› Forums › General Melanoma Community › NRAS Positive and Molecular Targeted Therapy
- This topic has 18 replies, 5 voices, and was last updated 8 years, 10 months ago by
taylorpipes@gmail.com.
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- August 27, 2016 at 6:35 am
My significant other has Stage IV melanoma which moved from the original location (his back) to his stomach. The melanoma has only traveled to his stomach and has not metastisized to other areas. He has been on an Opdivo and Yervoy regimen since April (he has gone through 5 rounds). A PET scan was done a week ago which revealed there has been no improvement, so we need to look at other options for treatment. He is NRAS positive and the oncologist recommends putting him on molecular targeted therapy, specifically a combination of Binimetinib and Trametinib. This has been quite a week with this news, but we are trying to hang in there.
Has anyone who is NRAS positive gone through targeted therapy?
Thank you.
- Replies
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- August 27, 2016 at 9:58 am
My husband was diagnosed Stage IV in November 2013 lung. Using a lung nodule, they ran the specimen through Intermountain Precision Genomics and found he had NRAS mutation with the drug match, Mekinist, single agent. This held him for 9 months begore moving on to single agent Keytruda.I’ve heard of bini but no experience so maybe others will be able to share more targeted experiences with you.
Best wishes to both of you! Cathy
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- August 27, 2016 at 9:58 am
My husband was diagnosed Stage IV in November 2013 lung. Using a lung nodule, they ran the specimen through Intermountain Precision Genomics and found he had NRAS mutation with the drug match, Mekinist, single agent. This held him for 9 months begore moving on to single agent Keytruda.I’ve heard of bini but no experience so maybe others will be able to share more targeted experiences with you.
Best wishes to both of you! Cathy
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- August 27, 2016 at 9:58 am
My husband was diagnosed Stage IV in November 2013 lung. Using a lung nodule, they ran the specimen through Intermountain Precision Genomics and found he had NRAS mutation with the drug match, Mekinist, single agent. This held him for 9 months begore moving on to single agent Keytruda.I’ve heard of bini but no experience so maybe others will be able to share more targeted experiences with you.
Best wishes to both of you! Cathy
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- August 28, 2016 at 12:54 am
A tumor sample of mine tested positive for NRAS. It was the "G12A" NRAS mutation. I understand there are a few different ones considered to be significant. I have not gone through a targeted therapy. I almost got into a trial combining Mekinist with an anti-PD-L1 drug a couple of years ago but I ended up in a different trial instead.
Does lack of improvement mean the tumor(s) are stable — not shrinking but not growing ? Or has their growth been unaffected by the combo?
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- August 28, 2016 at 12:54 am
A tumor sample of mine tested positive for NRAS. It was the "G12A" NRAS mutation. I understand there are a few different ones considered to be significant. I have not gone through a targeted therapy. I almost got into a trial combining Mekinist with an anti-PD-L1 drug a couple of years ago but I ended up in a different trial instead.
Does lack of improvement mean the tumor(s) are stable — not shrinking but not growing ? Or has their growth been unaffected by the combo?
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- August 28, 2016 at 6:50 am
Thank you for your post, my understanding is that the tumor is growing. Having said that, his oncologist said that the Yervoy/Opdivo treatments may have had benefit because he was initially very anemic, experienced bleeding, and had to have blood transfusions and after taking the Yervoy/Opdivo regimen had thereafter not experienced bleeding and he was no longer anemic. However, I took him in a couple of weeks ago for a blood draw and he ended up losing consciousness at the doctor's office and having to be admitted to the hospital a couple of days and having another blood transfusion. So for several months between the transfusions, although the regimen was brutal and he lost a lot of weight, no blood loss/anemia.
Since my significant other has gone through the Yervoy/Opdivo treatments, we were told he will be a good candidate for the targeted therapy.
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- August 28, 2016 at 6:50 am
Thank you for your post, my understanding is that the tumor is growing. Having said that, his oncologist said that the Yervoy/Opdivo treatments may have had benefit because he was initially very anemic, experienced bleeding, and had to have blood transfusions and after taking the Yervoy/Opdivo regimen had thereafter not experienced bleeding and he was no longer anemic. However, I took him in a couple of weeks ago for a blood draw and he ended up losing consciousness at the doctor's office and having to be admitted to the hospital a couple of days and having another blood transfusion. So for several months between the transfusions, although the regimen was brutal and he lost a lot of weight, no blood loss/anemia.
Since my significant other has gone through the Yervoy/Opdivo treatments, we were told he will be a good candidate for the targeted therapy.
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- August 28, 2016 at 6:50 am
Thank you for your post, my understanding is that the tumor is growing. Having said that, his oncologist said that the Yervoy/Opdivo treatments may have had benefit because he was initially very anemic, experienced bleeding, and had to have blood transfusions and after taking the Yervoy/Opdivo regimen had thereafter not experienced bleeding and he was no longer anemic. However, I took him in a couple of weeks ago for a blood draw and he ended up losing consciousness at the doctor's office and having to be admitted to the hospital a couple of days and having another blood transfusion. So for several months between the transfusions, although the regimen was brutal and he lost a lot of weight, no blood loss/anemia.
Since my significant other has gone through the Yervoy/Opdivo treatments, we were told he will be a good candidate for the targeted therapy.
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- August 31, 2016 at 2:47 am
I hope there's a good treatment for your significan other to try next. I'm sorry he's dealing with so much. Clinical trials can take longer to enroll in than one would hope, but might be a good option to consider.
One clinical trial out there for NRAS combines MEK162 with LEE011. MEK162, also called bimentinib, is a MEK inhibitor, not yet approved, and maybe newer than Mekinist. LEE011 is a CDK4/6 inhibitor. Don't know what that means but apparently it had good enough results in a trial for another cancer type they stopped the trial early. I like the idea of a combo trial – I picked one – because it tries to hit from two completely different directions. I don't see anything else on the clinical trials web site but that was a quick look. There is a clinical trial finder service provided by the MRF you could try — they found trials I missed when I tried it.
https://clinicaltrials.gov/ct2/show/NCT01781572
https://www.melanoma.org/understand-melanoma/melanoma-treatment/find-a-clinical-trial
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- August 31, 2016 at 2:47 am
I hope there's a good treatment for your significan other to try next. I'm sorry he's dealing with so much. Clinical trials can take longer to enroll in than one would hope, but might be a good option to consider.
One clinical trial out there for NRAS combines MEK162 with LEE011. MEK162, also called bimentinib, is a MEK inhibitor, not yet approved, and maybe newer than Mekinist. LEE011 is a CDK4/6 inhibitor. Don't know what that means but apparently it had good enough results in a trial for another cancer type they stopped the trial early. I like the idea of a combo trial – I picked one – because it tries to hit from two completely different directions. I don't see anything else on the clinical trials web site but that was a quick look. There is a clinical trial finder service provided by the MRF you could try — they found trials I missed when I tried it.
https://clinicaltrials.gov/ct2/show/NCT01781572
https://www.melanoma.org/understand-melanoma/melanoma-treatment/find-a-clinical-trial
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- August 31, 2016 at 2:47 am
I hope there's a good treatment for your significan other to try next. I'm sorry he's dealing with so much. Clinical trials can take longer to enroll in than one would hope, but might be a good option to consider.
One clinical trial out there for NRAS combines MEK162 with LEE011. MEK162, also called bimentinib, is a MEK inhibitor, not yet approved, and maybe newer than Mekinist. LEE011 is a CDK4/6 inhibitor. Don't know what that means but apparently it had good enough results in a trial for another cancer type they stopped the trial early. I like the idea of a combo trial – I picked one – because it tries to hit from two completely different directions. I don't see anything else on the clinical trials web site but that was a quick look. There is a clinical trial finder service provided by the MRF you could try — they found trials I missed when I tried it.
https://clinicaltrials.gov/ct2/show/NCT01781572
https://www.melanoma.org/understand-melanoma/melanoma-treatment/find-a-clinical-trial
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- August 28, 2016 at 12:54 am
A tumor sample of mine tested positive for NRAS. It was the "G12A" NRAS mutation. I understand there are a few different ones considered to be significant. I have not gone through a targeted therapy. I almost got into a trial combining Mekinist with an anti-PD-L1 drug a couple of years ago but I ended up in a different trial instead.
Does lack of improvement mean the tumor(s) are stable — not shrinking but not growing ? Or has their growth been unaffected by the combo?
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- August 29, 2016 at 8:28 pm
Hi Sally and Dree,
I am NRAS positive but have (so far) had luck with the ipi/nivo combo. However, I attended the Immunotherapy in Melanoma symposium put on my MRF a couple of weeks ago. The researcher who presented, Dr. Eduardo Davila, stated that the newest hope in the melanoma world is combining immunotherapy with molecular therapy. Are there any combos out there? Trials?
Best of luck,
Ashley
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- August 29, 2016 at 8:28 pm
Hi Sally and Dree,
I am NRAS positive but have (so far) had luck with the ipi/nivo combo. However, I attended the Immunotherapy in Melanoma symposium put on my MRF a couple of weeks ago. The researcher who presented, Dr. Eduardo Davila, stated that the newest hope in the melanoma world is combining immunotherapy with molecular therapy. Are there any combos out there? Trials?
Best of luck,
Ashley
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- August 29, 2016 at 8:28 pm
Hi Sally and Dree,
I am NRAS positive but have (so far) had luck with the ipi/nivo combo. However, I attended the Immunotherapy in Melanoma symposium put on my MRF a couple of weeks ago. The researcher who presented, Dr. Eduardo Davila, stated that the newest hope in the melanoma world is combining immunotherapy with molecular therapy. Are there any combos out there? Trials?
Best of luck,
Ashley
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- February 1, 2017 at 8:45 pm
Hello Ashley,
My wife has stage iv and we just learned that she tested for the NRAS mutation. Previously, we were unsure and at the same time the combo of Ipi+Nivo was really working. She went from a high tumor burden to now having only two tumors and doing very well.
I was wondering how you were doing with your treatment and if you had any other learnings or information about the NRAS side of things?
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- February 1, 2017 at 8:45 pm
Hello Ashley,
My wife has stage iv and we just learned that she tested for the NRAS mutation. Previously, we were unsure and at the same time the combo of Ipi+Nivo was really working. She went from a high tumor burden to now having only two tumors and doing very well.
I was wondering how you were doing with your treatment and if you had any other learnings or information about the NRAS side of things?
-
- February 1, 2017 at 8:45 pm
Hello Ashley,
My wife has stage iv and we just learned that she tested for the NRAS mutation. Previously, we were unsure and at the same time the combo of Ipi+Nivo was really working. She went from a high tumor burden to now having only two tumors and doing very well.
I was wondering how you were doing with your treatment and if you had any other learnings or information about the NRAS side of things?
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Tagged: cutaneous melanoma
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