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Mixed results from Yervoy–what now?

Forums General Melanoma Community Mixed results from Yervoy–what now?

  • Post
    jmmm
    Participant

    My husband was dx with stage 4 in January.  He had 2 surgeries to remove 2 tumors (sm. bowel and lung).  He has the c-kit marker and was put on Gleevec for 7 weeks.  A follow up scan showed 2 new tumors–one in the small bowel and one near his heart.  His dr.

    My husband was dx with stage 4 in January.  He had 2 surgeries to remove 2 tumors (sm. bowel and lung).  He has the c-kit marker and was put on Gleevec for 7 weeks.  A follow up scan showed 2 new tumors–one in the small bowel and one near his heart.  His dr. started him on Yervoy.  He completed his 4 doses and just had his 12 week scan.  The GI tumor was completely gone and the heart tumor was "dead" and half the size before treatment.  We were amazed.  Unfortunately, there was some activity in some lymphnodes in his belly–the radiologist believes it to be new tumors–the largest one was 2.4 cm with an uptake value of 5.6.  These tumors were not there before the Yervoy treatment.  The Dr. isn't sure what to think–my husband is the fist patient he's treated with Yervoy.  He thinks it could just be an immune reaction from the Yervoy.  Has anyone heard of a yervoy taking care of tumors, but allowing new tumors to grow??  Or has anyone heard of yervoy causing lymphnodes to appear as new metastisis??  The Dr. wants to rescan in 6 weeks, but we're both nervous waiting.  Any thoughts??

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  • Replies
      lhaley
      Participant

      I would negotiate scans in 4 weeks.  My melanoma specialist told me he scans at 12 weeks and then if stable at 16 weeks to look for a late response. 

      lhaley
      Participant

      I would negotiate scans in 4 weeks.  My melanoma specialist told me he scans at 12 weeks and then if stable at 16 weeks to look for a late response. 

      JerryfromFauq
      Participant

      There are at least 4 c-kit tarketed drugs being tried now.  Dasatinib is one that is tried for people that either could not take the Gleevec or else dor people that Gleevec was not effective on.  Do you know which specific DNA mutation you husband has.  There are at least 3 different DNA mutations known to occur in c-kit melanomas.  There are different tils going on to determine which drug works best on which mutation.  Wish c-kit was just one thing.  Heck, I even wish that melanoma wa just one thing rather than maybe a hundred different ones.  It doesn't even follow just one signaling pathway.  This is reasons it is so likely to reappeaar.

         Was he still on the Gleevec when the scan that found the new tumor?  Gleevec is labeled  a cytostatic in most reports. I have been on it for 2 1/4 years now.  Dr WenJen Hwu at MD anderon uses it in conjunction with Tramodal which is an apoptosis drug that also crosses the blood brain barrier.

         Ipi (Yervoy) has been knon to wait up to a year for tumors to disappear.  One problem is that one may not have that year to wait.

        I would try to get the next scan in 4 weeks and pray for something good to show up.  She hd been having some success with this combo for c-kit melanomoa.

      JerryfromFauq
      Participant

      There are at least 4 c-kit tarketed drugs being tried now.  Dasatinib is one that is tried for people that either could not take the Gleevec or else dor people that Gleevec was not effective on.  Do you know which specific DNA mutation you husband has.  There are at least 3 different DNA mutations known to occur in c-kit melanomas.  There are different tils going on to determine which drug works best on which mutation.  Wish c-kit was just one thing.  Heck, I even wish that melanoma wa just one thing rather than maybe a hundred different ones.  It doesn't even follow just one signaling pathway.  This is reasons it is so likely to reappeaar.

         Was he still on the Gleevec when the scan that found the new tumor?  Gleevec is labeled  a cytostatic in most reports. I have been on it for 2 1/4 years now.  Dr WenJen Hwu at MD anderon uses it in conjunction with Tramodal which is an apoptosis drug that also crosses the blood brain barrier.

         Ipi (Yervoy) has been knon to wait up to a year for tumors to disappear.  One problem is that one may not have that year to wait.

        I would try to get the next scan in 4 weeks and pray for something good to show up.  She hd been having some success with this combo for c-kit melanomoa.

      ValinMtl
      Participant

      Yevoy did wonders for my cutaneous melanoma on my right leg September – November 2010.  My oncologist actually congratulated me but unfortunately, scan in November showed growth (about 2.6 in short axis diametre) in lymph node of left groin.  We were hoping in was just a lymph node responding to ipilimumab.  Alas, February showed huge increase in lymph node and sub-qs popping up on right leg but we still proceeded with another round of ipi.  Did two treatments..but infection in lymph node ended up in hospital..scan showed more growth (8.2 cm x 6.7 cm)..off trial in May.

      It's a hard call, I know many have had increases in size and then disappeared but for me didn't work.  I am now participating at TIL clinical trial at NIH.  I just had two masses in July removed in left groin and hopefully, they are now growing white cells in lab. Good luck…I'd agree, another scan in 6 weeks but do have a back-up plan ready.   Val

      ValinMtl
      Participant

      Yevoy did wonders for my cutaneous melanoma on my right leg September – November 2010.  My oncologist actually congratulated me but unfortunately, scan in November showed growth (about 2.6 in short axis diametre) in lymph node of left groin.  We were hoping in was just a lymph node responding to ipilimumab.  Alas, February showed huge increase in lymph node and sub-qs popping up on right leg but we still proceeded with another round of ipi.  Did two treatments..but infection in lymph node ended up in hospital..scan showed more growth (8.2 cm x 6.7 cm)..off trial in May.

      It's a hard call, I know many have had increases in size and then disappeared but for me didn't work.  I am now participating at TIL clinical trial at NIH.  I just had two masses in July removed in left groin and hopefully, they are now growing white cells in lab. Good luck…I'd agree, another scan in 6 weeks but do have a back-up plan ready.   Val

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