MRF-Logo2019-Horizontal-RGB
Steroids impact on Immunotherapy
REGISTER
The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

Steroids impact on Immunotherapy

› Forums › General Melanoma Community › Steroids impact on Immunotherapy

  • Post
    • May 7, 2015 at 7:05 pm
    michael1212
    Participant

      I have heard some people mention that steroids, while often needed for side effects, reduce the effectiveness of Immunotherapy drugs such as Yervoy, Nivolumab, Keytruda etc. My oncologist seems to have a different opinion – that steroids does not reduce the effectiveness of the immunotherapy drugs.

      Has anyone heard from their melanoma oncologist one way or another about this?

      Thanks.

    Viewing 17 reply threads
    • Replies
        • May 7, 2015 at 7:48 pm
        Mat
        Participant

          There is a paper written by Wolchok (MSK) on this from a few years ago (you can likely find by Googling).  My recollection is that there is no issue with prednisone impacting an ipi response.  Remicade (which is a bazooka steroid sometimes needed for colitis) was not studied.  Not aware of the research on impact on PD-1.

          • May 7, 2015 at 7:48 pm
          Mat
          Participant

            There is a paper written by Wolchok (MSK) on this from a few years ago (you can likely find by Googling).  My recollection is that there is no issue with prednisone impacting an ipi response.  Remicade (which is a bazooka steroid sometimes needed for colitis) was not studied.  Not aware of the research on impact on PD-1.

            • May 7, 2015 at 7:48 pm
            Mat
            Participant

              There is a paper written by Wolchok (MSK) on this from a few years ago (you can likely find by Googling).  My recollection is that there is no issue with prednisone impacting an ipi response.  Remicade (which is a bazooka steroid sometimes needed for colitis) was not studied.  Not aware of the research on impact on PD-1.

              • May 7, 2015 at 8:25 pm
              Julie in SoCal
              Participant

                I'm on Pembro and my Rock Star Doc has said that if my side effects get worse (they're not too bad now) he'll put me on prednisone as it doesn't lessen Pembro's effect.  I haven't asked, but I'd imagine that the data isn't mature enough to know if this is scientific fact or his experience. 

                Peace,

                Julie

                  • May 8, 2015 at 12:03 am
                  killmel
                  Participant

                    Hi Julie,

                     

                    I am so happy to see your post. I have been away from the board traveling.

                     

                    How many infusions have you had? What are your side effects? Can you tell if your tumor is shrinking yet. I bet you are anxious for your 1st set of scans to see how the drug is working. When are your scans?

                     

                    I am keeping my fingers & toes crossed for you and that you will be NED real soon.

                     

                    Shalom

                    A

                    • May 8, 2015 at 1:39 am
                    Julie in SoCal
                    Participant

                      Hey! 

                      I'm currently traveling, too.  It's no fun, but it must be done.

                      i've done 2 infusions, I have the third on Monday,  my first infusion has been the hardest- mostly headache, body ache, joint pain, and stomachs rumblings,  They lasted about a week. Not fun,  but it was very doable. The second infusion was much easier. A little headache and body ache, but only for a few days. Who knows how the third will go.

                      i am anxious for scans, but as my mets are pesky little in transits, I can monitor them without scans. At this point in time, they're starting to get softer, and I think, smaller.  It's amazing!  I imagine them gone, and it's easy to believe this as had this also with IPI.  I remember then thinking that this was my cure. Alas, it wasn't. Maybe Pembro will be!?!

                      wishing you the best,

                      Julie

                      • May 9, 2015 at 6:08 pm
                      Speedster
                      Participant

                        Julie,

                        I"m in a double blind trail of Ipilumab vs Nvolumab at Baylor Sammons in Dallas for Stage III patients and interesting looking at your side effects how thay are very similar to mine also after two treatments.  I had a few other side effects as my GP put me on Doxycycline for a developing respiratory infection, which put everyting on tilt given an advese reation no one expected.    It resolved quickly after sopping aside from a rash that's ongoing. 

                        From the symptoms, I think I'm on the Ipi leg of the trial, yet I'm not yet 100% sure.

                        I'm excited for you that you sense your tumors feel softer and smaller!!  I pray we're going to be cancer free soon! 

                        Steve

                        • May 11, 2015 at 5:12 pm
                        Julie in SoCal
                        Participant

                          Hey Steve,

                          If I was NED I'd so want to be on the trial you're on. Hope which ever drug you're getting does a number on Mel for you!!

                          I had Ipi last year, and it worked much slower.  My main side effect was a killer headache (probably pituitary gland inflammation), fatigue, and joint pain (lovely arthritis – like symptoms). It took Ipi a long time to work– long enough for us to start to talk about a "Plan B," but when it kicked in it, it took care of all of my known tumors.  

                          Pembro's working much quicker! And my side effects are very similar to Ipi- headache, achy, fatigue, joint pain, and a little tummy rumbling.  I'm not sure I'd know the difference between Ipi and Pembro, just on my side effects.  I've only had 2 treatments and I'm already feeling a difference in my tumors.  

                          But of course the kicker for all of this is duration of response. Ipi worked for about a year, then mel figured out a way to defeat it.  Mel's a tricky son of a gun.  

                          Shalom,

                          Julie

                           

                          • May 11, 2015 at 5:12 pm
                          Julie in SoCal
                          Participant

                            Hey Steve,

                            If I was NED I'd so want to be on the trial you're on. Hope which ever drug you're getting does a number on Mel for you!!

                            I had Ipi last year, and it worked much slower.  My main side effect was a killer headache (probably pituitary gland inflammation), fatigue, and joint pain (lovely arthritis – like symptoms). It took Ipi a long time to work– long enough for us to start to talk about a "Plan B," but when it kicked in it, it took care of all of my known tumors.  

                            Pembro's working much quicker! And my side effects are very similar to Ipi- headache, achy, fatigue, joint pain, and a little tummy rumbling.  I'm not sure I'd know the difference between Ipi and Pembro, just on my side effects.  I've only had 2 treatments and I'm already feeling a difference in my tumors.  

                            But of course the kicker for all of this is duration of response. Ipi worked for about a year, then mel figured out a way to defeat it.  Mel's a tricky son of a gun.  

                            Shalom,

                            Julie

                             

                            • May 11, 2015 at 5:12 pm
                            Julie in SoCal
                            Participant

                              Hey Steve,

                              If I was NED I'd so want to be on the trial you're on. Hope which ever drug you're getting does a number on Mel for you!!

                              I had Ipi last year, and it worked much slower.  My main side effect was a killer headache (probably pituitary gland inflammation), fatigue, and joint pain (lovely arthritis – like symptoms). It took Ipi a long time to work– long enough for us to start to talk about a "Plan B," but when it kicked in it, it took care of all of my known tumors.  

                              Pembro's working much quicker! And my side effects are very similar to Ipi- headache, achy, fatigue, joint pain, and a little tummy rumbling.  I'm not sure I'd know the difference between Ipi and Pembro, just on my side effects.  I've only had 2 treatments and I'm already feeling a difference in my tumors.  

                              But of course the kicker for all of this is duration of response. Ipi worked for about a year, then mel figured out a way to defeat it.  Mel's a tricky son of a gun.  

                              Shalom,

                              Julie

                               

                              • May 9, 2015 at 6:08 pm
                              Speedster
                              Participant

                                Julie,

                                I"m in a double blind trail of Ipilumab vs Nvolumab at Baylor Sammons in Dallas for Stage III patients and interesting looking at your side effects how thay are very similar to mine also after two treatments.  I had a few other side effects as my GP put me on Doxycycline for a developing respiratory infection, which put everyting on tilt given an advese reation no one expected.    It resolved quickly after sopping aside from a rash that's ongoing. 

                                From the symptoms, I think I'm on the Ipi leg of the trial, yet I'm not yet 100% sure.

                                I'm excited for you that you sense your tumors feel softer and smaller!!  I pray we're going to be cancer free soon! 

                                Steve

                                • May 9, 2015 at 6:08 pm
                                Speedster
                                Participant

                                  Julie,

                                  I"m in a double blind trail of Ipilumab vs Nvolumab at Baylor Sammons in Dallas for Stage III patients and interesting looking at your side effects how thay are very similar to mine also after two treatments.  I had a few other side effects as my GP put me on Doxycycline for a developing respiratory infection, which put everyting on tilt given an advese reation no one expected.    It resolved quickly after sopping aside from a rash that's ongoing. 

                                  From the symptoms, I think I'm on the Ipi leg of the trial, yet I'm not yet 100% sure.

                                  I'm excited for you that you sense your tumors feel softer and smaller!!  I pray we're going to be cancer free soon! 

                                  Steve

                                  • May 8, 2015 at 1:39 am
                                  Julie in SoCal
                                  Participant

                                    Hey! 

                                    I'm currently traveling, too.  It's no fun, but it must be done.

                                    i've done 2 infusions, I have the third on Monday,  my first infusion has been the hardest- mostly headache, body ache, joint pain, and stomachs rumblings,  They lasted about a week. Not fun,  but it was very doable. The second infusion was much easier. A little headache and body ache, but only for a few days. Who knows how the third will go.

                                    i am anxious for scans, but as my mets are pesky little in transits, I can monitor them without scans. At this point in time, they're starting to get softer, and I think, smaller.  It's amazing!  I imagine them gone, and it's easy to believe this as had this also with IPI.  I remember then thinking that this was my cure. Alas, it wasn't. Maybe Pembro will be!?!

                                    wishing you the best,

                                    Julie

                                    • May 8, 2015 at 1:39 am
                                    Julie in SoCal
                                    Participant

                                      Hey! 

                                      I'm currently traveling, too.  It's no fun, but it must be done.

                                      i've done 2 infusions, I have the third on Monday,  my first infusion has been the hardest- mostly headache, body ache, joint pain, and stomachs rumblings,  They lasted about a week. Not fun,  but it was very doable. The second infusion was much easier. A little headache and body ache, but only for a few days. Who knows how the third will go.

                                      i am anxious for scans, but as my mets are pesky little in transits, I can monitor them without scans. At this point in time, they're starting to get softer, and I think, smaller.  It's amazing!  I imagine them gone, and it's easy to believe this as had this also with IPI.  I remember then thinking that this was my cure. Alas, it wasn't. Maybe Pembro will be!?!

                                      wishing you the best,

                                      Julie

                                      • May 8, 2015 at 12:03 am
                                      killmel
                                      Participant

                                        Hi Julie,

                                         

                                        I am so happy to see your post. I have been away from the board traveling.

                                         

                                        How many infusions have you had? What are your side effects? Can you tell if your tumor is shrinking yet. I bet you are anxious for your 1st set of scans to see how the drug is working. When are your scans?

                                         

                                        I am keeping my fingers & toes crossed for you and that you will be NED real soon.

                                         

                                        Shalom

                                        A

                                        • May 8, 2015 at 12:03 am
                                        killmel
                                        Participant

                                          Hi Julie,

                                           

                                          I am so happy to see your post. I have been away from the board traveling.

                                           

                                          How many infusions have you had? What are your side effects? Can you tell if your tumor is shrinking yet. I bet you are anxious for your 1st set of scans to see how the drug is working. When are your scans?

                                           

                                          I am keeping my fingers & toes crossed for you and that you will be NED real soon.

                                           

                                          Shalom

                                          A

                                        • May 7, 2015 at 8:25 pm
                                        Julie in SoCal
                                        Participant

                                          I'm on Pembro and my Rock Star Doc has said that if my side effects get worse (they're not too bad now) he'll put me on prednisone as it doesn't lessen Pembro's effect.  I haven't asked, but I'd imagine that the data isn't mature enough to know if this is scientific fact or his experience. 

                                          Peace,

                                          Julie

                                          • May 7, 2015 at 8:25 pm
                                          Julie in SoCal
                                          Participant

                                            I'm on Pembro and my Rock Star Doc has said that if my side effects get worse (they're not too bad now) he'll put me on prednisone as it doesn't lessen Pembro's effect.  I haven't asked, but I'd imagine that the data isn't mature enough to know if this is scientific fact or his experience. 

                                            Peace,

                                            Julie

                                            • May 8, 2015 at 2:49 am
                                            arthurjedi007
                                            Participant

                                              My onc's nurse said if I get the symptoms of colitis they give steroids to slow down the medicine in that case yervoy. They didn't need to do that for me fortunately. Sooo I'm reading between the lines with that but if I get the symptom I'm calling the nurse to get the steroids anyway.

                                              Artie

                                              • May 8, 2015 at 2:49 am
                                              arthurjedi007
                                              Participant

                                                My onc's nurse said if I get the symptoms of colitis they give steroids to slow down the medicine in that case yervoy. They didn't need to do that for me fortunately. Sooo I'm reading between the lines with that but if I get the symptom I'm calling the nurse to get the steroids anyway.

                                                Artie

                                                • May 8, 2015 at 2:49 am
                                                arthurjedi007
                                                Participant

                                                  My onc's nurse said if I get the symptoms of colitis they give steroids to slow down the medicine in that case yervoy. They didn't need to do that for me fortunately. Sooo I'm reading between the lines with that but if I get the symptom I'm calling the nurse to get the steroids anyway.

                                                  Artie

                                                  • May 8, 2015 at 9:56 pm
                                                  Jubes
                                                  Participant

                                                    Hi I had to go on steroids two weeks ago and now being weaned down over a five weeks period. Not sure if I will be able to go back on keytruda. Just anecdotally. My doctor told me he had another patient who got bad cramps like me at about the same time in treatment(  7 months) who had to be hospitalized and put on steroids. He had to stay off keytruda after that. But the keytruda has continued to work for another 3 years now

                                                    This is something so new the doctors admit they don't know and every case is different

                                                    anne-Louise 

                                                     

                                                    • May 8, 2015 at 9:56 pm
                                                    Jubes
                                                    Participant

                                                      Hi I had to go on steroids two weeks ago and now being weaned down over a five weeks period. Not sure if I will be able to go back on keytruda. Just anecdotally. My doctor told me he had another patient who got bad cramps like me at about the same time in treatment(  7 months) who had to be hospitalized and put on steroids. He had to stay off keytruda after that. But the keytruda has continued to work for another 3 years now

                                                      This is something so new the doctors admit they don't know and every case is different

                                                      anne-Louise 

                                                       

                                                      • May 8, 2015 at 9:56 pm
                                                      Jubes
                                                      Participant

                                                        Hi I had to go on steroids two weeks ago and now being weaned down over a five weeks period. Not sure if I will be able to go back on keytruda. Just anecdotally. My doctor told me he had another patient who got bad cramps like me at about the same time in treatment(  7 months) who had to be hospitalized and put on steroids. He had to stay off keytruda after that. But the keytruda has continued to work for another 3 years now

                                                        This is something so new the doctors admit they don't know and every case is different

                                                        anne-Louise 

                                                         

                                                        • May 8, 2015 at 9:56 pm
                                                        Jubes
                                                        Participant

                                                          Hi I had to go on steroids two weeks ago and now being weaned down over a five weeks period. Not sure if I will be able to go back on keytruda. Just anecdotally. My doctor told me he had another patient who got bad cramps like me at about the same time in treatment(  7 months) who had to be hospitalized and put on steroids. He had to stay off keytruda after that. But the keytruda has continued to work for another 3 years now

                                                          This is something so new the doctors admit they don't know and every case is different

                                                          anne-Louise 

                                                           

                                                          • May 8, 2015 at 9:56 pm
                                                          Jubes
                                                          Participant

                                                            Hi I had to go on steroids two weeks ago and now being weaned down over a five weeks period. Not sure if I will be able to go back on keytruda. Just anecdotally. My doctor told me he had another patient who got bad cramps like me at about the same time in treatment(  7 months) who had to be hospitalized and put on steroids. He had to stay off keytruda after that. But the keytruda has continued to work for another 3 years now

                                                            This is something so new the doctors admit they don't know and every case is different

                                                            anne-Louise 

                                                             

                                                            • May 8, 2015 at 9:56 pm
                                                            Jubes
                                                            Participant

                                                              Hi I had to go on steroids two weeks ago and now being weaned down over a five weeks period. Not sure if I will be able to go back on keytruda. Just anecdotally. My doctor told me he had another patient who got bad cramps like me at about the same time in treatment(  7 months) who had to be hospitalized and put on steroids. He had to stay off keytruda after that. But the keytruda has continued to work for another 3 years now

                                                              This is something so new the doctors admit they don't know and every case is different

                                                              anne-Louise 

                                                               

                                                              • May 9, 2015 at 5:29 pm
                                                              Speedster
                                                              Participant

                                                                I entered the clinical trial of Ipilimumab vs. Nivomumab at Baylor Sammons and was told of the concernt that steroids can hamper the effectiveness.  I"m glad to hear they may not as they may be needed as things progress.   

                                                                • May 9, 2015 at 5:29 pm
                                                                Speedster
                                                                Participant

                                                                  I entered the clinical trial of Ipilimumab vs. Nivomumab at Baylor Sammons and was told of the concernt that steroids can hamper the effectiveness.  I"m glad to hear they may not as they may be needed as things progress.   

                                                                  • May 9, 2015 at 5:29 pm
                                                                  Speedster
                                                                  Participant

                                                                    I entered the clinical trial of Ipilimumab vs. Nivomumab at Baylor Sammons and was told of the concernt that steroids can hamper the effectiveness.  I"m glad to hear they may not as they may be needed as things progress.   

                                                                Viewing 17 reply threads
                                                                • You must be logged in to reply to this topic.
                                                                About the MRF Patient Forum

                                                                The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                                                                The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

                                                                Popular Topics