› Forums › General Melanoma Community › Targeted therapy vs immunotherapy
- This topic has 9 replies, 6 voices, and was last updated 3 years, 7 months ago by
Daisy2018.
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- September 17, 2020 at 3:55 am
Hello my fellow melanoma bravest. I have been reading here for a while and this is the first post. You are an amazing group of brave people which gives newbies a lot of courage to keep fighting. I used to think that stage 4 in cancer is you have to make your funeral arrangements and I see many people living decent quality of life still. I was diagnosed with stage 1b in February 2020, had a surgery and was clear. Last month I had a scan and it followed with the surgery with stage 3c.
I am still recovering with a drain in my leg and lots of discomfort. Not taking any pain meds though.
Couple question if I may?!
One oncologist had offered targeted therapy since I am BRAF positive and another one offered immunotherapy. I feel I have more chance of remission with immunotherapy. What is the opinion here?
Second question Is about post op cares. Did you use ice? What else did you do to recover faster? It’s getting quite annoying hopping on one leg.
Thanks a lot!
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- September 17, 2020 at 11:13 am
as a 3c’er, i saw 2 different oncs. mainly by mistake. but it did result in 2 completely different Oncs prescribing me.1st they moved immediately to immo(opvido) prescription after results of SLNB. . BRAF and targeted therapy were never discussed. When asked they seem to suggest opvido would be sufficient. In fact one gave me the NCCN guideline Version 3.2109 sheet which lists nivo and BRAF treatments for 3c. So obviously she was aware of BRAF.
my gut feeling is neither doc is that knowledgeable about melanoma. In fact one onc was with a 400 person cancer group who lists 1 melanoma specialist for the entire firm.the other issue is that i have come to understand BRAF may not be long lasting. Others here will confirm or correct that opinion.
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- September 17, 2020 at 2:10 pm
Hello Daisy. Sorry you have the need to be here, but glad you are finding support and info you need. There are many smart and caring peeps on this forum. You are right. LIVING with melanoma is our focus. I was diagnosed Stage IIIb for melanoma in 2003 (no treatments were available then), Stage IV in 2010, immunotherapy trial and I’m still here!! Not just here – but hiking, running, playing, working, LIVING!!! And I am not alone! So, there is certainly hope!As far as healing – generally speaking ice can be helpful for swelling and possibly pain though you have to be sure not to damage the tissue with an ice “burn”. Ice packs are most helpful in the first 24 hours. Warmth leads to greater blood supply and in theory healing. HOWEVER, with any incision or open wound one has to be careful with either one! Rest and time usually does the most good.
As to your main question – targeted vs immunotherapy. Here is a primer I put together that covers current therapies for melanoma that you may find helpful:
Given your status, I presume you are seeking adjuvant care – treatment that is given after melanoma has been removed. Here is a report that covers the history of these treatments in that way and points to consider: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2020/03/adjuvant-therapy-for-melanoma-state-of.html
And finally here are lots more reports on all the drugs being used as adjuvant in melanoma: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=adjuvant
Hope that helps clarify a few things and provides information to discuss with your docs. Ask more questions as you have the need. I wish you my best. Celeste
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- September 17, 2020 at 4:07 pm
Hi Daisy, just to add some more stuff for you to read or watch, here are a couple of links which talk about adjuvant stage 3 treatment options for melanoma from this years ASCO meeting for oncologist’s. Three main trials to consider, checkmate 238 for nivo vs Ipi, keynote 054 of pembro vs placebo and for targeted therapy braf + patients Combi AD of Dab+ Tram. Data for these trials are starting to get to benchmarks( mature time lines) showing RFS stats with Combi AD being the longest studied with 5 year stats. Two links to Onclive which has a series from ASCO with other discussions of adjuvant therapy, youtube link for first video and onclive link for second which will ask you to join with no costs involved and they have post’s with oncologist’s talking about research on a regular basis, so well worth the trouble of joining. https://www.youtube.com/watch?time_continue=5&v=YYI9aZBJ8S8&feature=emb_logo https://www.onclive.com/view/advances-in-the-treatment-of-malignant-melanoma?seriesVid=6-
- September 17, 2020 at 7:52 pm
Thanks for your responses.
I saw two oncologist. One offered MeK+ Barf pills.
Another one offered Keytruda. I was leaning towards Keytruda. I feel like with Keytruda it may put in remission. I hope. I pray. Fingers and toes crossed. With targeted therapy pills it will buy me 6-9 months and it will come back in stage 4.
What do you think?
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- September 20, 2020 at 6:58 pm
Hello Daisy,Welcome on board, we all wish you never had to be here, but I hope you will find all the love and support you need in this community
I think you are totally making the right decision here, definitely shoot for immunotherapy, it takes longer time to work usually 3 months and sometimes even 6 month. But when it works, it works and it is sustainable.
It is great news that you are BRAF positive, you can keep the targeted therapy as a second option in your pocket to buy you time whenever needed. For us, it worked super well, with minimal side effects for 9 months. But we tried it after immunotherapy.
Stay strong my dear, I will keep you in my thoughts and prayers.
Love,
S.-
- September 22, 2020 at 7:08 pm
Thank you everybody, thank you Summer
That’s what one oncologist offered. He wanted to do BRAF, MEK first.
I thought it will just delay inevitable where’s with immunotherapy I have a chance for cure. That’s what second oncologist agreed on to do immunotherapy.
It’s so hard to agree to put this poison in your veins.
I don’t take Tylenol and now I will take a medication which may shot down some of my glands and I should be happy if it happens because the alternative is even scarier. God help us all! And hopefully medicine does it trick!
Scared
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- September 24, 2020 at 3:40 am
Personally, I would go to single immunotherapy 1st over targeted therapy. Keytruda is a sister drug of Opdivo and both have far less side effects than Yervoy. The side effects which occur most often are relatively minor and can be dealt with. Immunotherapy is awesome when it works so leaving targeted therapy in your arsenal for a rainy day is always prudent. Of course, only you and your oncologist can decide what treatment is right for you.
Best of luck regardless of what you choose.
Melanie-
- September 24, 2020 at 5:27 pm
Hey Melanie,
Yes, that’s what I was leaning towards immunotherapy and targeted therapy later.
I did speak with my oncologist today and asked him about the test to test if I will respond to PD1 treatment.
He said Insurances not always cover it. I said wouldn’t be beneficial to know before starting the treatment if it’s the right treatment?
He said he will try to request it with insurance company.
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