ed williams

MB, last video on the topic from ASCO 2022. https://ascopost.com/news/september-2022/addition-of-t-vec-to-pembrolizumab-in-advanced-melanoma/

MB, this is another injectable called RP1 and is in clinical trial called IGNYTE. Dr. Pavlick from Cornell Medicine talks about how it works in following short video. https://www.onclive.com/view/dr-pavlick-on-the-mechanisms-of-action-of-rp1-in-cutaneous-melanoma

MB, this is Onclive peer panel doctor from Moffitt talking about how they use T-vec, May of 2023 video. https://www.onclive.com/view/tumor-directed-oncolytic-therapies-for-melanoma-and-cscc

Jeff, staging is a process of gathering information. Depth of tumor, lymph nodes positive or negative. If positive you jump up to stage 3 and depending on some factors will settle into a letter following #3. I was 3a back in 2012 based on pathology and sentinel lymph node biopsy results. Not great options back then for treatment as there are now for what is called adjuvant treatment. Stage 3 is tough, do you throw the big guns at the cancer, if there is any left in body or wait to see if it comes back and then treat. I progressed to lung and brain tumors by 2013 and was treated with cyberknife SRS radiation for the brain mets and then qualified for checkmate 067 clinical trial where i was lucky to get nivolumab Pd-1 drug before FDA approved. Well, long story, short version, still here and drug treatment worked. Today there are more options for treatments if the cancer was to return than back in 2013-14 timeline. Big decision will be to wait and watch with scans or treat with immunotherapy right off the hop. Ask them to do BRAF+ mutation genetic testing to see if targeted therapy drugs will be an option. Aim at Melanoma has a great information page of what to do after staging as does the MRF have information to help you understand options. https://www.aimatmelanoma.org/?gclid=CjwKCAjw-KipBhBtEiwAWjgwrBCW6ihYXuPklhQrHcajTheIFJcrG_PrmWZ6t6yqCf0JCxD5zJY5aRoCP9oQAvD_BwE

Finem, SOX10 and MELAN A are part of immunohistochemistry test that look at tissue from surgery tissue/biopsy using stains added to slice of tissue and then look under the microscope to see if tissue is melanoma or not. Following article gets into the testing of tissue. BRAF mutation status of being positive or negative does not make difference in first line treatment setting these days as Immunotherapy treatments have proven via clinical trials to be best starting point. If your tumor turns out to be BRAF+ then you have option if immunotherapy does not work of switching to targeted therapy drugs like BRAFTovi and MEKTovi ( there are two other drug pills combination to pick from).https://pubmed.ncbi.nlm.nih.gov/25356946/

Lucas the recent findings from treatment for a couple of rounds and then surgery vs going right to surgery then giving immunotherapy as adjuvant treatment has shown in recent trials to be superior (look up Opacin, Nadina, Prado and Donimi clinical trials). Third following link gets good at 37:00 min mark neoadjuvant. Then first following links get into the research of neo-adjuvant immunotherapy vs adjuvant. Second link starts at 1hr 10min mark. https://www.nejm.org/doi/full/10.1056/NEJMoa2211437 https://www.youtube.com/watch?v=vSdUEfXHiLE https://www.youtube.com/watch?v=LPhuuC4QnTw

I am sorry but you can not comment on this post ladies!!! Melanoma humor!!!

Jeff, I hope thinks go smoothly and you get lot’s of T-cells ready for action!!! This following article was published by Iovance at the ESMO conference in the fall of 2022 and published in early December of 2022 on the topic of IL-2 doses and responses based on how much patients could handle and I thought it might be worth a read for you and maybe a discussion with your medical team on the data. https://www.onclive.com/view/lifileucel-induces-response-in-metastatic-melanoma-independent-of-number-of-il-2-doses-received

Jeff, without BRAF status they will probably offer one year of either of the PD-1 drugs, Nivolumab (Opdivo) or pembrolizumab (Keytruda). The problem with adjuvant treatment is the risk of developing life long issue from the drugs are real and for endocrine toxicities they will be life long. It all becomes stats at this point, what % chance of melanoma coming back vs doing observation with scans. Tough to make the right choice, I am sure your oncologist will go over the numbers with you. I had Nivolumab and developed kind of fatigue issues that have not gone away. I also have developed some stomach issues that are pain in the ass. I can not sleep on flat surface without acid reflux any longer. I stayed on the treatments for a long time as back then they had no end point, the drug as part of clinical trial was available until progression. Good luck with the decisions, no wrong way to go as if you decide to wait on treatment it will be just as effect if you were to progress. A lot of new stuff in development as well for stage 4 patients which is great in having options.

Ed, following link features a leading expert in melanoma from Australia and she talks about the concept of neo-adjuvant treatment before surgery and the logic and immune response that can happen when tumor is present vs giving drug after surgery with no tumor present. Doctors can learn a lot by how the tumor tissue look under the microscope after surgery. When there is tumor the immunotherapy drugs have a target to do their thing. good luck with decision. https://www.youtube.com/watch?v=LPhuuC4QnTw

The numbers come from Checkmate 067, which started in 2014 and patients could not have had Ipilimumab prior which was approved in 2011 time frame. So (untreated) would mean new stage 4 and if you read checkmate 067 clinical trial it goes into more detail of who qualified. Today with adjuvant immunotherapy by the time they are stage 4 they have had either targeted therapy or pd-1 treatment already. Go to result section of following article and you will see where the 945 # comes from. I was one of the 315 in the Nivo arm of the trial. https://www.nejm.org/doi/full/10.1056/NEJMoa1910836 https://clinicaltrials.gov/ct2/show/NCT01844505

Did you even read the comments and the dates written??? A day late and a dollar short comes to mind!!!

leon, private button so no one can see what you wrote is one of the many reason many have left the site. Way to hard to know how to post and where it is going let alone reading old posts to see what others have done in the past!!!