My Stage 3B – is it too late for immunotherapy now?

January 2014 was told Stage 2, had WLE and 2 SLN biopsy with 1 having a couple tiny possible mel cells. No further treatment recommend/available. 3 month skin exams first few years, then every 6 months. No scans.
Then Dec 2018 had MRI for Crohn’s Disease that picked up tumor lower right flank (same area as original melanoma). This tumor was supposedly a pillar cyst per dermatologist I saw when I first noticed the lump back in August 2018. Biopsy January 2019 showed deposits of melanoma. This was an In-Transit Melanoma, sometimes referred to or similar in prognosis as Satellite melanoma. Had PET scan which was clean and WLE surgery February 22. This time I was at Stage 3B. And I was also told my original Melanoma in January 2014 was actually Stage 3 and not Stage 2 after current docs looked at old path reports and actual old path slides. Tested and I was BRAF positive and eligible for Taflinar & Mekinist combo as adjuvant OR could opt for immunotherapy. However, with my Crohn’s history the local oncologist at Blue Ridge Cancer Care preferred Targeted Therapy for the BRAF in lieu of Keytruda Immunotherapy due to my auto-immune Crohn’s and less chance of Taf/Mek causing problem with Crohn’s. over immunotherapy. I also saw specialist Dr. Salamas at Duke for 2nd opinion and she wouldn’t do either adjuvant treatment and preferred wait and watch approach because of possible side effects of either treatment with my Crohn’s. I went back to local oncologist and ended up starting BRAF inhibitors Taf/Mek combo late April 2019 and within about 10 days or so started having fever and chills that kept rising over course of a few days with OTC not helping and extreme shaking. Ended up in hospital for a week (ICU first 3 days) with all sorts of serious side affects of increasing fever to 105, severe dehydration, liver levels through the roof, very low blood pressure, intestinal inflammation including exacerbation of Crohn’s, etc. Docs ended up scheduling Crohn’s surgery a week after I was released from hospital as a result of the Taf/Mek side affects. (removed about 8 or 9 inches small intestine). That surgery was June 3. Was going to end up needing Crohn’s surgery in a year or so, but medication pushed that plan ahead. Oncologist wanted to try the immunotherapy next, once I recovered from Crohn’s surgery. However, time was ticking due to having to stop the Taf/Mek after 2 1/2 weeks or sick sick at home for a week, then in hospital for a week, then at home recovering for another week before being back in hospital for yet another week for Crohn’s surgery, to then at home recovering for 4 weeks and could be on no adjuvant therapy. Surgeon said I needed at least 4 weeks after surgery before starting immunotherapy to allow enough healing. Fast forward to first week in July (5 weeks out from surgery) I saw my oncologist and now to the question:

The BIG question is whether adjuvant immunotherapy will have any benefit at all since were are 5 months out since surgery to remove the melanoma? All trials and studies on Stage 3 adjuvant therapy immunotherapy was within 12 weeks of surgical re-section. Doc suggests it likely won’t have any benefit based on that. But wants me to be comfortable in decision. This is where I am at – Do I try immunotherapy and hope no serious side affects and further hope there may be benefit (of which no one can say it has even a chance this far out from surgery). OR do I wait, do periodic scans and pray? Doc is trying to get insurance to approve another PET scan since it has been about 3 to 4 months since last one and – I’m sure they will deny. Worse case then get a CT to make sure things still look NED. And when get those results decide whether to “try” immunotherapy at 5 to 6 months out from my surgery date. I’m worried I’ll waste time and have bad side effects on immunotherapy for no potential benefit. But I’m also worried to not do anything And worried if it comes back a 3rd time, I won’t be so lucky at it will come back at the next Stage. I’m going to have to make a decision in the next week . And is there any possibility that the TAF/MEK combo I was taking for 2.5 to 3 weeks could have done anything?