Webinair on Systemic therapies

I cannot believe that noone has posted yet about this weeks Webinair.

Excellent.  Thankyou very much cure OM and i was able to ask a question!

Please thank Dr Weber and Dr Flaherty for their informitive talks.

I would like to ask furhter questions – sorry i guess I never grew out of the "Elephants Child " syndrome.

To Dr Weber I would like to ask further about Ipilimumab.

3 years ago the recommendation was to permanently discontinue Ipilimumab if the ALT/AST rose >7x normal.

I cannot believe that noone has posted yet about this weeks Webinair.

Excellent.  Thankyou very much cure OM and i was able to ask a question!

Please thank Dr Weber and Dr Flaherty for their informitive talks.

I would like to ask furhter questions – sorry i guess I never grew out of the "Elephants Child " syndrome.

To Dr Weber I would like to ask further about Ipilimumab.

3 years ago the recommendation was to permanently discontinue Ipilimumab if the ALT/AST rose >7x normal.

Now it is at 5x normal.

This must mean that some people who survived the hepatitis and maybe got a response will still be alive.  So obviously this is a saftey issue. However is it that as the drug was rolled out into more widespread practice some of the less experienced centres failed to appreciate the risks soon enough. In his experience was there a link to those with the more severe hepatitis -5-7 x normal having clinical benefti from the drug.  Would he consider reintroducing Yervoy in these patients if they were to relapse now 3 years later. Or would he observe the current saftey guidelines – the tempatation for patients with few options must surely be to risk the drug again? Which way would his clinical experience push him?

Also to Dr Weber- concerning T lymhocytes and TIL

Are the size of the metastases in OM relevant in the T lymphocyte infiltration. Are smaller metastases less likely to have the "bad" lymphocyete- the exhauseted ones . Is it possible that substances that are released by the tumour cells which cause the exhaustion in T cells. ? So early treatment would be beneficial.?

What size tumour is needed for TIL and does this lead to more of the lymphocytes being in the "exhasuted state"

Have studies been done using the circulating lymphocytes in OM rather than the tumour "exahausted " ones and are these able to be grown more easily?

Once again many thanks for giving us this wonderful oppourtunity.

Carpe diem

Lesley