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Would u start Yervoy or Keytruda at age 79 for stage 3 head/neck melanoma?
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Would u start Yervoy or Keytruda at age 79 for stage 3 head/neck melanoma?

› Forums › General Melanoma Community › Would u start Yervoy or Keytruda at age 79 for stage 3 head/neck melanoma?

  • Post
    • July 4, 2017 at 6:48 pm
    HHN
    Participant

      If you have been on Yervoy or Keytruda, would you personally do it again if you were at the age of 79?  I am otherwise healthy and stage 3 head and neck melanoma (1 positive node) which appears to be have a worse prognosis than regular melanoma.  Appreciate your responses.

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    • Replies
        • July 4, 2017 at 7:16 pm
        jennunicorn
        Participant

          If you're able to get Keytruda, then that would be the best option as there is less toxicity with Keytruda. It's not approved for stage 3 yet, but if you're able to get it through a trial, then that's the way to go.

          • July 4, 2017 at 7:19 pm
          Patrisa
          Participant

            I would also go for Keytruda, can't think of one reason against it… if you fear side effects  you can always quit, but my father for example hasn't had any…

            Good luck,

            Patrisa

            • July 4, 2017 at 9:06 pm
            Fen
            Participant

              Why would the location of the melanoma affect the outcome?  Just curious.

               

                • July 5, 2017 at 1:13 am
                Nemesis
                Participant

                  It usually does. Maybe proximity to important organs? Legs and arms melanomas tend to be less dangerous than head/neck ones, with trunk melanomas being somewhat intermediate.

                   

                  • July 5, 2017 at 1:32 pm
                  Fen
                  Participant

                    thanks for the info

                     

                  • July 5, 2017 at 1:32 am
                  kris1
                  Participant

                    Hi there!  I am struggling with a similar decision, but am 37yrs old…which changes some of the decision calculus a little bit, but not the options available.  Congrats on making it to 79!

                    Based on my research and understanding, Keytruda is clearly superior for advanced stages in terms of both efficacy and side effects, but is still in trial for adjuvant / Stage 3A-B where it is not yet proven (or approved). 

                    I am trying to understand why Keytruda's better results that are proven in later stages would NOT be analogous to earlier stages.  I am considering getting it off-label, since it is not yet approved.  (there is a trial you can qualify for comparing the two, but it requires complete lymph node removal, which is an outdated procedure with no proven benefit).

                    I am a bit scared of ipi, especially because I have a strong immune system which actually puts me at greater risk for the side effects : (

                    Would be interested in what data or perspective others may have on Keytruda vs Yervoy for Stage 3A-B.  

                    Thanks,

                    Kris 

                      • July 5, 2017 at 4:39 am
                      jennunicorn
                      Participant

                        Hi Kris, just wondering where you heard that having a strong immune system means you would be at greater risk for side effects? I also have a strong immune system and am young and did not experience any major side effects from Ipi, which I did twice, once at 10mg/kg for 6 infusions and second time at 3mg/kg for 4 infusions. I think having previous autoimmune disorders or having a weakened immune system would put someone at more risk for major side effects, not the other way around. Not saying Ipi is the way to go for everyone, but it has helped people when there were no other options and getting it at the lower dosage (3mg/kg) for stage 3 adjuvant treatment is a decent plan if you can't get Keytruda or Opdivo. I don't think you'll be able to get Keytruda off-label, it's pretty close to impossible, not even considering the many thousands of dollars needed to pay for it. 

                        • July 5, 2017 at 4:21 pm
                        ed williams
                        Participant

                          Hi Kris, just to add to what Jennifer stated above, I have a link to an expert panel of Melanoma specialist who cover the topic for you. Best Wishes!!!Ed  https://www.youtube.com/watch?v=oZSdAf_u6dY

                        • July 7, 2017 at 12:46 pm
                        Bubbles
                        Participant

                          Just in case you were worried about your age in relation to immunotherapy [which includes ipi (yervoy), pembro (Keytruda), and nivo (Opdivo)] this article may be reassuring in that it notes that patients much older than yourself have done well on these therapies.

                          http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/01/with-immunotherapy-elderly-with.html  

                          I wish you well with whatever you decide re treatment.  Celeste

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