Thanks everyone for the advice, I really appreciate it. The guy who were seeing has been at univ of Michigan for 20 yrs, plus residency at Harvard and has done thousands of these. I'm pretty sure he's qualified and very good at this.
we are trying to get other opinions, but with the brain mets my wife has been told not to fly so we're relying on the possibility of phone consults. Also the mets are growing – visibly larger in a 3 week period – so we don't want to wait any longer.
her onc, who we love and trust very much, is concerned with the inflammatory effects of dosing ipi or nivo too close to the srs – thinking 4 weeks afterward maybe and it's been 6 weeks since her last dose, so not much chance of combinatorial effects I think?
She is at her 4th cycle on the combo so he might move her straight to nivo alone, having seen too many people take that 4th dose and then have to be off treatment entirely.
With ipi and nivo they are still struggling to find the balance between killing the cancer and toxicity…
