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Recurrence after complete response
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Recurrence after complete response

› Forums › General Melanoma Community › Recurrence after complete response

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    • July 13, 2023 at 10:14 pm
    Lucas
    Participant
      Recent biopsy shows a single recurrence in my left inguinal lymph node. This is a previous cancer site and PET scan shows no disseminated disease. I had distant widespread lymphatic disease previously before a complete response to ipi/nivo. My question is and I’ve drowned myself in data. Is do I go straight to surgery to remove this met? Doctor warns that there could be micrometastic disease but data tells me different. I’ve read that I still have disease control, but a local immune failure in this pre existing lymph node. Me and my general oncologists plan is to treat with nivo/relatlimab lag3 for 2 cycles before surgery. The data around this in the neo/adjuvant setting is phenomenal, however not sure it will work after ipi/nivo? I’m left to ponder, do I go straight to surgery and be NED or retry ipi/nivo or give this new combo a chance and possibly become unresectable??Any thoughts or suggestions would be appreciated!
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        • July 14, 2023 at 6:43 pm
        ed williams
        Participant
          Lucas the recent findings from treatment for a couple of rounds and then surgery vs going right to surgery then giving immunotherapy as adjuvant treatment has shown in recent trials to be superior (look up Opacin, Nadina, Prado and Donimi clinical trials). Third following link gets good at 37:00 min mark neoadjuvant. Then first following links get into the research of neo-adjuvant immunotherapy vs adjuvant. Second link starts at 1hr 10min mark. https://www.nejm.org/doi/full/10.1056/NEJMoa2211437 https://www.youtube.com/watch?v=vSdUEfXHiLE https://www.youtube.com/watch?v=LPhuuC4QnTw
          • July 14, 2023 at 7:08 pm
          Lucas
          Participant
            Ed thank you for the response! I have seen that neo-adjuvant data and read those studies. However those are based in first line treatment. Because I’ve had my response already and only have the single progressing lesion it complicates things. Would neo-adjuvant be effective in the 2nd line setting?
            Based on my previous response and the non disseminated disease at this time. Data shows that surgery is a really good option. The idea would be that I have micro-metastatic control in other areas. I’m just not sure that immunotherapy will provide a benefit at this stage . I will be having a single infusion of nivo/relatlimab first, but I don’t feel I have the benefit of time to wait for another. Thanks again Ed!
            • July 15, 2023 at 8:42 am
            Edwin
            Participant
              I had melanoma in several bones. After ipi/nivo immunotherapy followed by nivo alone, my bone cancer disappeared. Then cancer was found in a lymph node under my left jaw. My doctors decided that surgery would probably not help. I had radiation to that lymph node and continued nivo immunotherapy. Now PET scans show no evidence of melanoma.
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