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What to do following a year of success, then progression with Keytruda
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What to do following a year of success, then progression with Keytruda

› Forums › General Melanoma Community › What to do following a year of success, then progression with Keytruda

  • Post
    • October 9, 2017 at 5:40 am
    Spl25
    Participant

      So it looks like this may be the end of the road on Keytruda for me. I’ve had a more than 50% reduction in my Mets (mostly the lungs, liver and lymph nodes) on Keytruda, but recently had a medium sized new met pop up in a lymph node, possibly more than one. Looking at my options (based on doctor conversations and lurking), i see

      1. Braf/mek inhibitors

      2. Chemo or biochemo

      3. TIL (although it’s unclear whether my Mets are harvestable)

      4. Ipi + maybe Nivo

      5. A pd-1 + experimental agent (lag-3, HDAC, IDO….others?) clinical trial

      6. Something I’ve not heard of before – systemic vaccines? New mabs?

      has anyone here had a durable CR after failing a year of Keytruda (that would be FANTASTIC to hear!)? What did you do? Anybody get a mixed response or durable remission afterwards? Any suggestions from the science-minded folks on here? Honestly BRAF targeted therapy is not very attractive to me since the disease is moving fairly slowly at the moment. I am not pain and/or brief misery averse.

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        • October 9, 2017 at 8:53 am
        Mat
        Participant

          I've been stable on ipi-nivo for 18 mos after progressing on Keytruda.  The success rate (stable or better) for patients of this type is around 20 percent based on a small MSK study.

          • October 9, 2017 at 4:55 pm
          MovingOn
          Participant

            Maybe also consider an intralesional (PV-10, T-VEC, others) to zap the lymph node. Doesn’t seem like a failure on Keytruda, most Melanoma has regressed. The lymph node is doing it’s job in catching the migrating melanoma cells. Sounds like you are close to success.

              • October 10, 2017 at 1:48 am
              Spl25
              Participant

                Thanks – they are hila lymph nodes so I’m not sure if they are accessible 

              • October 27, 2017 at 8:57 pm
              Twhite00000
              Participant
                The trial I am in may be of interest

                https://clinicaltrials.gov/ct2/show/NCT03026517

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