someone who has gone from Braf/Mek to inmunotherapy (before resistance)and back to braf/Mek succesfully?
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someone who has gone from Braf/Mek to inmunotherapy (before resistance)and back to braf/Mek succesfully?

› Forums › General Melanoma Community › someone who has gone from Braf/Mek to inmunotherapy (before resistance)and back to braf/Mek succesfully?

  • Post
    • July 15, 2014 at 4:16 pm
    jualonso
    Participant

      As i said in the post, i would like to know tbe people who decide to stop the combo before the resistance appear and go through inmunotheraphy to check in the case thag it did not work came back to combo and it continued working.

      Thanks for your answers

    Viewing 5 reply threads
    • Replies
        • July 16, 2014 at 1:02 am
        dhrahn
        Participant

          My husband started on zelboraf alone.  It worked for about 9 months and then things started growing again… Then went to yervoy (didn't work), trial includeing interlleuikin (didn't work), he was on eap PD1 only 2 infusions and had an "explosion" of tumors metastising to liver, spleen, spine all over really.  We have 2 oncologists, one doesn't think he was on PD1 long enough to know if it was working or wasn't working.  But at the time he was hospitalized for failing kidney, dehydration, pain and contipation they put him on steroids and decided to restart zelboraf and add mek hoping that his body had "forgotten" about the Z.  He has been on it about 2 weeks and things already are shrinking again….  They don't think it will work as long as it did last time but it's working for now… Once it quits working, hopefully PD1 will be FDA approved and we can try that route again….    So to answer your question, it is working after coming back to it for now…. 

          • July 16, 2014 at 1:02 am
          dhrahn
          Participant

            My husband started on zelboraf alone.  It worked for about 9 months and then things started growing again… Then went to yervoy (didn't work), trial includeing interlleuikin (didn't work), he was on eap PD1 only 2 infusions and had an "explosion" of tumors metastising to liver, spleen, spine all over really.  We have 2 oncologists, one doesn't think he was on PD1 long enough to know if it was working or wasn't working.  But at the time he was hospitalized for failing kidney, dehydration, pain and contipation they put him on steroids and decided to restart zelboraf and add mek hoping that his body had "forgotten" about the Z.  He has been on it about 2 weeks and things already are shrinking again….  They don't think it will work as long as it did last time but it's working for now… Once it quits working, hopefully PD1 will be FDA approved and we can try that route again….    So to answer your question, it is working after coming back to it for now…. 

              • July 17, 2014 at 11:12 am
              jualonso
              Participant

                Thanks for your reply.

                And good luck with the fight

                • July 17, 2014 at 11:12 am
                jualonso
                Participant

                  Thanks for your reply.

                  And good luck with the fight

                  • July 17, 2014 at 11:12 am
                  jualonso
                  Participant

                    Thanks for your reply.

                    And good luck with the fight

                  • July 16, 2014 at 1:02 am
                  dhrahn
                  Participant

                    My husband started on zelboraf alone.  It worked for about 9 months and then things started growing again… Then went to yervoy (didn't work), trial includeing interlleuikin (didn't work), he was on eap PD1 only 2 infusions and had an "explosion" of tumors metastising to liver, spleen, spine all over really.  We have 2 oncologists, one doesn't think he was on PD1 long enough to know if it was working or wasn't working.  But at the time he was hospitalized for failing kidney, dehydration, pain and contipation they put him on steroids and decided to restart zelboraf and add mek hoping that his body had "forgotten" about the Z.  He has been on it about 2 weeks and things already are shrinking again….  They don't think it will work as long as it did last time but it's working for now… Once it quits working, hopefully PD1 will be FDA approved and we can try that route again….    So to answer your question, it is working after coming back to it for now…. 

                    • July 18, 2014 at 6:23 am
                    JerryfromFauq
                    Participant

                      There are also reports that starting and stopping and restarting Zelboraf intermittently will restart and even make Zelboraf work longer.

                       

                      • July 18, 2014 at 6:23 am
                      JerryfromFauq
                      Participant

                        There are also reports that starting and stopping and restarting Zelboraf intermittently will restart and even make Zelboraf work longer.

                         

                        • July 18, 2014 at 6:23 am
                        JerryfromFauq
                        Participant

                          There are also reports that starting and stopping and restarting Zelboraf intermittently will restart and even make Zelboraf work longer.

                           

                            • July 18, 2014 at 8:39 am
                            rick1981
                            Participant

                              I discussed this with our doctor in Belgium (he attended ASCO) and he was hesitent to do this. "Why change if it works?" and research that Catherine Poole highlighted, show this can be 24 months. When I replied that it may take 8-12 weeks for immuno to kick in and therefore it gives the melanoma time to grow again (after the body become resistent to BRAF/MEK) he agreed Nivo could indeed be a good option to switch to… BUT:

                              – Nivo hasn't been approved yet. I mentioned Japan, the EAP and the FDA approval request in the US, but he says he expects that the European EMA (FDA equivalent) will take longer (and no request has been made yet) and after that every single European country still needs to approve it. So could be long…

                              – If you switch to immuno in Belgium, the insurance company won't pay for your Trametinib anymore…

                              So guess we have to hope for Merck's PD1 or a quicker-than-expected Nivo approval in Europe.

                              • July 18, 2014 at 8:39 am
                              rick1981
                              Participant

                                I discussed this with our doctor in Belgium (he attended ASCO) and he was hesitent to do this. "Why change if it works?" and research that Catherine Poole highlighted, show this can be 24 months. When I replied that it may take 8-12 weeks for immuno to kick in and therefore it gives the melanoma time to grow again (after the body become resistent to BRAF/MEK) he agreed Nivo could indeed be a good option to switch to… BUT:

                                – Nivo hasn't been approved yet. I mentioned Japan, the EAP and the FDA approval request in the US, but he says he expects that the European EMA (FDA equivalent) will take longer (and no request has been made yet) and after that every single European country still needs to approve it. So could be long…

                                – If you switch to immuno in Belgium, the insurance company won't pay for your Trametinib anymore…

                                So guess we have to hope for Merck's PD1 or a quicker-than-expected Nivo approval in Europe.

                                • July 18, 2014 at 8:39 am
                                rick1981
                                Participant

                                  I discussed this with our doctor in Belgium (he attended ASCO) and he was hesitent to do this. "Why change if it works?" and research that Catherine Poole highlighted, show this can be 24 months. When I replied that it may take 8-12 weeks for immuno to kick in and therefore it gives the melanoma time to grow again (after the body become resistent to BRAF/MEK) he agreed Nivo could indeed be a good option to switch to… BUT:

                                  – Nivo hasn't been approved yet. I mentioned Japan, the EAP and the FDA approval request in the US, but he says he expects that the European EMA (FDA equivalent) will take longer (and no request has been made yet) and after that every single European country still needs to approve it. So could be long…

                                  – If you switch to immuno in Belgium, the insurance company won't pay for your Trametinib anymore…

                                  So guess we have to hope for Merck's PD1 or a quicker-than-expected Nivo approval in Europe.

                                  • July 19, 2014 at 12:05 am
                                  jualonso
                                  Participant

                                    Hi Rick,

                                    My doc say the the same as your but i know for other patients that for example in Sloan kettering center in New York the put patients on braf mek just to get the best respose and switch to inmunotherapy. Also Dc. Sznol do the same. For me seems very clear and very logic. If you are NED with inhibitors and you take them till resistance, you wont be able to use anymore. Otherwise if you switch to inmunotherapy (during this time tumors are growing) and it does not work you can go back to braf mek to make the tumors shrink again. On this way you have chance to try another drug as soon as you reduce tumors again to a good level.

                                    In Spain pembrolizumab is in compassionate use aprobed. You have to fail Or ipi or braf.

                                     

                                    Good luck to you and to everyone

                                    • July 19, 2014 at 12:05 am
                                    jualonso
                                    Participant

                                      Hi Rick,

                                      My doc say the the same as your but i know for other patients that for example in Sloan kettering center in New York the put patients on braf mek just to get the best respose and switch to inmunotherapy. Also Dc. Sznol do the same. For me seems very clear and very logic. If you are NED with inhibitors and you take them till resistance, you wont be able to use anymore. Otherwise if you switch to inmunotherapy (during this time tumors are growing) and it does not work you can go back to braf mek to make the tumors shrink again. On this way you have chance to try another drug as soon as you reduce tumors again to a good level.

                                      In Spain pembrolizumab is in compassionate use aprobed. You have to fail Or ipi or braf.

                                       

                                      Good luck to you and to everyone

                                      • July 19, 2014 at 12:05 am
                                      jualonso
                                      Participant

                                        Hi Rick,

                                        My doc say the the same as your but i know for other patients that for example in Sloan kettering center in New York the put patients on braf mek just to get the best respose and switch to inmunotherapy. Also Dc. Sznol do the same. For me seems very clear and very logic. If you are NED with inhibitors and you take them till resistance, you wont be able to use anymore. Otherwise if you switch to inmunotherapy (during this time tumors are growing) and it does not work you can go back to braf mek to make the tumors shrink again. On this way you have chance to try another drug as soon as you reduce tumors again to a good level.

                                        In Spain pembrolizumab is in compassionate use aprobed. You have to fail Or ipi or braf.

                                         

                                        Good luck to you and to everyone

                                  Viewing 5 reply threads
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