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Lenvatinib plus Pembrolizumab for melanoma
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Lenvatinib plus Pembrolizumab for melanoma

› Forums › General Melanoma Community › Lenvatinib plus Pembrolizumab for melanoma

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    • December 10, 2019 at 3:29 am
    Roberto
    Participant
      Hello everyone. I was out of this forum for a while taking care of my wife who went through an isolated limb infusion. Just a palliative treatment to try to prevent leg amputation. Well, has anyone ever heard about using a drug called Levantinib in conjunction with pembrolizumab to treat melanoma? Levatinib is an approved thyroid cancer drug but is currently under study for the treatment of melanoma. My doctor came back from a congress in Europe and said that everyone was very enthusiastic about the potential of this drug also for the treatment of melanoma. There are several studies of this drug for various types of cancer, including melanoma, and it seems that the preliminary results seem to be fantastic, according to my doctor informed me.
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        • December 10, 2019 at 4:36 am
        Bubbles
        Participant
          I hope your wife is doing well, Roberto.

          Your report is interesting. We know that the ipi/nivo combo garners a greater than 50% ORR (creeping pretty close to 60% depending on the study) for melanoma patients and those responses have been durable over time – though that time frame is still being determined by many amazing ratties. The side effects (mostly from the ipi component can certainly be difficult) but…

          Here is a report on the pembro/levantinib combo: https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.8_suppl.15
          Only 21 patients. ORR = 47.6% All patients experienced some side effects, apparently with 62% of them dealing with Grade 3/4 events. They noted: “Dose reduction and interruption due to TRAEs occurred in 13 (62%) and 10 (48%) pts, respectively.:

          Here are the studies currently ongoing or completed using levantinib in melanoma: https://clinicaltrials.gov/ct2/results?recrs=&cond=melanoma&term=Lenvatinib&cntry=&state=&city=&dist=

          Hopefully, these studies will find positive results for melanoma patients. Ratties rule. For what it’s worth.

          • December 10, 2019 at 2:04 pm
          Linda5
          Participant
            Hi Roberto…I am currently in this trial, since June. Personally I have had good results on my lung mets (down from 1 cm to 3 mm as of my end of October scans) but no response to 2 small brain mets so we zapped those last month). It was a tough start with blood pressure and dizziness issues, so I am on a reduced dose of Lenvatinib.
            I do find the treatment difficult, I’m now on blood pressure meds, have nausea on and off, they do lots of heart function monitoring, and I have general fatigue, but as long as it’s working I guess that’s the main thing.
            I guess there are a few people on it here (Princess Margaret in Toronto) as one of the docs told me they are generally seeing good results.
            Linda
            • December 10, 2019 at 2:23 pm
            gopher38
            Participant
              This sounds promising. How about Levantinib+Opdivo+Ipi? Where do I sign?
                • December 10, 2019 at 3:42 pm
                ed williams
                Participant
                  Hi Gopher38, early days in a new combination brings hope but after having so many new combinations not make the grade ie. IDO inhibitor epacadostat + Pembro trial failure (see link following)https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30274-8/fulltext it might be wise to let the trial run for some time and gets some data before thinking that this is the next great thing. The drug is approved in a couple of other cancer types and the company Eisai has a web page with possible side effects for those patients,https://us.eisai.com/our-products so there is a history of data with side effects which might help potential patients make an educate decision about trying this new drug. The early trials run so far in melanoma specific is based on pretty small #’s but the new phase 3 randomized trial based on 660 patients should give us all the information we need in the future. If you click on Levantinib on their own home page you will see a pretty detailed list of side effects for Levantinib in three different cancers where it is already approved. http://www.lenvima.com/
                  • December 10, 2019 at 3:44 pm
                  ed williams
                  Participant
                    Sorry about link to Epacadostat, here is another talking about the IDo failure in the phase 3 trial with Pembro. https://lifescivc.com/2018/04/life-after-echo-301-lessons-learned-about-modulating-ido-tdo-to-treat-cancer/
                  • December 10, 2019 at 4:31 pm
                  gopher38
                  Participant
                    Hello Ed,
                    Thanks for the links. I was mostly joking about combining the three … but not completely. I haven’t had much in terms of side effects from either nivo or ipi, so I’d probably be more willing to add another element to the mix if there was a chance it could raise effectiveness than people who have experienced more severe side effects. But even I wouldn’t throw in treatments willy-nilly, even if they’d let me 😉 So let’s get those trials going!!

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