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Trial advice please!
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Trial advice please!

› Forums › Cutaneous Melanoma Community › Trial advice please!

  • Post
    • March 31, 2017 at 10:31 pm
    Prd10
    Participant

      My full history is in my profile.  I'm currently on pembro with a liver tumor and a subcutaneous tumor.  The subcutaneous tumor doesn't appear to be responding to pembro, although I'm very open to it being pseudo progression I want to be prepared to switch gears if necessary.  I'll have a scan next week to confirm.  At this point I've only done pembro.  

      I've been offered two trials if I qualify based on blood and tumor testing.

      Trial 1 is IMCgp100 with durvalumab or tremelimumab.

      Trial 2 is MGA271 with IPI.

      Is anyone on these trials?  Any advice or information?  What questions would you ask (I don't see any current efficacy data, and fairly vague side effect profiles)? Does one seem better than the other?

      Dr. Luke gave a good basic explanation of each and we will discuss again.  I'm just having a hard time wrapping my brain around it all.  I don't want to throw in the towel on pembro, but don't want to be foolish either.  This subcutaneous tumor just blew up when I started pembro.  It's big, red, painful, itchy but it changes throughout the 3 week cycles which makes me think something is happening(maybe it's just something bad happening) I know the liver tumor is more important so we will see what that's doing.

      Would it make sense to ask for radiation on the subcutaneous tumor?  Would you try ipi/nivo before moving to a trial?  

      Thanks for any advice!  Caitlin

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        • March 31, 2017 at 11:38 pm
        ed williams
        Participant

          Hi Caitlin, first off I would always go with the advice of a Melanoma specialist like Dr. Luke, that being said this is the first time that I have heard of MGA 271 or Enoblituzumab or Macrogenics the company behind it https://www.macrogenics.com/enoblituzumab-anti-b7-h3/. That is my experince so I would have to go with what Dr. Luke's advice would be about Enoblituzumab. As far as Nivo/Ipi combination from Bristol Myer Squibb, I would have to say that it is proven to have the  best % chance of working with an increased risk of pretty serious side effect that go with it. If Dr. Luke has taken tumor sample from you and has determined that your tumor is cold and doesn't have Tils present then the question becomes how to get your tumor hot? Would a bispecific drug like gp100 be the way to go or maybe Epacadostat (IDO) combined with an Immunotherapy drug be better? I can say with 100% confidence that I don't have the answer but the options that have been given to you, are solid from what I have researched. I hope that the "something" that is happening is a positive response to Pembro and that you won't have to change treatment!!! Best Wishes!!!Ed

            • April 1, 2017 at 4:35 pm
            Prd10
            Participant

              Thanks Ed!  It really does help me sort through it all.  I agree that I'm lucky to have Dr. Luke and a good plan.

              I will get the results of my blood work, the tumor testing and the scan this week.  I know Dr. Luke is leery of the side effect profile of IPI/NIVO but certainly said it's an option.  I'm open to a clinical trial but can't say the unknown on top of unknown isn't scary as heck! 

              Really appreciate the feedback! 

            • April 1, 2017 at 8:46 pm
            Bubbles
            Participant

              Caitlin,

              Sorry you are dealing with all this.  It is hard to choose what to do in melanoma world.  However, here is a report on MGA 271 with pembro that might give you some info:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2016/07/new-trial-recruiting-pembro-plus-mga271.html  

              Weber addresses durvalumab here:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=durvalumab

              more below….

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