› Forums › General Melanoma Community › Only HD IL-2
- This topic has 48 replies, 7 voices, and was last updated 11 years, 8 months ago by
TSchulz.
- Post
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- August 30, 2013 at 1:31 am
I am new to this board, my husband was diagnosed
With Melanoma in Dec 2011 15.5mm/ ulcerated mole on his shoulder..
He had
Surgery to remove mole and margins- the cancer spread
To four sentinel nodes and one non sentinel node.. He had another
Surgery to remove the rest of the nodes under
The right arm- there was a tumor in one of the nodes.
Had three more surgeries ton remove other moles that looked
Suspicious — all were Melanoma. No treatment was given… Interferon
was discussed but with the risk only being reduced by 1%, he did
Not do it. Jan of 2013 clear CT…. July 2013 pain on right
Side– CT showed mass on lung and inflamed lymph nodes-biopsy confirmed
Metastatic Melanoma— the only treatment he just finished
16 doses HD IL-2–goes for a Follow up CT Next week. When
I read this board I see that most people has lots of various treatments…
Is IL -2 enough??!
Sorry so long.
Thanks
nancy
- Replies
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- August 30, 2013 at 2:08 am
Ask Rick, 22 years ago he had IL-2 as his only Stage IV melanoma treatment. Has been NED since then. If he goes 5 years without a re-occuraance, the odds are that it will never come back. How many weeks of the IL-2 did he have? Was it just the two weeks in Round one of the IL-2 treatments? If he is a complete responder it will be great. If he is a partial responder or even a noe responder, there is a likelyhood that the IL-2 will have enhanced his immume system sso that another type treatment will be successful. I was a patial responder and went through 49 bags in the three rounds (six weeks) of IL-2 treatments (Full course). I know others that have gone over the five year mark of BEING NED and are still go ing on with life. I have known some a few that only got less than ten bags and could not take the side effects, but still were a complete rewponder so far. Melanoma is such an individual thing (as is our bodies). Do you know what DNA mutation he has?
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- August 30, 2013 at 2:08 am
Ask Rick, 22 years ago he had IL-2 as his only Stage IV melanoma treatment. Has been NED since then. If he goes 5 years without a re-occuraance, the odds are that it will never come back. How many weeks of the IL-2 did he have? Was it just the two weeks in Round one of the IL-2 treatments? If he is a complete responder it will be great. If he is a partial responder or even a noe responder, there is a likelyhood that the IL-2 will have enhanced his immume system sso that another type treatment will be successful. I was a patial responder and went through 49 bags in the three rounds (six weeks) of IL-2 treatments (Full course). I know others that have gone over the five year mark of BEING NED and are still go ing on with life. I have known some a few that only got less than ten bags and could not take the side effects, but still were a complete rewponder so far. Melanoma is such an individual thing (as is our bodies). Do you know what DNA mutation he has?
-
- August 30, 2013 at 2:08 am
Ask Rick, 22 years ago he had IL-2 as his only Stage IV melanoma treatment. Has been NED since then. If he goes 5 years without a re-occuraance, the odds are that it will never come back. How many weeks of the IL-2 did he have? Was it just the two weeks in Round one of the IL-2 treatments? If he is a complete responder it will be great. If he is a partial responder or even a noe responder, there is a likelyhood that the IL-2 will have enhanced his immume system sso that another type treatment will be successful. I was a patial responder and went through 49 bags in the three rounds (six weeks) of IL-2 treatments (Full course). I know others that have gone over the five year mark of BEING NED and are still go ing on with life. I have known some a few that only got less than ten bags and could not take the side effects, but still were a complete rewponder so far. Melanoma is such an individual thing (as is our bodies). Do you know what DNA mutation he has?
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- August 30, 2013 at 3:20 am
Nancy, do you know if the mass on your husband's lung is melanoma? If it is, your husband is Stage IV. There are very few treatment options available for Stage III patients. But several are available for Stage IV. And you are correct, I don't think anybody with Stage IV is treated only with IL-2 anymore.
I disagree with Jerry's implication that just because one person he knows is NED after IL-2 that means that IL-2 alone is a good bet. It's not. However, I do agree with him that IL-2 can stimulate the immune system and, inconjunction with other immunotherapies, it can be helpful. Have your doctors talked to you about Yervoy (also called "ipi")? That is a recently approved immunnotherapy for Stage IV patients. Anti-PD1 promises to be even better than Yervoy but that is still in clinical trials. Has your doctor talked to you about clinical trials? And I also second Jerry on his suggestion that your husband's tumor be tested for BRAF and c-kit mutations. Very imporant.
Now that your husband has progressed, it is doubly important for him to melanoma specialty center. The most well-known are MD Anderson, Moffitt, Mass General, and UCLA. But there are many other very good melanoma clinics in other places. Tell us where you live and we will try to point you in the right direction.
Your instincts are dead-on– there is nothing wrong with taking IL-2, but it alone is not enough. Go to a melanoma specialty clinic and at least get a second opinion.
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- August 30, 2013 at 3:20 am
Nancy, do you know if the mass on your husband's lung is melanoma? If it is, your husband is Stage IV. There are very few treatment options available for Stage III patients. But several are available for Stage IV. And you are correct, I don't think anybody with Stage IV is treated only with IL-2 anymore.
I disagree with Jerry's implication that just because one person he knows is NED after IL-2 that means that IL-2 alone is a good bet. It's not. However, I do agree with him that IL-2 can stimulate the immune system and, inconjunction with other immunotherapies, it can be helpful. Have your doctors talked to you about Yervoy (also called "ipi")? That is a recently approved immunnotherapy for Stage IV patients. Anti-PD1 promises to be even better than Yervoy but that is still in clinical trials. Has your doctor talked to you about clinical trials? And I also second Jerry on his suggestion that your husband's tumor be tested for BRAF and c-kit mutations. Very imporant.
Now that your husband has progressed, it is doubly important for him to melanoma specialty center. The most well-known are MD Anderson, Moffitt, Mass General, and UCLA. But there are many other very good melanoma clinics in other places. Tell us where you live and we will try to point you in the right direction.
Your instincts are dead-on– there is nothing wrong with taking IL-2, but it alone is not enough. Go to a melanoma specialty clinic and at least get a second opinion.
-
- August 30, 2013 at 3:20 am
Nancy, do you know if the mass on your husband's lung is melanoma? If it is, your husband is Stage IV. There are very few treatment options available for Stage III patients. But several are available for Stage IV. And you are correct, I don't think anybody with Stage IV is treated only with IL-2 anymore.
I disagree with Jerry's implication that just because one person he knows is NED after IL-2 that means that IL-2 alone is a good bet. It's not. However, I do agree with him that IL-2 can stimulate the immune system and, inconjunction with other immunotherapies, it can be helpful. Have your doctors talked to you about Yervoy (also called "ipi")? That is a recently approved immunnotherapy for Stage IV patients. Anti-PD1 promises to be even better than Yervoy but that is still in clinical trials. Has your doctor talked to you about clinical trials? And I also second Jerry on his suggestion that your husband's tumor be tested for BRAF and c-kit mutations. Very imporant.
Now that your husband has progressed, it is doubly important for him to melanoma specialty center. The most well-known are MD Anderson, Moffitt, Mass General, and UCLA. But there are many other very good melanoma clinics in other places. Tell us where you live and we will try to point you in the right direction.
Your instincts are dead-on– there is nothing wrong with taking IL-2, but it alone is not enough. Go to a melanoma specialty clinic and at least get a second opinion.
-
- August 30, 2013 at 3:37 am
POW, want a dozen names? I only personally know one of over 22 years. Yes, read the Posts and the Oncological recommended treatment regimesn and technical reports , IL-2 is often used alone. In the cases where it does not provide a complete response, then of course other treatments are tried. This certainly is true for IPI (Yervoy), BRAF, and even PD-1 treatments as well as all other options.
-
- August 30, 2013 at 3:40 am
Do a search on this board alone and you will find many that IL-2 has helped.
-
- August 30, 2013 at 3:46 am
I will agree that not many Onc's do the IL-2, this isnot because it never works alone, but because theynever learned to use it properly. It takes a highly trained Onc and staff to properly administer it.
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- August 30, 2013 at 5:07 am
Stage IV melanoma immunotherapy treatment algorithm
http://www.nature.com/nrclinonc/journal/vaop/ncurrent/fig_tab/nrclinonc.2013.153_F3.html
IL-2 can be considered in those patients who have a good PS and otherwise qualify for IL-2 administration as per local institutional guidelines.
The panel recommended that IL-2 be considered first, provided that patients have a good PS and otherwise meet local institutional guidelines for IL-2 administration. Patients who are not candidates for IL-2 therapy should consider ipilimumab.
Algorithim by:
From The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma
- Howard L. Kaufman,
- John M. Kirkwood,
- F. Stephen Hodi,
- Sanjiv Agarwala,
- Thomas Amatruda,
- Steven D. Bines,
- Joseph I. Clark,
- Brendan Curti,
- Marc S. Ernstoff,
- Thomas Gajewski,
- Rene Gonzalez,
- Laura Jane Hyde,
- David Lawson,
- Michael Lotze,
- Jose Lutzky,
- Kim Margolin,
- David F. McDermott,
- Donald Morton,
- Anna Pavlick,
- Jon M. Richards,
- William Sharfman,
- Vernon K. Sondak,
- Jeffrey Sosman,
- Susan Steel,
- Ahmad Tarhini
- et al.
- Nature Reviews Clinical Oncology
- doi:10.1038/nrclinonc.2013.153
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- August 30, 2013 at 5:24 am
Hey Jerry,
I was curious if you have heard of anyone going through IL2 with brain mets? My specialist, Dr. Minor, was considering me doing IL2 but chose Yervoy due to my brain mets, I just wondered why??
I've also heard of people who have either partially or completely responded to IL2. It's something that they still use but if your not a responder you may have to try other treatments. I believe it may still be an option for me or temodar if I can't get into a trial due to brain mets. I actually wanted to do the IL2 over the yervoy.
It is good to know if your dad has the BRAF mutation though. But he may respond very well to IL2 and not need anything else.
All my best to you and your family,
Denise
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- August 30, 2013 at 5:55 am
TRADIONALLY il-2 HAS NOT BEEN ADMINISTERED TO MELANOMA patients with brain mets. however
http://www.doctortipster.com/
17675-il-2-therapy-increases-su rvival-in-patients-with-advanc ed-melanoma.html#ixzz2btF40JF6 says: "
IL-2 therapy increases survival in patients with advanced melanoma
Researchers at Saint Louis University have made new progress against advanced melanoma, the most aggressive skin cancer. A retrospective study conducted by them showed that patients with brain metastases respond to high-dose of interleukin-2. The study, which was published in the Journal of Chemotherapy Research and Practice, showed that IL-2 treatment can prolong the overall survival of melanoma patients with brain metastases.
John Richart, MD, associate professor of internal medicine at SLU and principal investigator of the study, said that in the past IL-2 therapy was not used in patients with melanoma and brain metastases because it was considered futile. The study showed that the presence of brain metastases does not exclude the patient to receive this kind of treatment because it can actually prolong his life.
******************************************************************************
I don't know if one can find a location that will do it or not.
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- August 30, 2013 at 12:14 pm
Jerry, thank you for your responses.
My husband did two weeks of the IL2,
The side effects were brutal and during the second
Week wanted to stop after the first dose, but did
Push through and did five more….. I know he
Is BRAF negative and he is currently being tested
For the NRAS mutation– to see if he can be part of
A clinical trial?!?! All of this is so new to us and hard to digest.
I appreciate your kindness… There is hope!!!
My Best to you,
Nancy-
- August 30, 2013 at 12:14 pm
Jerry, thank you for your responses.
My husband did two weeks of the IL2,
The side effects were brutal and during the second
Week wanted to stop after the first dose, but did
Push through and did five more….. I know he
Is BRAF negative and he is currently being tested
For the NRAS mutation– to see if he can be part of
A clinical trial?!?! All of this is so new to us and hard to digest.
I appreciate your kindness… There is hope!!!
My Best to you,
Nancy -
- August 30, 2013 at 12:14 pm
Jerry, thank you for your responses.
My husband did two weeks of the IL2,
The side effects were brutal and during the second
Week wanted to stop after the first dose, but did
Push through and did five more….. I know he
Is BRAF negative and he is currently being tested
For the NRAS mutation– to see if he can be part of
A clinical trial?!?! All of this is so new to us and hard to digest.
I appreciate your kindness… There is hope!!!
My Best to you,
Nancy
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- August 30, 2013 at 1:52 pm
I have to disagree with POW (and agree with Jerry) on the IL2- it absolutely can be all you ever need. It's the oldest therapy we've got, and it's really rough (I know, I went through a full 3 rounds with it), but it's still the closest thing we've got to a cure, even with the new "miricle drugs". It only helps a small percentage of people who get it, but really, Yervoy isn't any better in that respect. Jerry's right- if you're a complete responder and can make it a couple of years (I was told 2, Jerry says 5) odds are it will never come back. Most of those people are boasting decades of being disease free- again closest thing we have to a cure, when it works.
Next best that's available currently is the Yervoy, but again only helps a relatively small percentage of people and even complete responders only average a 3-5 year remission. Decades or lifetime sure does beat the pants off of a couple years in my book, even if the side effects are easier to manage. Then come the BRAF inhibitors, which are great for those who are eligible to get them, but can stop working for some within a month, so for me they're a last resort. The new PD-1 drugs look pretty good but are to new to know what the remissions are going to be like, so right now I say go for the gold with the IL2- hopefully you'll be in the group that gets that beautiful long remission that lasts a lifetime!
Other nice "features" of IL2 include that you don't lose much time- they'll have a pretty good idea at your 6-8 week scan whether or not it's likely to work and if it isn't you can move on to something else. This is in contrast to Yervoy, where after you finish the entire course they still shrug their shoulders for a couple of months so you potentially wait 5-6 months to figure out whether or not it's working. It's good that you're doing IL2 first as doing Yervoy before IL2 can increase the likelyhood of more severe side effects.
As I said, I did a full 3 rounds of IL2 last winter. I had subQ, lung and spinal mets (which were very painful). I appeared to be a complete responder with only 3 subQ tumors left by the time I started the 3rd round. By the time I left the hospital I could feel those subQ's shrinking too. I was very excited, but sadly it wasn't meant to be for me and now I've just finished Yervoy. I will say though that none of my current tumors are leftover from before/during the IL2. ALL of the tumors I had before or during IL2 are completely gone and have not re-grown. All of my current tumors are new disease. So IL2 definitely did something, and I can't tell you how grateful I am that it got rid of the spinal mets. Unfortunately it wasn't enough for me, but it may be for your husband.
Go for it! Trust in your decision and know that there are other options should it turn out that this one isn't enough for you, but IL2 is still the most amazing therapy we've got.
Best of luck
-Eva
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- August 30, 2013 at 1:52 pm
I have to disagree with POW (and agree with Jerry) on the IL2- it absolutely can be all you ever need. It's the oldest therapy we've got, and it's really rough (I know, I went through a full 3 rounds with it), but it's still the closest thing we've got to a cure, even with the new "miricle drugs". It only helps a small percentage of people who get it, but really, Yervoy isn't any better in that respect. Jerry's right- if you're a complete responder and can make it a couple of years (I was told 2, Jerry says 5) odds are it will never come back. Most of those people are boasting decades of being disease free- again closest thing we have to a cure, when it works.
Next best that's available currently is the Yervoy, but again only helps a relatively small percentage of people and even complete responders only average a 3-5 year remission. Decades or lifetime sure does beat the pants off of a couple years in my book, even if the side effects are easier to manage. Then come the BRAF inhibitors, which are great for those who are eligible to get them, but can stop working for some within a month, so for me they're a last resort. The new PD-1 drugs look pretty good but are to new to know what the remissions are going to be like, so right now I say go for the gold with the IL2- hopefully you'll be in the group that gets that beautiful long remission that lasts a lifetime!
Other nice "features" of IL2 include that you don't lose much time- they'll have a pretty good idea at your 6-8 week scan whether or not it's likely to work and if it isn't you can move on to something else. This is in contrast to Yervoy, where after you finish the entire course they still shrug their shoulders for a couple of months so you potentially wait 5-6 months to figure out whether or not it's working. It's good that you're doing IL2 first as doing Yervoy before IL2 can increase the likelyhood of more severe side effects.
As I said, I did a full 3 rounds of IL2 last winter. I had subQ, lung and spinal mets (which were very painful). I appeared to be a complete responder with only 3 subQ tumors left by the time I started the 3rd round. By the time I left the hospital I could feel those subQ's shrinking too. I was very excited, but sadly it wasn't meant to be for me and now I've just finished Yervoy. I will say though that none of my current tumors are leftover from before/during the IL2. ALL of the tumors I had before or during IL2 are completely gone and have not re-grown. All of my current tumors are new disease. So IL2 definitely did something, and I can't tell you how grateful I am that it got rid of the spinal mets. Unfortunately it wasn't enough for me, but it may be for your husband.
Go for it! Trust in your decision and know that there are other options should it turn out that this one isn't enough for you, but IL2 is still the most amazing therapy we've got.
Best of luck
-Eva
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- August 30, 2013 at 1:52 pm
I have to disagree with POW (and agree with Jerry) on the IL2- it absolutely can be all you ever need. It's the oldest therapy we've got, and it's really rough (I know, I went through a full 3 rounds with it), but it's still the closest thing we've got to a cure, even with the new "miricle drugs". It only helps a small percentage of people who get it, but really, Yervoy isn't any better in that respect. Jerry's right- if you're a complete responder and can make it a couple of years (I was told 2, Jerry says 5) odds are it will never come back. Most of those people are boasting decades of being disease free- again closest thing we have to a cure, when it works.
Next best that's available currently is the Yervoy, but again only helps a relatively small percentage of people and even complete responders only average a 3-5 year remission. Decades or lifetime sure does beat the pants off of a couple years in my book, even if the side effects are easier to manage. Then come the BRAF inhibitors, which are great for those who are eligible to get them, but can stop working for some within a month, so for me they're a last resort. The new PD-1 drugs look pretty good but are to new to know what the remissions are going to be like, so right now I say go for the gold with the IL2- hopefully you'll be in the group that gets that beautiful long remission that lasts a lifetime!
Other nice "features" of IL2 include that you don't lose much time- they'll have a pretty good idea at your 6-8 week scan whether or not it's likely to work and if it isn't you can move on to something else. This is in contrast to Yervoy, where after you finish the entire course they still shrug their shoulders for a couple of months so you potentially wait 5-6 months to figure out whether or not it's working. It's good that you're doing IL2 first as doing Yervoy before IL2 can increase the likelyhood of more severe side effects.
As I said, I did a full 3 rounds of IL2 last winter. I had subQ, lung and spinal mets (which were very painful). I appeared to be a complete responder with only 3 subQ tumors left by the time I started the 3rd round. By the time I left the hospital I could feel those subQ's shrinking too. I was very excited, but sadly it wasn't meant to be for me and now I've just finished Yervoy. I will say though that none of my current tumors are leftover from before/during the IL2. ALL of the tumors I had before or during IL2 are completely gone and have not re-grown. All of my current tumors are new disease. So IL2 definitely did something, and I can't tell you how grateful I am that it got rid of the spinal mets. Unfortunately it wasn't enough for me, but it may be for your husband.
Go for it! Trust in your decision and know that there are other options should it turn out that this one isn't enough for you, but IL2 is still the most amazing therapy we've got.
Best of luck
-Eva
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- August 30, 2013 at 2:59 pm
Happily, as Jerry posted (above and in a separate thread) an expert panel of melanoma oncologists just this week published a consesus of treatment recommendations. They said:
1. IL-2 is not a recommended treatment for Stage III melanoma. A minority of the experts do recommend IL-2 for Stage III but only as part of a biochemo "cocktail" containing a number of other drugs, too.
2. For reasonably healthy Stage IV patients, they recommend IL-2 as the first treatment option regardless of BRAF status. If patients progress or fail to respond to the IL-2 (which is the usual case) they recommend using Yervoy as the second line treatment. This seems to support the notion that IL-2 may not do much on its own but it can potentiate the effect of other immunotherapies like Yervoy.
So I stand corrected in that IL-2 is recommended for healthy Stage IV patients (i.e., low tumor burden or those with slowly growing tumors). However, I am correct in saying that IL-2 alone is not enough. In most cases (not all) the patient should expect to go on to Yervoy or anti-PD1 or some other immunotherapy after the IL-2. You, Eva, are a good example of that sequence of events.
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- August 30, 2013 at 3:06 pm
Thank you, Eva for your response and encouraging
Words— Sept 6 Ct scan– I will post and let you know what the IL-2
did for my husband!!
Wishing you well,
Nancy-
- August 30, 2013 at 5:24 am
Hey Jerry,
I was curious if you have heard of anyone going through IL2 with brain mets? My specialist, Dr. Minor, was considering me doing IL2 but chose Yervoy due to my brain mets, I just wondered why??
I've also heard of people who have either partially or completely responded to IL2. It's something that they still use but if your not a responder you may have to try other treatments. I believe it may still be an option for me or temodar if I can't get into a trial due to brain mets. I actually wanted to do the IL2 over the yervoy.
It is good to know if your dad has the BRAF mutation though. But he may respond very well to IL2 and not need anything else.
All my best to you and your family,
Denise
-
- August 30, 2013 at 5:24 am
Hey Jerry,
I was curious if you have heard of anyone going through IL2 with brain mets? My specialist, Dr. Minor, was considering me doing IL2 but chose Yervoy due to my brain mets, I just wondered why??
I've also heard of people who have either partially or completely responded to IL2. It's something that they still use but if your not a responder you may have to try other treatments. I believe it may still be an option for me or temodar if I can't get into a trial due to brain mets. I actually wanted to do the IL2 over the yervoy.
It is good to know if your dad has the BRAF mutation though. But he may respond very well to IL2 and not need anything else.
All my best to you and your family,
Denise
-
- August 30, 2013 at 5:01 pm
POW, thank you for responding …. Our next
step is to wait for the CT scan Sept 6th to see
how he responded to the IL-2……my husband does
See a melanoma specialist…,,,we went today
And they mentioned that his LdH levels are decreasing
Which is a sign of lower tumor burden?? Does anybody
Know if that is the case?? My husband’s dr is on
Vacation and we saw his partner today and that
Is what she said…… All along his main dr said
that the only thing that will show results is the CT
Scan…. Any thoughts on this?? Who is right??
Thank you.
Wishing you well,
Nancy -
- August 30, 2013 at 5:01 pm
POW, thank you for responding …. Our next
step is to wait for the CT scan Sept 6th to see
how he responded to the IL-2……my husband does
See a melanoma specialist…,,,we went today
And they mentioned that his LdH levels are decreasing
Which is a sign of lower tumor burden?? Does anybody
Know if that is the case?? My husband’s dr is on
Vacation and we saw his partner today and that
Is what she said…… All along his main dr said
that the only thing that will show results is the CT
Scan…. Any thoughts on this?? Who is right??
Thank you.
Wishing you well,
Nancy -
- August 30, 2013 at 5:01 pm
POW, thank you for responding …. Our next
step is to wait for the CT scan Sept 6th to see
how he responded to the IL-2……my husband does
See a melanoma specialist…,,,we went today
And they mentioned that his LdH levels are decreasing
Which is a sign of lower tumor burden?? Does anybody
Know if that is the case?? My husband’s dr is on
Vacation and we saw his partner today and that
Is what she said…… All along his main dr said
that the only thing that will show results is the CT
Scan…. Any thoughts on this?? Who is right??
Thank you.
Wishing you well,
Nancy -
- September 14, 2013 at 9:03 pm
Nancy,
I am one who still believes trying HD IL-2 as the first line treatment in the proper patient should absolutely be considered. Yes, the chances of response are low and the side effects difficult – but short lived. But, the potential payoff is worth taking if the patient is one who can tolerated the treatment. I believe you basically lose nothing by trying HD IL-2 and may hit the home run. You may also, set a good foundation for whatever next treatment lies ahead. I hope the scans next week show outstanding results! Stable is good at this point.
All the best, Troy
-
- September 14, 2013 at 9:03 pm
Nancy,
I am one who still believes trying HD IL-2 as the first line treatment in the proper patient should absolutely be considered. Yes, the chances of response are low and the side effects difficult – but short lived. But, the potential payoff is worth taking if the patient is one who can tolerated the treatment. I believe you basically lose nothing by trying HD IL-2 and may hit the home run. You may also, set a good foundation for whatever next treatment lies ahead. I hope the scans next week show outstanding results! Stable is good at this point.
All the best, Troy
-
- September 14, 2013 at 9:03 pm
Nancy,
I am one who still believes trying HD IL-2 as the first line treatment in the proper patient should absolutely be considered. Yes, the chances of response are low and the side effects difficult – but short lived. But, the potential payoff is worth taking if the patient is one who can tolerated the treatment. I believe you basically lose nothing by trying HD IL-2 and may hit the home run. You may also, set a good foundation for whatever next treatment lies ahead. I hope the scans next week show outstanding results! Stable is good at this point.
All the best, Troy
-
- August 30, 2013 at 3:37 am
POW, want a dozen names? I only personally know one of over 22 years. Yes, read the Posts and the Oncological recommended treatment regimesn and technical reports , IL-2 is often used alone. In the cases where it does not provide a complete response, then of course other treatments are tried. This certainly is true for IPI (Yervoy), BRAF, and even PD-1 treatments as well as all other options.
-
- August 30, 2013 at 3:37 am
POW, want a dozen names? I only personally know one of over 22 years. Yes, read the Posts and the Oncological recommended treatment regimesn and technical reports , IL-2 is often used alone. In the cases where it does not provide a complete response, then of course other treatments are tried. This certainly is true for IPI (Yervoy), BRAF, and even PD-1 treatments as well as all other options.
-
- August 30, 2013 at 3:40 am
Do a search on this board alone and you will find many that IL-2 has helped.
-
- August 30, 2013 at 3:40 am
Do a search on this board alone and you will find many that IL-2 has helped.
-
- August 30, 2013 at 3:46 am
I will agree that not many Onc's do the IL-2, this isnot because it never works alone, but because theynever learned to use it properly. It takes a highly trained Onc and staff to properly administer it.
-
- August 30, 2013 at 3:46 am
I will agree that not many Onc's do the IL-2, this isnot because it never works alone, but because theynever learned to use it properly. It takes a highly trained Onc and staff to properly administer it.
-
- August 30, 2013 at 5:07 am
Stage IV melanoma immunotherapy treatment algorithm
http://www.nature.com/nrclinonc/journal/vaop/ncurrent/fig_tab/nrclinonc.2013.153_F3.html
IL-2 can be considered in those patients who have a good PS and otherwise qualify for IL-2 administration as per local institutional guidelines.
The panel recommended that IL-2 be considered first, provided that patients have a good PS and otherwise meet local institutional guidelines for IL-2 administration. Patients who are not candidates for IL-2 therapy should consider ipilimumab.
Algorithim by:
From The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma
- Howard L. Kaufman,
- John M. Kirkwood,
- F. Stephen Hodi,
- Sanjiv Agarwala,
- Thomas Amatruda,
- Steven D. Bines,
- Joseph I. Clark,
- Brendan Curti,
- Marc S. Ernstoff,
- Thomas Gajewski,
- Rene Gonzalez,
- Laura Jane Hyde,
- David Lawson,
- Michael Lotze,
- Jose Lutzky,
- Kim Margolin,
- David F. McDermott,
- Donald Morton,
- Anna Pavlick,
- Jon M. Richards,
- William Sharfman,
- Vernon K. Sondak,
- Jeffrey Sosman,
- Susan Steel,
- Ahmad Tarhini
- et al.
- Nature Reviews Clinical Oncology
- doi:10.1038/nrclinonc.2013.153
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- August 30, 2013 at 5:07 am
Stage IV melanoma immunotherapy treatment algorithm
http://www.nature.com/nrclinonc/journal/vaop/ncurrent/fig_tab/nrclinonc.2013.153_F3.html
IL-2 can be considered in those patients who have a good PS and otherwise qualify for IL-2 administration as per local institutional guidelines.
The panel recommended that IL-2 be considered first, provided that patients have a good PS and otherwise meet local institutional guidelines for IL-2 administration. Patients who are not candidates for IL-2 therapy should consider ipilimumab.
Algorithim by:
From The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma
- Howard L. Kaufman,
- John M. Kirkwood,
- F. Stephen Hodi,
- Sanjiv Agarwala,
- Thomas Amatruda,
- Steven D. Bines,
- Joseph I. Clark,
- Brendan Curti,
- Marc S. Ernstoff,
- Thomas Gajewski,
- Rene Gonzalez,
- Laura Jane Hyde,
- David Lawson,
- Michael Lotze,
- Jose Lutzky,
- Kim Margolin,
- David F. McDermott,
- Donald Morton,
- Anna Pavlick,
- Jon M. Richards,
- William Sharfman,
- Vernon K. Sondak,
- Jeffrey Sosman,
- Susan Steel,
- Ahmad Tarhini
- et al.
- Nature Reviews Clinical Oncology
- doi:10.1038/nrclinonc.2013.153
-
- August 30, 2013 at 5:55 am
TRADIONALLY il-2 HAS NOT BEEN ADMINISTERED TO MELANOMA patients with brain mets. however
http://www.doctortipster.com/
17675-il-2-therapy-increases-su rvival-in-patients-with-advanc ed-melanoma.html#ixzz2btF40JF6 says: "
IL-2 therapy increases survival in patients with advanced melanoma
Researchers at Saint Louis University have made new progress against advanced melanoma, the most aggressive skin cancer. A retrospective study conducted by them showed that patients with brain metastases respond to high-dose of interleukin-2. The study, which was published in the Journal of Chemotherapy Research and Practice, showed that IL-2 treatment can prolong the overall survival of melanoma patients with brain metastases.
John Richart, MD, associate professor of internal medicine at SLU and principal investigator of the study, said that in the past IL-2 therapy was not used in patients with melanoma and brain metastases because it was considered futile. The study showed that the presence of brain metastases does not exclude the patient to receive this kind of treatment because it can actually prolong his life.
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I don't know if one can find a location that will do it or not.
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- August 30, 2013 at 5:55 am
TRADIONALLY il-2 HAS NOT BEEN ADMINISTERED TO MELANOMA patients with brain mets. however
http://www.doctortipster.com/
17675-il-2-therapy-increases-su rvival-in-patients-with-advanc ed-melanoma.html#ixzz2btF40JF6 says: "
IL-2 therapy increases survival in patients with advanced melanoma
Researchers at Saint Louis University have made new progress against advanced melanoma, the most aggressive skin cancer. A retrospective study conducted by them showed that patients with brain metastases respond to high-dose of interleukin-2. The study, which was published in the Journal of Chemotherapy Research and Practice, showed that IL-2 treatment can prolong the overall survival of melanoma patients with brain metastases.
John Richart, MD, associate professor of internal medicine at SLU and principal investigator of the study, said that in the past IL-2 therapy was not used in patients with melanoma and brain metastases because it was considered futile. The study showed that the presence of brain metastases does not exclude the patient to receive this kind of treatment because it can actually prolong his life.
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I don't know if one can find a location that will do it or not.
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- August 30, 2013 at 2:59 pm
Happily, as Jerry posted (above and in a separate thread) an expert panel of melanoma oncologists just this week published a consesus of treatment recommendations. They said:
1. IL-2 is not a recommended treatment for Stage III melanoma. A minority of the experts do recommend IL-2 for Stage III but only as part of a biochemo "cocktail" containing a number of other drugs, too.
2. For reasonably healthy Stage IV patients, they recommend IL-2 as the first treatment option regardless of BRAF status. If patients progress or fail to respond to the IL-2 (which is the usual case) they recommend using Yervoy as the second line treatment. This seems to support the notion that IL-2 may not do much on its own but it can potentiate the effect of other immunotherapies like Yervoy.
So I stand corrected in that IL-2 is recommended for healthy Stage IV patients (i.e., low tumor burden or those with slowly growing tumors). However, I am correct in saying that IL-2 alone is not enough. In most cases (not all) the patient should expect to go on to Yervoy or anti-PD1 or some other immunotherapy after the IL-2. You, Eva, are a good example of that sequence of events.
-
- August 30, 2013 at 2:59 pm
Happily, as Jerry posted (above and in a separate thread) an expert panel of melanoma oncologists just this week published a consesus of treatment recommendations. They said:
1. IL-2 is not a recommended treatment for Stage III melanoma. A minority of the experts do recommend IL-2 for Stage III but only as part of a biochemo "cocktail" containing a number of other drugs, too.
2. For reasonably healthy Stage IV patients, they recommend IL-2 as the first treatment option regardless of BRAF status. If patients progress or fail to respond to the IL-2 (which is the usual case) they recommend using Yervoy as the second line treatment. This seems to support the notion that IL-2 may not do much on its own but it can potentiate the effect of other immunotherapies like Yervoy.
So I stand corrected in that IL-2 is recommended for healthy Stage IV patients (i.e., low tumor burden or those with slowly growing tumors). However, I am correct in saying that IL-2 alone is not enough. In most cases (not all) the patient should expect to go on to Yervoy or anti-PD1 or some other immunotherapy after the IL-2. You, Eva, are a good example of that sequence of events.
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Tagged: cutaneous melanoma
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