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out of options

Forums General Melanoma Community out of options

  • Post
    ecc26
    Participant

      got back from the oncologist this morning and he confirmed my suspicions that the Ipi/pd-1 combo is not working. now what? there was talk about chemo and hospice and we set another apt for Wed so I could have time to make a decision. I've just finished looking the cliicaltrials.gov listiing and don't see anything for me.

      I need help and any suggestions are welcome

      -Eva

    Viewing 29 reply threads
    • Replies
        BrianP
        Participant

          Eva,

          I'm sorry.  Can you remind me of your location?

          BrianP
          Participant

            Eva,

            I'm sorry.  Can you remind me of your location?

            BrianP
            Participant

              Eva,

              I'm sorry.  Can you remind me of your location?

              Mli0709
              Participant

                have you tried getting second opinion? Are you being followed by a specialist?

                Mli0709
                Participant

                  have you tried getting second opinion? Are you being followed by a specialist?

                  Mli0709
                  Participant

                    have you tried getting second opinion? Are you being followed by a specialist?

                    Casitas1
                    Participant

                      Eva, I had failed both ipi/nivo. But responded to Keytruda and now NED. Maybe worth mentioning to yor doc?

                      Good luck, Paul

                        Casitas1
                        Participant

                          Hi Eva, I forgot to mention that after I failed ipi/nivo I did low dose Carbo/Cisplatin. This may have had a synergistic effect with the Keytruda.

                          Best, Paul

                          Casitas1
                          Participant

                            Hi Eva, I forgot to mention that after I failed ipi/nivo I did low dose Carbo/Cisplatin. This may have had a synergistic effect with the Keytruda.

                            Best, Paul

                            Casitas1
                            Participant

                              Hi Eva, I forgot to mention that after I failed ipi/nivo I did low dose Carbo/Cisplatin. This may have had a synergistic effect with the Keytruda.

                              Best, Paul

                              Mli0709
                              Participant

                                Hi Paul, can you share more about your experience? I'm just very curious to know. My mom had stage 3c mucosal melanoma on her vulva so surgery was not an option. She was started on ipi/nevo but had to d/c due to severe rash (she has psoriasis) so they dropped the ipi kept her on nevo. Tumor kept growing so they gave her 6 weeks radiation to shrink the tumor down for the pain (she was on heavy opiods and could barely sit down)….the tumor shrunk completely but later scans showed mats to her lungs and back. They stopped nevo (she got 6 treatments) because she said she failed on it and then recommended chemo. She got 2 cycles of chemo (dacarbazine/cisplastin/vinblastine) but could not tolorate weakness and tumors didn't shrink in follow up scan. I'm just interested to know why they didn't consider keytruda as an option for her. I'm not too familiar with the drug. Is it in the same class as nevo? do you know what the differences are? They told my mom that she ran out of options as well at this point but we are seeking second opinion.

                                 

                                Thanks,

                                Maria

                                Mli0709
                                Participant

                                  Hi Paul, can you share more about your experience? I'm just very curious to know. My mom had stage 3c mucosal melanoma on her vulva so surgery was not an option. She was started on ipi/nevo but had to d/c due to severe rash (she has psoriasis) so they dropped the ipi kept her on nevo. Tumor kept growing so they gave her 6 weeks radiation to shrink the tumor down for the pain (she was on heavy opiods and could barely sit down)….the tumor shrunk completely but later scans showed mats to her lungs and back. They stopped nevo (she got 6 treatments) because she said she failed on it and then recommended chemo. She got 2 cycles of chemo (dacarbazine/cisplastin/vinblastine) but could not tolorate weakness and tumors didn't shrink in follow up scan. I'm just interested to know why they didn't consider keytruda as an option for her. I'm not too familiar with the drug. Is it in the same class as nevo? do you know what the differences are? They told my mom that she ran out of options as well at this point but we are seeking second opinion.

                                   

                                  Thanks,

                                  Maria

                                  Mli0709
                                  Participant

                                    Hi Paul, can you share more about your experience? I'm just very curious to know. My mom had stage 3c mucosal melanoma on her vulva so surgery was not an option. She was started on ipi/nevo but had to d/c due to severe rash (she has psoriasis) so they dropped the ipi kept her on nevo. Tumor kept growing so they gave her 6 weeks radiation to shrink the tumor down for the pain (she was on heavy opiods and could barely sit down)….the tumor shrunk completely but later scans showed mats to her lungs and back. They stopped nevo (she got 6 treatments) because she said she failed on it and then recommended chemo. She got 2 cycles of chemo (dacarbazine/cisplastin/vinblastine) but could not tolorate weakness and tumors didn't shrink in follow up scan. I'm just interested to know why they didn't consider keytruda as an option for her. I'm not too familiar with the drug. Is it in the same class as nevo? do you know what the differences are? They told my mom that she ran out of options as well at this point but we are seeking second opinion.

                                     

                                    Thanks,

                                    Maria

                                    Casitas1
                                    Participant

                                      Hi Maria, As far as the differences between Nivo and Keytruda go they are basically the same both are pd-1. Different manufacturers one Merk and the other Bristol Meyers. My doctor told me they are made with different proteins though. From your post it sounds as if your mom had complete response to one tumor with Radiation and Nivo? I had to go thru 3 different opinions before i found my current doctor a Melanoma specialist. Please ask me any questions or check my bio for all my treatments to date.

                                      Best of luck to your Mom, Paul

                                      Casitas1
                                      Participant

                                        Hi Maria, As far as the differences between Nivo and Keytruda go they are basically the same both are pd-1. Different manufacturers one Merk and the other Bristol Meyers. My doctor told me they are made with different proteins though. From your post it sounds as if your mom had complete response to one tumor with Radiation and Nivo? I had to go thru 3 different opinions before i found my current doctor a Melanoma specialist. Please ask me any questions or check my bio for all my treatments to date.

                                        Best of luck to your Mom, Paul

                                        Casitas1
                                        Participant

                                          Hi Maria, As far as the differences between Nivo and Keytruda go they are basically the same both are pd-1. Different manufacturers one Merk and the other Bristol Meyers. My doctor told me they are made with different proteins though. From your post it sounds as if your mom had complete response to one tumor with Radiation and Nivo? I had to go thru 3 different opinions before i found my current doctor a Melanoma specialist. Please ask me any questions or check my bio for all my treatments to date.

                                          Best of luck to your Mom, Paul

                                          Mikers
                                          Participant

                                            Hi, Paul, could you please describe the dosage of carboplatin and paxlitaxel?

                                            Thank you!

                                            Mikers
                                            Participant

                                              Hi, Paul, could you please describe the dosage of carboplatin and paxlitaxel?

                                              Thank you!

                                              Mikers
                                              Participant

                                                Hi, Paul, could you please describe the dosage of carboplatin and paxlitaxel?

                                                Thank you!

                                                Casitas1
                                                Participant

                                                  Mikers, not sure of the dosage but it was considered low dose with out all the nasty side effects. I did have hair loss and an occasional bloody nose and that was it. Tumor grew during treatment but became necrotic in center.
                                                  |
                                                  Best, Paul

                                                  Casitas1
                                                  Participant

                                                    Mikers, not sure of the dosage but it was considered low dose with out all the nasty side effects. I did have hair loss and an occasional bloody nose and that was it. Tumor grew during treatment but became necrotic in center.
                                                    |
                                                    Best, Paul

                                                    Mikers
                                                    Participant

                                                      Thank you, Paul!

                                                      Could yuo also mention approximately timing between pembro and chemo and previous immuno therapy?

                                                      Mikers
                                                      Participant

                                                        Thank you, Paul!

                                                        Could yuo also mention approximately timing between pembro and chemo and previous immuno therapy?

                                                        Casitas1
                                                        Participant

                                                          Hi Mike, I started combo in July 2015 and discontinued in Aug.(two infusions) Started Low dose chemo in Dec. 4 doses Had a scan Jan. 2016 that showed bone met and lymph node tumor gone. However soft tissue tumor in cheek had grown by a third. Started Keytruda Jan. 11th 2016 and have done 11 bags and NED after 10.

                                                          Hoping this helps, Paul

                                                           

                                                          Casitas1
                                                          Participant

                                                            Hi Mike, I started combo in July 2015 and discontinued in Aug.(two infusions) Started Low dose chemo in Dec. 4 doses Had a scan Jan. 2016 that showed bone met and lymph node tumor gone. However soft tissue tumor in cheek had grown by a third. Started Keytruda Jan. 11th 2016 and have done 11 bags and NED after 10.

                                                            Hoping this helps, Paul

                                                             

                                                            Casitas1
                                                            Participant

                                                              Hi Mike, I started combo in July 2015 and discontinued in Aug.(two infusions) Started Low dose chemo in Dec. 4 doses Had a scan Jan. 2016 that showed bone met and lymph node tumor gone. However soft tissue tumor in cheek had grown by a third. Started Keytruda Jan. 11th 2016 and have done 11 bags and NED after 10.

                                                              Hoping this helps, Paul

                                                               

                                                              Mikers
                                                              Participant

                                                                Thank you, Paul!

                                                                Could yuo also mention approximately timing between pembro and chemo and previous immuno therapy?

                                                                Casitas1
                                                                Participant

                                                                  Mikers, not sure of the dosage but it was considered low dose with out all the nasty side effects. I did have hair loss and an occasional bloody nose and that was it. Tumor grew during treatment but became necrotic in center.
                                                                  |
                                                                  Best, Paul

                                                                  ecc26
                                                                  Participant

                                                                    already faied that one, too

                                                                    ecc26
                                                                    Participant

                                                                      already faied that one, too

                                                                      ecc26
                                                                      Participant

                                                                        already faied that one, too

                                                                      Casitas1
                                                                      Participant

                                                                        Eva, I had failed both ipi/nivo. But responded to Keytruda and now NED. Maybe worth mentioning to yor doc?

                                                                        Good luck, Paul

                                                                        Casitas1
                                                                        Participant

                                                                          Eva, I had failed both ipi/nivo. But responded to Keytruda and now NED. Maybe worth mentioning to yor doc?

                                                                          Good luck, Paul

                                                                          keepthefaith11
                                                                          Participant
                                                                            Eva, please don’t give up! The mention of hospice made me tear up. I have been reading your previous posts all the way back to 2014. Seems you did respond to BRAF/MEK, if only for a few months. I am by no means an expert in this but it seems people can go back on those inhibitors and respond again. This would buy you some time to look for other options. I heard one doctor on OncLive talk about using the inhibitors in this fashion.

                                                                            Praying for you.

                                                                            Annie

                                                                            keepthefaith11
                                                                            Participant
                                                                              Eva, please don’t give up! The mention of hospice made me tear up. I have been reading your previous posts all the way back to 2014. Seems you did respond to BRAF/MEK, if only for a few months. I am by no means an expert in this but it seems people can go back on those inhibitors and respond again. This would buy you some time to look for other options. I heard one doctor on OncLive talk about using the inhibitors in this fashion.

                                                                              Praying for you.

                                                                              Annie

                                                                              keepthefaith11
                                                                              Participant
                                                                                Eva, please don’t give up! The mention of hospice made me tear up. I have been reading your previous posts all the way back to 2014. Seems you did respond to BRAF/MEK, if only for a few months. I am by no means an expert in this but it seems people can go back on those inhibitors and respond again. This would buy you some time to look for other options. I heard one doctor on OncLive talk about using the inhibitors in this fashion.

                                                                                Praying for you.

                                                                                Annie

                                                                                JoshF
                                                                                Participant

                                                                                  Keep looking Eva…please. Use the resources here; there may be options out there. I know it's tough, kick back!!! Let's find something…tell me how I can help!

                                                                                  JoshF
                                                                                  Participant

                                                                                    Keep looking Eva…please. Use the resources here; there may be options out there. I know it's tough, kick back!!! Let's find something…tell me how I can help!

                                                                                    JoshF
                                                                                    Participant

                                                                                      Keep looking Eva…please. Use the resources here; there may be options out there. I know it's tough, kick back!!! Let's find something…tell me how I can help!

                                                                                      kylez
                                                                                      Participant

                                                                                        The clinical trial finder service here at MRF is actually surprisingly good at finding trials, including obscure ones. At least it was a few years ago when I tried it. They found stuff I'd never heard of, in a very narrow situation where I thought I qualified for nothing. It takes a little while to fill in the info. I think it's RN's who do the search, and I'm guessing they may have better tools at their disposal than searching clinicaltrials.gov as it is.

                                                                                        https://www.melanoma.org/understand-melanoma/melanoma-treatment/find-a-clinical-trial

                                                                                        I hate that feeling, "no options". I hope you get to a good next step in your plan. -Kyle

                                                                                         

                                                                                        kylez
                                                                                        Participant

                                                                                          The clinical trial finder service here at MRF is actually surprisingly good at finding trials, including obscure ones. At least it was a few years ago when I tried it. They found stuff I'd never heard of, in a very narrow situation where I thought I qualified for nothing. It takes a little while to fill in the info. I think it's RN's who do the search, and I'm guessing they may have better tools at their disposal than searching clinicaltrials.gov as it is.

                                                                                          https://www.melanoma.org/understand-melanoma/melanoma-treatment/find-a-clinical-trial

                                                                                          I hate that feeling, "no options". I hope you get to a good next step in your plan. -Kyle

                                                                                           

                                                                                          kylez
                                                                                          Participant

                                                                                            The clinical trial finder service here at MRF is actually surprisingly good at finding trials, including obscure ones. At least it was a few years ago when I tried it. They found stuff I'd never heard of, in a very narrow situation where I thought I qualified for nothing. It takes a little while to fill in the info. I think it's RN's who do the search, and I'm guessing they may have better tools at their disposal than searching clinicaltrials.gov as it is.

                                                                                            https://www.melanoma.org/understand-melanoma/melanoma-treatment/find-a-clinical-trial

                                                                                            I hate that feeling, "no options". I hope you get to a good next step in your plan. -Kyle

                                                                                             

                                                                                            eric w
                                                                                            Participant

                                                                                              There is lag-3, ido, cdk4/6, Tim-3, and pdl-1 trials out there.

                                                                                              eric w
                                                                                              Participant

                                                                                                There is lag-3, ido, cdk4/6, Tim-3, and pdl-1 trials out there.

                                                                                                eric w
                                                                                                Participant

                                                                                                  There is lag-3, ido, cdk4/6, Tim-3, and pdl-1 trials out there.

                                                                                                  kylez
                                                                                                  Participant

                                                                                                    Eva,

                                                                                                    If you're off the combo, has your cluster of issues eased off any? The severe back pain, constipation and stomach pain that put you in the hospital and stopped you from eating? 

                                                                                                    If you've stopped treatment and they've eased off, I guess you might be leery of another immunotherapy. Do you know if it was the IPI, the PD1 or the combo that was giving you those symptoms? 

                                                                                                    The thing I liked about the clincal trial finder service here is that the woman I talked to on the other end of the line knew medical terminology and exclusion criteria in part because she was a nurse IIRC. I also believe the service is paid for in part by the pharma companies. That would motivate them to provide a good matching service because they're trying to fill trials. It seemed like they filtered out things that sounded good but I couldn't have done for one reason or another. I think everything they gave me looked like I would probably qualify.

                                                                                                    Trying to figure out which of the trials is promising is not something I know. Something that sounds innocuous might turn out to be the next blockbuster. Something that sounds great might fizzle. Something tha might fizzle for everyone else might work great for you.  

                                                                                                    I hope you are getting some relief now. I hope you turn up some possiblities for your next step.

                                                                                                    kylez
                                                                                                    Participant

                                                                                                      Eva,

                                                                                                      If you're off the combo, has your cluster of issues eased off any? The severe back pain, constipation and stomach pain that put you in the hospital and stopped you from eating? 

                                                                                                      If you've stopped treatment and they've eased off, I guess you might be leery of another immunotherapy. Do you know if it was the IPI, the PD1 or the combo that was giving you those symptoms? 

                                                                                                      The thing I liked about the clincal trial finder service here is that the woman I talked to on the other end of the line knew medical terminology and exclusion criteria in part because she was a nurse IIRC. I also believe the service is paid for in part by the pharma companies. That would motivate them to provide a good matching service because they're trying to fill trials. It seemed like they filtered out things that sounded good but I couldn't have done for one reason or another. I think everything they gave me looked like I would probably qualify.

                                                                                                      Trying to figure out which of the trials is promising is not something I know. Something that sounds innocuous might turn out to be the next blockbuster. Something that sounds great might fizzle. Something tha might fizzle for everyone else might work great for you.  

                                                                                                      I hope you are getting some relief now. I hope you turn up some possiblities for your next step.

                                                                                                      kylez
                                                                                                      Participant

                                                                                                        Eva,

                                                                                                        If you're off the combo, has your cluster of issues eased off any? The severe back pain, constipation and stomach pain that put you in the hospital and stopped you from eating? 

                                                                                                        If you've stopped treatment and they've eased off, I guess you might be leery of another immunotherapy. Do you know if it was the IPI, the PD1 or the combo that was giving you those symptoms? 

                                                                                                        The thing I liked about the clincal trial finder service here is that the woman I talked to on the other end of the line knew medical terminology and exclusion criteria in part because she was a nurse IIRC. I also believe the service is paid for in part by the pharma companies. That would motivate them to provide a good matching service because they're trying to fill trials. It seemed like they filtered out things that sounded good but I couldn't have done for one reason or another. I think everything they gave me looked like I would probably qualify.

                                                                                                        Trying to figure out which of the trials is promising is not something I know. Something that sounds innocuous might turn out to be the next blockbuster. Something that sounds great might fizzle. Something tha might fizzle for everyone else might work great for you.  

                                                                                                        I hope you are getting some relief now. I hope you turn up some possiblities for your next step.

                                                                                                        Maria C
                                                                                                        Participant

                                                                                                          Eva, I don't have any suggestions for you like so many others on this board, who are offering practical treatment, trial, and physician options. I do hope you and/or your support team are exploring all of them. I just wanted to reach out and let you know that you have been in my thoughts and prayers every day since I read your post. So many hearts are joining yours to keep you strong…and strategic. Toward that end, I hope you've had a chance to get a second or third opinion – alternate strategies – to get you back on a healing path…

                                                                                                          ((((((HUGS))))))

                                                                                                          Maria C
                                                                                                          Participant

                                                                                                            Eva, I don't have any suggestions for you like so many others on this board, who are offering practical treatment, trial, and physician options. I do hope you and/or your support team are exploring all of them. I just wanted to reach out and let you know that you have been in my thoughts and prayers every day since I read your post. So many hearts are joining yours to keep you strong…and strategic. Toward that end, I hope you've had a chance to get a second or third opinion – alternate strategies – to get you back on a healing path…

                                                                                                            ((((((HUGS))))))

                                                                                                            Maria C
                                                                                                            Participant

                                                                                                              Eva, I don't have any suggestions for you like so many others on this board, who are offering practical treatment, trial, and physician options. I do hope you and/or your support team are exploring all of them. I just wanted to reach out and let you know that you have been in my thoughts and prayers every day since I read your post. So many hearts are joining yours to keep you strong…and strategic. Toward that end, I hope you've had a chance to get a second or third opinion – alternate strategies – to get you back on a healing path…

                                                                                                              ((((((HUGS))))))

                                                                                                              BrianP
                                                                                                              Participant

                                                                                                                Eva,

                                                                                                                Have any of your doctors mentioned the NCI Match trial.  I don't know much about it but apparently it is a trial where they take patients who have not responded to other treatments and do a complete genetic test of their disease.  They then taylor the treatment to the unique genetic traits.  Here is the link to the trial.  It is being conducted at nearly a 1000 sites.

                                                                                                                https://clinicaltrials.gov/ct2/show/NCT02465060?term=nci+match&rank=1

                                                                                                                BrianP
                                                                                                                Participant

                                                                                                                  Eva,

                                                                                                                  Have any of your doctors mentioned the NCI Match trial.  I don't know much about it but apparently it is a trial where they take patients who have not responded to other treatments and do a complete genetic test of their disease.  They then taylor the treatment to the unique genetic traits.  Here is the link to the trial.  It is being conducted at nearly a 1000 sites.

                                                                                                                  https://clinicaltrials.gov/ct2/show/NCT02465060?term=nci+match&rank=1

                                                                                                                  BrianP
                                                                                                                  Participant

                                                                                                                    Eva,

                                                                                                                    Have any of your doctors mentioned the NCI Match trial.  I don't know much about it but apparently it is a trial where they take patients who have not responded to other treatments and do a complete genetic test of their disease.  They then taylor the treatment to the unique genetic traits.  Here is the link to the trial.  It is being conducted at nearly a 1000 sites.

                                                                                                                    https://clinicaltrials.gov/ct2/show/NCT02465060?term=nci+match&rank=1

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