› Forums › General Melanoma Community › Opdivo vs Keytruda
- This topic has 36 replies, 9 voices, and was last updated 7 years, 7 months ago by
Francyn.
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- October 9, 2015 at 12:11 pm
HI
I just got back from my appointment and what t thought was a Stage III B prognosis turns out is Stage IV and the Doctor wants me to start either Keytruda or Opdivo, Which one do most people use and how bad are the side effects?
What have you found to be the success rate when you go back for further scans? The Doctor seems to feel that this is the best option for me and probably the only choice for right now. I guess once you are on this drug it is for life is what I have heard.
What is the best and easiest way to get these drugs administered that you have found, going in through an IV in you arm, a PICC line or a PORT? I am still trying to cope with this new information so I can move on and make the right choice.
I know that with this support group out there I will be able to cope and make it.
Thanks everyone.
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- October 9, 2015 at 12:55 pm
Others on here will have more information, but the FDA just approved Opdivo and Yervoy combination therapy as first line treatment for Stage 4, if you do not have the Braf mutation. Not sure if you've had that genetic testing to determine your Braf status. The usual course of action if you are Braf positive is treatment with Braf inhibitor drugs first, followed by Yervoy, if necessary, and then either Opdivo or Keytruda if necessary. The use of Opdivo or Keytruda as a single agent may not be the most effective regimen in your case, and also may not be approved by insurance, as the use of these drugs as a single agent as a first-line treatment for stage 4 has not been approved. Some have gotten approvals for single agent, first line use of Opdivo/Keytruda stage 4, but it would not be a given. The Opdivo/Yervoy combo therapy does have approval as first-line for Stage 4, Braf negative Melanoma as I mentioned above and has shown better results than single agent treatments
Above all, if you're not seeing a Melanoma specialist for your care already, I would strongly consider seeing one. They will be up on the latest treatments and better be able to make informed decisions on whether to switch treatments, start and stop treatments, how to manage side effects, etc.
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- October 9, 2015 at 12:55 pm
Others on here will have more information, but the FDA just approved Opdivo and Yervoy combination therapy as first line treatment for Stage 4, if you do not have the Braf mutation. Not sure if you've had that genetic testing to determine your Braf status. The usual course of action if you are Braf positive is treatment with Braf inhibitor drugs first, followed by Yervoy, if necessary, and then either Opdivo or Keytruda if necessary. The use of Opdivo or Keytruda as a single agent may not be the most effective regimen in your case, and also may not be approved by insurance, as the use of these drugs as a single agent as a first-line treatment for stage 4 has not been approved. Some have gotten approvals for single agent, first line use of Opdivo/Keytruda stage 4, but it would not be a given. The Opdivo/Yervoy combo therapy does have approval as first-line for Stage 4, Braf negative Melanoma as I mentioned above and has shown better results than single agent treatments
Above all, if you're not seeing a Melanoma specialist for your care already, I would strongly consider seeing one. They will be up on the latest treatments and better be able to make informed decisions on whether to switch treatments, start and stop treatments, how to manage side effects, etc.
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- October 9, 2015 at 12:55 pm
Others on here will have more information, but the FDA just approved Opdivo and Yervoy combination therapy as first line treatment for Stage 4, if you do not have the Braf mutation. Not sure if you've had that genetic testing to determine your Braf status. The usual course of action if you are Braf positive is treatment with Braf inhibitor drugs first, followed by Yervoy, if necessary, and then either Opdivo or Keytruda if necessary. The use of Opdivo or Keytruda as a single agent may not be the most effective regimen in your case, and also may not be approved by insurance, as the use of these drugs as a single agent as a first-line treatment for stage 4 has not been approved. Some have gotten approvals for single agent, first line use of Opdivo/Keytruda stage 4, but it would not be a given. The Opdivo/Yervoy combo therapy does have approval as first-line for Stage 4, Braf negative Melanoma as I mentioned above and has shown better results than single agent treatments
Above all, if you're not seeing a Melanoma specialist for your care already, I would strongly consider seeing one. They will be up on the latest treatments and better be able to make informed decisions on whether to switch treatments, start and stop treatments, how to manage side effects, etc.
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- October 9, 2015 at 12:59 pm
One note of clarification, I think you may be able to go from Opdivo/Keytruda from the Braf inhibitor drugs directly without using Yervoy in between, but I'm not sure. Hopefully somebody else can fill in this gap for me.
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- October 9, 2015 at 12:59 pm
One note of clarification, I think you may be able to go from Opdivo/Keytruda from the Braf inhibitor drugs directly without using Yervoy in between, but I'm not sure. Hopefully somebody else can fill in this gap for me.
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- October 9, 2015 at 12:59 pm
One note of clarification, I think you may be able to go from Opdivo/Keytruda from the Braf inhibitor drugs directly without using Yervoy in between, but I'm not sure. Hopefully somebody else can fill in this gap for me.
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- October 9, 2015 at 1:13 pm
How did you go from stage III to IV with only a SLND? I assume now you will not have the lymph node dissection. I am stage IIIB and I am on a trial that is either Yervoy or Opdivo (Very similar to Keytuda). I have had 2 treatments of Yervoy or 4 treatments of Opdivo. Only side effects I have had so far is itchy skin and some bloating.
I have been trying my best to just get an IV every week. Last week they prirked me 3 times. Two misses so I am going in to get q port on Wed. I do not think a PICC line is an option.
Yervoy is 4 treatments every 3 weeks. If you get that I would just do the IV. Opdivo is 26 treatments every 2 weeks.
Best of luck to you. I do hope you have insurance as the combo treatment will cost over $250,000 in drugs alone and about a year of infusions.
Tom
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- October 9, 2015 at 1:13 pm
How did you go from stage III to IV with only a SLND? I assume now you will not have the lymph node dissection. I am stage IIIB and I am on a trial that is either Yervoy or Opdivo (Very similar to Keytuda). I have had 2 treatments of Yervoy or 4 treatments of Opdivo. Only side effects I have had so far is itchy skin and some bloating.
I have been trying my best to just get an IV every week. Last week they prirked me 3 times. Two misses so I am going in to get q port on Wed. I do not think a PICC line is an option.
Yervoy is 4 treatments every 3 weeks. If you get that I would just do the IV. Opdivo is 26 treatments every 2 weeks.
Best of luck to you. I do hope you have insurance as the combo treatment will cost over $250,000 in drugs alone and about a year of infusions.
Tom
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- October 9, 2015 at 1:13 pm
How did you go from stage III to IV with only a SLND? I assume now you will not have the lymph node dissection. I am stage IIIB and I am on a trial that is either Yervoy or Opdivo (Very similar to Keytuda). I have had 2 treatments of Yervoy or 4 treatments of Opdivo. Only side effects I have had so far is itchy skin and some bloating.
I have been trying my best to just get an IV every week. Last week they prirked me 3 times. Two misses so I am going in to get q port on Wed. I do not think a PICC line is an option.
Yervoy is 4 treatments every 3 weeks. If you get that I would just do the IV. Opdivo is 26 treatments every 2 weeks.
Best of luck to you. I do hope you have insurance as the combo treatment will cost over $250,000 in drugs alone and about a year of infusions.
Tom
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- October 9, 2015 at 3:07 pm
From what I understand and my experience with both is the side affects are mild if any. Granted some people do have severe side affects. Since keytruda is every 3 weeks I would choose that over opdivo every 2 weeks so I don't get poked as often. Granted if you get a port then that would not be a big deal from what I hear. I was on keytruda a year then opdivo since last May. I haven't got a port yet. Was going to last winter but had severe choking issues and never got back to it.
Some people got Ned on just keytruda. I've not been that lucky but at least I get mixed results. Some stuff grows and some doesn't.
Artie
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- October 9, 2015 at 3:07 pm
From what I understand and my experience with both is the side affects are mild if any. Granted some people do have severe side affects. Since keytruda is every 3 weeks I would choose that over opdivo every 2 weeks so I don't get poked as often. Granted if you get a port then that would not be a big deal from what I hear. I was on keytruda a year then opdivo since last May. I haven't got a port yet. Was going to last winter but had severe choking issues and never got back to it.
Some people got Ned on just keytruda. I've not been that lucky but at least I get mixed results. Some stuff grows and some doesn't.
Artie
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- October 9, 2015 at 3:07 pm
From what I understand and my experience with both is the side affects are mild if any. Granted some people do have severe side affects. Since keytruda is every 3 weeks I would choose that over opdivo every 2 weeks so I don't get poked as often. Granted if you get a port then that would not be a big deal from what I hear. I was on keytruda a year then opdivo since last May. I haven't got a port yet. Was going to last winter but had severe choking issues and never got back to it.
Some people got Ned on just keytruda. I've not been that lucky but at least I get mixed results. Some stuff grows and some doesn't.
Artie
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- October 9, 2015 at 7:10 pm
Get a port!
My husband's doc is an Opdivo guy. He had some reason about amount of supporting research but as best I can figure Ketruda and Opdivo are about the same. IIRC his belief was that Opdivo had been looking at it long enough that they had better data on all the dosage recommendations. Not sure that is true, frankly I am not even sure I am remember it correctly because in that meeting we were talking about all sorts of things.
We went with just the Opdivo and if anything pops then we might start the yervoy.
My husband is stage IV NED and so far, first scans after the surgery (3months) he is still NED. The big side effects are itching and fatigue.
Kathy
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- October 9, 2015 at 7:10 pm
Get a port!
My husband's doc is an Opdivo guy. He had some reason about amount of supporting research but as best I can figure Ketruda and Opdivo are about the same. IIRC his belief was that Opdivo had been looking at it long enough that they had better data on all the dosage recommendations. Not sure that is true, frankly I am not even sure I am remember it correctly because in that meeting we were talking about all sorts of things.
We went with just the Opdivo and if anything pops then we might start the yervoy.
My husband is stage IV NED and so far, first scans after the surgery (3months) he is still NED. The big side effects are itching and fatigue.
Kathy
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- October 9, 2015 at 7:10 pm
Get a port!
My husband's doc is an Opdivo guy. He had some reason about amount of supporting research but as best I can figure Ketruda and Opdivo are about the same. IIRC his belief was that Opdivo had been looking at it long enough that they had better data on all the dosage recommendations. Not sure that is true, frankly I am not even sure I am remember it correctly because in that meeting we were talking about all sorts of things.
We went with just the Opdivo and if anything pops then we might start the yervoy.
My husband is stage IV NED and so far, first scans after the surgery (3months) he is still NED. The big side effects are itching and fatigue.
Kathy
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- October 10, 2015 at 9:11 pm
Daisy,
Statistically there's not much of a difference between opdivo and keytruda. Keytruda seems to have a slight edge but very slight. There's been no head to head comparison so I wouldn't put a whole lot of emphasis on the slight edge keytruda seems to have so far. As has been stated one nice thing about keytruda is it's once every three weeks instead of every two weeks for opdivo.
Treatment is definitely not for life. Most trials for the two drugs were designed for 2 years but many experts think that's overkill.
I'd recommend a port but I don't think I'd get it right away. Some people have severe side effects right off the bat and don't stay on the drug very long. Many of those people have amazing results. What I'm getting at is I wouldn't want to get a port installed for only two months of treatment. I'd go for a couple months and if things look good then go for the port. I have one and would definitely recommend it.
Brian
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- October 10, 2015 at 9:11 pm
Daisy,
Statistically there's not much of a difference between opdivo and keytruda. Keytruda seems to have a slight edge but very slight. There's been no head to head comparison so I wouldn't put a whole lot of emphasis on the slight edge keytruda seems to have so far. As has been stated one nice thing about keytruda is it's once every three weeks instead of every two weeks for opdivo.
Treatment is definitely not for life. Most trials for the two drugs were designed for 2 years but many experts think that's overkill.
I'd recommend a port but I don't think I'd get it right away. Some people have severe side effects right off the bat and don't stay on the drug very long. Many of those people have amazing results. What I'm getting at is I wouldn't want to get a port installed for only two months of treatment. I'd go for a couple months and if things look good then go for the port. I have one and would definitely recommend it.
Brian
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- October 10, 2015 at 9:11 pm
Daisy,
Statistically there's not much of a difference between opdivo and keytruda. Keytruda seems to have a slight edge but very slight. There's been no head to head comparison so I wouldn't put a whole lot of emphasis on the slight edge keytruda seems to have so far. As has been stated one nice thing about keytruda is it's once every three weeks instead of every two weeks for opdivo.
Treatment is definitely not for life. Most trials for the two drugs were designed for 2 years but many experts think that's overkill.
I'd recommend a port but I don't think I'd get it right away. Some people have severe side effects right off the bat and don't stay on the drug very long. Many of those people have amazing results. What I'm getting at is I wouldn't want to get a port installed for only two months of treatment. I'd go for a couple months and if things look good then go for the port. I have one and would definitely recommend it.
Brian
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- October 29, 2015 at 6:18 am
Hi Daisy, I'm Stage 3B and currently on Opdivo. The only side effect I've had was diarrhea which was severe at first but immodium every 24 hours completely takes care of that problem. I've had 10 rounds so far and just had my first progress scans this week, 50% skrinage or more in all my tumors. I'm very excited! According to my melanoma specialist he wanted to try this first and see if it worked before advacing to Keytruda or one of the other combination therapies. At this point in time so many treatments are becoming available and they are mixing and matching to do combos I dont think it matters unless you have BRAF positive (I am not). My doctor feels like once one thing stops working we will try the next whether that be Keytruda, Yervoy, or some combination of them. If you trust your doctor I would go with his first suggestion as long as he feels comfortable using the next as a "back up". Personally I like knowing my doctor has a Plan B in his pocket just in case. For reference, I am unknown primary, first spot was in my parotid gland, had that removed along with a neck dissection of all lymph nodes which came back clean. Did 25 rounds of radiation (which SUCKED!) for insurance and thought i was clean. 6 months later I woke up this April not being bale to move the right side of my face, doctors thought it was Bells Palsy but a CT scan revelaed the melanoma moved to my brain and began to bleed. I had a successful crainiotomy and then 2 months later during a routine colonoscopy they thought they perforted my bowel but instead accidently found a tumor. I had 20 and 30 cm of my small and large instentines removed and all came back positive for melanoma. I immediately began Opdivo and so far we are doing good! Let us know how you are doing and what treatment you began, I am curious to see how you are progressing! Wishing you all the best!
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- October 29, 2015 at 6:18 am
Hi Daisy, I'm Stage 3B and currently on Opdivo. The only side effect I've had was diarrhea which was severe at first but immodium every 24 hours completely takes care of that problem. I've had 10 rounds so far and just had my first progress scans this week, 50% skrinage or more in all my tumors. I'm very excited! According to my melanoma specialist he wanted to try this first and see if it worked before advacing to Keytruda or one of the other combination therapies. At this point in time so many treatments are becoming available and they are mixing and matching to do combos I dont think it matters unless you have BRAF positive (I am not). My doctor feels like once one thing stops working we will try the next whether that be Keytruda, Yervoy, or some combination of them. If you trust your doctor I would go with his first suggestion as long as he feels comfortable using the next as a "back up". Personally I like knowing my doctor has a Plan B in his pocket just in case. For reference, I am unknown primary, first spot was in my parotid gland, had that removed along with a neck dissection of all lymph nodes which came back clean. Did 25 rounds of radiation (which SUCKED!) for insurance and thought i was clean. 6 months later I woke up this April not being bale to move the right side of my face, doctors thought it was Bells Palsy but a CT scan revelaed the melanoma moved to my brain and began to bleed. I had a successful crainiotomy and then 2 months later during a routine colonoscopy they thought they perforted my bowel but instead accidently found a tumor. I had 20 and 30 cm of my small and large instentines removed and all came back positive for melanoma. I immediately began Opdivo and so far we are doing good! Let us know how you are doing and what treatment you began, I am curious to see how you are progressing! Wishing you all the best!
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- October 3, 2016 at 3:27 am
Stage IV diagnosed 5/20/16. Had 2 doses of Yervoy 3 weeks apart, then 1 dose of Opdivo (3 weeks), then both 3 weeks later. My body did not like it. I went into a toxic state and week later was hospitalized. Got steroids to bring me back. CT showed no change in original abdominal lymph node tumors and new lymph node tumors in chest cavity around aorta. Everything still in lymph nodes. Have had two chemo treatments with TaxiL and Carboplatin. Still trying to get approval or donation of Avastin from Genetec. One more chemo next week, then CT around Halloween. Onc will decide then for more chemo or Keytruda. My concern is will my body react the same way to Keytruda as it did with Opdivo? Are they essentially the same drug or are they different? I also developed immune deficiency so I usually need two bags of red blood a week. Tough battle but I am a tough warrior.
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- October 4, 2016 at 1:06 am
Sorry Francyn for your tough road.
Every Oncologist I talk to consider Keytruda and Opdivo equivalent. Having said that there was a poster on here who recently posted he did not respond to opdivo and his doctor gave Keytruda a try and the poster had a good response. That same poster said the doctor told him he'd tried that with 3 other patients and 2 of the 3 reponded to Keytruda after not having a response to opdivo. It might be worth a try.
Have you heard of this trial?
https://clinicaltrials.gov/ct2/show/NCT02465060?term=nci+match&rank=1
It's a trial where they test the genetics of your tumor and then prescribe a drug accordingly. You could get a drug that is used for other cancers such as breast or kidney. It has over a thousand locations so there might be one near you. Might be something to consider down the road.
Brian
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- October 5, 2016 at 4:35 pm
Thanks for the info on the trial. It had not begun when I was first diagnosed. I made contact and have instructions on what to do and when. I need to wait for next CT and see how chemo has reacted. Will talk to my current oncologist about trial and keep it in mind if other treatments fail. It is nice to have one more possible option. I would need to go to a different oncologist and health system, but I don't think that is unusual. It is nice to have another option and help. Thank you to a different oncologist and health system, but I don't think that is unusual. It is nice to have another option and hope.
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- October 5, 2016 at 4:35 pm
Thanks for the info on the trial. It had not begun when I was first diagnosed. I made contact and have instructions on what to do and when. I need to wait for next CT and see how chemo has reacted. Will talk to my current oncologist about trial and keep it in mind if other treatments fail. It is nice to have one more possible option. I would need to go to a different oncologist and health system, but I don't think that is unusual. It is nice to have another option and help. Thank you to a different oncologist and health system, but I don't think that is unusual. It is nice to have another option and hope.
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- October 5, 2016 at 4:35 pm
Thanks for the info on the trial. It had not begun when I was first diagnosed. I made contact and have instructions on what to do and when. I need to wait for next CT and see how chemo has reacted. Will talk to my current oncologist about trial and keep it in mind if other treatments fail. It is nice to have one more possible option. I would need to go to a different oncologist and health system, but I don't think that is unusual. It is nice to have another option and help. Thank you to a different oncologist and health system, but I don't think that is unusual. It is nice to have another option and hope.
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- October 4, 2016 at 1:06 am
Sorry Francyn for your tough road.
Every Oncologist I talk to consider Keytruda and Opdivo equivalent. Having said that there was a poster on here who recently posted he did not respond to opdivo and his doctor gave Keytruda a try and the poster had a good response. That same poster said the doctor told him he'd tried that with 3 other patients and 2 of the 3 reponded to Keytruda after not having a response to opdivo. It might be worth a try.
Have you heard of this trial?
https://clinicaltrials.gov/ct2/show/NCT02465060?term=nci+match&rank=1
It's a trial where they test the genetics of your tumor and then prescribe a drug accordingly. You could get a drug that is used for other cancers such as breast or kidney. It has over a thousand locations so there might be one near you. Might be something to consider down the road.
Brian
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- October 4, 2016 at 1:06 am
Sorry Francyn for your tough road.
Every Oncologist I talk to consider Keytruda and Opdivo equivalent. Having said that there was a poster on here who recently posted he did not respond to opdivo and his doctor gave Keytruda a try and the poster had a good response. That same poster said the doctor told him he'd tried that with 3 other patients and 2 of the 3 reponded to Keytruda after not having a response to opdivo. It might be worth a try.
Have you heard of this trial?
https://clinicaltrials.gov/ct2/show/NCT02465060?term=nci+match&rank=1
It's a trial where they test the genetics of your tumor and then prescribe a drug accordingly. You could get a drug that is used for other cancers such as breast or kidney. It has over a thousand locations so there might be one near you. Might be something to consider down the road.
Brian
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- October 3, 2016 at 3:27 am
Stage IV diagnosed 5/20/16. Had 2 doses of Yervoy 3 weeks apart, then 1 dose of Opdivo (3 weeks), then both 3 weeks later. My body did not like it. I went into a toxic state and week later was hospitalized. Got steroids to bring me back. CT showed no change in original abdominal lymph node tumors and new lymph node tumors in chest cavity around aorta. Everything still in lymph nodes. Have had two chemo treatments with TaxiL and Carboplatin. Still trying to get approval or donation of Avastin from Genetec. One more chemo next week, then CT around Halloween. Onc will decide then for more chemo or Keytruda. My concern is will my body react the same way to Keytruda as it did with Opdivo? Are they essentially the same drug or are they different? I also developed immune deficiency so I usually need two bags of red blood a week. Tough battle but I am a tough warrior.
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- October 3, 2016 at 3:27 am
Stage IV diagnosed 5/20/16. Had 2 doses of Yervoy 3 weeks apart, then 1 dose of Opdivo (3 weeks), then both 3 weeks later. My body did not like it. I went into a toxic state and week later was hospitalized. Got steroids to bring me back. CT showed no change in original abdominal lymph node tumors and new lymph node tumors in chest cavity around aorta. Everything still in lymph nodes. Have had two chemo treatments with TaxiL and Carboplatin. Still trying to get approval or donation of Avastin from Genetec. One more chemo next week, then CT around Halloween. Onc will decide then for more chemo or Keytruda. My concern is will my body react the same way to Keytruda as it did with Opdivo? Are they essentially the same drug or are they different? I also developed immune deficiency so I usually need two bags of red blood a week. Tough battle but I am a tough warrior.
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- October 29, 2015 at 6:18 am
Hi Daisy, I'm Stage 3B and currently on Opdivo. The only side effect I've had was diarrhea which was severe at first but immodium every 24 hours completely takes care of that problem. I've had 10 rounds so far and just had my first progress scans this week, 50% skrinage or more in all my tumors. I'm very excited! According to my melanoma specialist he wanted to try this first and see if it worked before advacing to Keytruda or one of the other combination therapies. At this point in time so many treatments are becoming available and they are mixing and matching to do combos I dont think it matters unless you have BRAF positive (I am not). My doctor feels like once one thing stops working we will try the next whether that be Keytruda, Yervoy, or some combination of them. If you trust your doctor I would go with his first suggestion as long as he feels comfortable using the next as a "back up". Personally I like knowing my doctor has a Plan B in his pocket just in case. For reference, I am unknown primary, first spot was in my parotid gland, had that removed along with a neck dissection of all lymph nodes which came back clean. Did 25 rounds of radiation (which SUCKED!) for insurance and thought i was clean. 6 months later I woke up this April not being bale to move the right side of my face, doctors thought it was Bells Palsy but a CT scan revelaed the melanoma moved to my brain and began to bleed. I had a successful crainiotomy and then 2 months later during a routine colonoscopy they thought they perforted my bowel but instead accidently found a tumor. I had 20 and 30 cm of my small and large instentines removed and all came back positive for melanoma. I immediately began Opdivo and so far we are doing good! Let us know how you are doing and what treatment you began, I am curious to see how you are progressing! Wishing you all the best!
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