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pembro

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    poppymac
    Participant
    hi,i had 3.5mm mole removed from right cheek in jan 2018
    WLE on april 10 2018 was clear
    pet scan on june 1st showed node involvement
    neck dissection in july 18 showed 13 nodes infected
    started pembro on sep 13 stopped after progression showed on nov 30 brain met
    dec 27 SRS on met and no treatment since but ned
    my question is did pembro work despite being stopped early

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      ed williams
      Participant
      Question, had they scanned brain prior to nov 30 or was that the first time? If it was the first time that brain was scanned then met could have been there for some time and since you have had no other tumors in your body to judge if there has been shrinkage, then hard to say what effect pembro had after I would presume two treatments.

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        poppymac
        Participant
        thank u for your imput ed,
        i had scan the previous august which was ned and had 4 treatment of pembro before nov 30 scan
        as the disease as my oncologist calls it had been very intense in my neck area I think pembro must have did something
        also is SRS enough for brain met on it’s own

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        hxcadam
        Participant
        SRS has been shown to be enough to treat melanoma brain mets. I myself have 2, 1 is currently shrinking. The other had no change during my last MRI after SRS but was showing treatment related inflammation. Immunotherapy by itself hasn’t shown to be very effective treating brain mets but the combo I believe has shown to be the most effective at crossing the blood/brain barrier.

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        ed williams
        Participant
        Hi hxcadam, while I would agree with SRS working on treating brain mets, I had three zapped back in fall of 2013 and so far they haven’t returned. When it comes to single agent pd-1 drugs like nivo working in the brain, two recent trials (ABC, checkmate 204) have shown about 20% durable responses but compare that in the same two trials to the combination of Ipi+nivo of around 55% to 58% durable response similar to response in melanoma patient when tumors are in none brain regions. The experts are now trying to run trials combining the two, SRS and ipi+nivo to see if they can get an even better outcome. They are calling this trial ABC-X trial. Here is link. https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.TPS9600

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