as I understand it she has developed resistance to targeted therapy and you are now switching to Pd-1. The most recent data that I can find is from ESMO ,fall of 2016. Here is a link https://m.youtube.com/watch?v=NE2KL43UtiA I will look for some data for treating brain mets, may be Celeste will post something for you! Best wishes!!! Ed
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- February 12, 2017 at 3:10 pm
Sorry you and your wife are dealing with this. Immunotherapy, esp when combined with radiation, IS very effective in treating melanoma brain mets! You may well know this part, but here is a report I put together a couple of years ago to explain that – YES!!!, anti-PD1 can trigger a response in the brain!
Here is a report about why researchers think that the combo of immunotherapy and radiation is so effective….a little arcane and sciencey – but if you are interested:
…more below…
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- February 12, 2017 at 3:15 pm
Here is a link that has a boat load of articles re immunotherapy and radiation…some for melanoma generally…some for brain mets specifically: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=radiation+and+immunotherapy&max-results=20&by-date=true
Do not be alarmed that many of the good reports are about ipi with radiation. I do not believe that ipi is more efffective than anti-Pd1 when combined with SRS…only that we have been doing it longer and therefore have more data.
I hope this helps. I wish you and your wife my best. Celeste
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- February 12, 2017 at 3:15 pm
Here is a link that has a boat load of articles re immunotherapy and radiation…some for melanoma generally…some for brain mets specifically: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=radiation+and+immunotherapy&max-results=20&by-date=true
Do not be alarmed that many of the good reports are about ipi with radiation. I do not believe that ipi is more efffective than anti-Pd1 when combined with SRS…only that we have been doing it longer and therefore have more data.
I hope this helps. I wish you and your wife my best. Celeste
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- February 12, 2017 at 3:15 pm
Here is a link that has a boat load of articles re immunotherapy and radiation…some for melanoma generally…some for brain mets specifically: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=radiation+and+immunotherapy&max-results=20&by-date=true
Do not be alarmed that many of the good reports are about ipi with radiation. I do not believe that ipi is more efffective than anti-Pd1 when combined with SRS…only that we have been doing it longer and therefore have more data.
I hope this helps. I wish you and your wife my best. Celeste
-
- February 12, 2017 at 3:10 pm
Sorry you and your wife are dealing with this. Immunotherapy, esp when combined with radiation, IS very effective in treating melanoma brain mets! You may well know this part, but here is a report I put together a couple of years ago to explain that – YES!!!, anti-PD1 can trigger a response in the brain!
Here is a report about why researchers think that the combo of immunotherapy and radiation is so effective….a little arcane and sciencey – but if you are interested:
…more below…
-
- February 12, 2017 at 3:10 pm
Sorry you and your wife are dealing with this. Immunotherapy, esp when combined with radiation, IS very effective in treating melanoma brain mets! You may well know this part, but here is a report I put together a couple of years ago to explain that – YES!!!, anti-PD1 can trigger a response in the brain!
Here is a report about why researchers think that the combo of immunotherapy and radiation is so effective….a little arcane and sciencey – but if you are interested:
…more below…
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- February 13, 2017 at 12:42 am
Hi Steven,
So sorry to hear that your wife has developed brain mets. I can't scientifically answer your question, although it appears the links from Celeste and Ed may have already tackled that for you. : ) From a personal perspective I can tell you that Keytruda worked QUITE WELL for controlling my brain metastasis. Prior to it's FDA approved use, I was developing 2-4 new brain lesions every month. My radiation oncologist was diligently zapping them with gamma knife radiation, buuuuuuut… we were all beginning to question just how many more months I could endure yet another gamma treatment (I've had 10). After my second Keytruda infusion, the brain mets stopped showing up. My medical oncologist and radiation oncologist were as shocked and pleasantly surprised as I was! Yervoy didn't stop them. MEK (I'm an unusual BRAF) only worked on them for one month. Pembro (Keytruda) stopped them in their tracks. Best wishes to you and your wife! SRS is definitely the way to handle anything that crops up in the brain… but Keytruda can indeed keep the new little buggers from developing.
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- February 13, 2017 at 12:42 am
Hi Steven,
So sorry to hear that your wife has developed brain mets. I can't scientifically answer your question, although it appears the links from Celeste and Ed may have already tackled that for you. : ) From a personal perspective I can tell you that Keytruda worked QUITE WELL for controlling my brain metastasis. Prior to it's FDA approved use, I was developing 2-4 new brain lesions every month. My radiation oncologist was diligently zapping them with gamma knife radiation, buuuuuuut… we were all beginning to question just how many more months I could endure yet another gamma treatment (I've had 10). After my second Keytruda infusion, the brain mets stopped showing up. My medical oncologist and radiation oncologist were as shocked and pleasantly surprised as I was! Yervoy didn't stop them. MEK (I'm an unusual BRAF) only worked on them for one month. Pembro (Keytruda) stopped them in their tracks. Best wishes to you and your wife! SRS is definitely the way to handle anything that crops up in the brain… but Keytruda can indeed keep the new little buggers from developing.
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- February 13, 2017 at 12:42 am
Hi Steven,
So sorry to hear that your wife has developed brain mets. I can't scientifically answer your question, although it appears the links from Celeste and Ed may have already tackled that for you. : ) From a personal perspective I can tell you that Keytruda worked QUITE WELL for controlling my brain metastasis. Prior to it's FDA approved use, I was developing 2-4 new brain lesions every month. My radiation oncologist was diligently zapping them with gamma knife radiation, buuuuuuut… we were all beginning to question just how many more months I could endure yet another gamma treatment (I've had 10). After my second Keytruda infusion, the brain mets stopped showing up. My medical oncologist and radiation oncologist were as shocked and pleasantly surprised as I was! Yervoy didn't stop them. MEK (I'm an unusual BRAF) only worked on them for one month. Pembro (Keytruda) stopped them in their tracks. Best wishes to you and your wife! SRS is definitely the way to handle anything that crops up in the brain… but Keytruda can indeed keep the new little buggers from developing.
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- February 13, 2017 at 7:36 am
Thanks to all for the info and support! Will review it, and let you know how it goes.
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- February 13, 2017 at 7:36 am
Thanks to all for the info and support! Will review it, and let you know how it goes.
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- February 15, 2017 at 5:08 pm
Hello!
I am new to this Forum. My Husband was diagnosed with Melanoma stage 2A ( big mole on his back) in 2012. Had a surgery . All the lymph nodes were clean and PET scan did not show any mets. So he was fine for more than 4 years.
Then In September of 2016 he started feeing headaches and made an appointment to get a MRI done. Two days before the apppoinrment he had a seisure and was admitted to the hospital . The MRI and CT scan showed very bad findings – 4 lesions in the head with 2 large ones ( around 3 cm), edema and multile small lung lesions.
WE were lucky to get in good hands of doctors at University of PA Hospital. He had a surgery to remove one of the large tumors in brain.
After that he had Gamma Knige surgery that treated the rest of the head lesions ( the more presize MRI test showed 10 of them).
He is positive for BRAF, so his oncologist prescribed the MEK/TAF combo that he was taking since November.
Unfuotunately he had very bad reaction to this mnedications – fever of 103-104 and terrible chills. He could not stay on meds for longer than 2 weeks without taking a week brake.
His first MRI and CT scan after 2 month of treatement showed a very good progress – the second large lesion in the head shrunk to 1.2 cm and others became smaller as well. Lung lesions decreased in size as well.
The second MRI just a couple days ago showed new growth.
The oncologist is swithcjing him to Keytruda and we have to start tomorrow our first infusion.
So we are "in the same boat" having the MEK/TAF combo before Keytruda ( although for only 3 month and not constantly).
I am very glad to read all the information about promising resultrs of treatment with Keytruda and SRS.
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- February 15, 2017 at 5:08 pm
Hello!
I am new to this Forum. My Husband was diagnosed with Melanoma stage 2A ( big mole on his back) in 2012. Had a surgery . All the lymph nodes were clean and PET scan did not show any mets. So he was fine for more than 4 years.
Then In September of 2016 he started feeing headaches and made an appointment to get a MRI done. Two days before the apppoinrment he had a seisure and was admitted to the hospital . The MRI and CT scan showed very bad findings – 4 lesions in the head with 2 large ones ( around 3 cm), edema and multile small lung lesions.
WE were lucky to get in good hands of doctors at University of PA Hospital. He had a surgery to remove one of the large tumors in brain.
After that he had Gamma Knige surgery that treated the rest of the head lesions ( the more presize MRI test showed 10 of them).
He is positive for BRAF, so his oncologist prescribed the MEK/TAF combo that he was taking since November.
Unfuotunately he had very bad reaction to this mnedications – fever of 103-104 and terrible chills. He could not stay on meds for longer than 2 weeks without taking a week brake.
His first MRI and CT scan after 2 month of treatement showed a very good progress – the second large lesion in the head shrunk to 1.2 cm and others became smaller as well. Lung lesions decreased in size as well.
The second MRI just a couple days ago showed new growth.
The oncologist is swithcjing him to Keytruda and we have to start tomorrow our first infusion.
So we are "in the same boat" having the MEK/TAF combo before Keytruda ( although for only 3 month and not constantly).
I am very glad to read all the information about promising resultrs of treatment with Keytruda and SRS.
-
- February 15, 2017 at 5:08 pm
Hello!
I am new to this Forum. My Husband was diagnosed with Melanoma stage 2A ( big mole on his back) in 2012. Had a surgery . All the lymph nodes were clean and PET scan did not show any mets. So he was fine for more than 4 years.
Then In September of 2016 he started feeing headaches and made an appointment to get a MRI done. Two days before the apppoinrment he had a seisure and was admitted to the hospital . The MRI and CT scan showed very bad findings – 4 lesions in the head with 2 large ones ( around 3 cm), edema and multile small lung lesions.
WE were lucky to get in good hands of doctors at University of PA Hospital. He had a surgery to remove one of the large tumors in brain.
After that he had Gamma Knige surgery that treated the rest of the head lesions ( the more presize MRI test showed 10 of them).
He is positive for BRAF, so his oncologist prescribed the MEK/TAF combo that he was taking since November.
Unfuotunately he had very bad reaction to this mnedications – fever of 103-104 and terrible chills. He could not stay on meds for longer than 2 weeks without taking a week brake.
His first MRI and CT scan after 2 month of treatement showed a very good progress – the second large lesion in the head shrunk to 1.2 cm and others became smaller as well. Lung lesions decreased in size as well.
The second MRI just a couple days ago showed new growth.
The oncologist is swithcjing him to Keytruda and we have to start tomorrow our first infusion.
So we are "in the same boat" having the MEK/TAF combo before Keytruda ( although for only 3 month and not constantly).
I am very glad to read all the information about promising resultrs of treatment with Keytruda and SRS.
-
- February 13, 2017 at 7:36 am
Thanks to all for the info and support! Will review it, and let you know how it goes.
-
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