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Eosinophilic gastroenteritis
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Eosinophilic gastroenteritis

› Forums › General Melanoma Community › Eosinophilic gastroenteritis

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    • July 13, 2017 at 2:48 am
    oocn
    Participant

      Hello everyone,

      Would be interested to see if anyone else has had a similar experience with pd-1 mono therapy. 

      Right now I am stage 3b, completion lymph node dissection of the neck. (1 year cancer free, thank goodness). 

      Currently enrolled in SWOG 1404 and randomized to pembro, recieving it every 3 weeks for a year in the adjuvant setting.

      About 5 months into the trial I started to experience abdominal pains after eating certain meals, but not others. I thought it was isolated to dairy or cheese perhaps (I think it may be partially, as both will knock me out of commission if I over indulge). However, it will also hit at other random meal times and is relatively inexplicable. A salad with corn on it the other night really did it as well. Generally it is nausea/stomach pain and cramping followed by a real need to lie down and certainly a bit of gas.

      The secondary piece to this puzzle is that my eosinophils have been really spiked by the pembro-I'm currently 35% over baseline. 

      Has anyone else ever heard of or put together this corrolation, or am I just crazy? Simethicone (Gas X) seems to generally do the trick, so we are continuing infusions. Just wondering if its one of those "itis" side effects….

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        • July 13, 2017 at 2:37 pm
        cancersnewnormal
        Participant

          My eso counts have gone up and down on blood labs, sometimes inexplicably. Without additional "evidence", my docs are pretty quick to dismiss them. However… your symptoms sound like what happened to me before my routine follow up CT showed a developing case of pancreatitis. Thankfully, we nipped things in the bud, and I escaped a full blown pancreatic attack. Keytruda (any immunotherapy really) can cause this as an autoimmune response. Discuss the issue with your docs and see if they can do some further blood labs to narrow down the cause. Checking for elevated amylase and lipase will rule out or confirm whether it is your pancreas. If it isn't pancreatitis, the intestines could definitely be getting "worked over" by the Keytruda as well. 

            • July 15, 2017 at 12:47 am
            oocn
            Participant

              Thanks for that response Niki and for sharing your story. I had a CT scan relatively recently and because these symtpoms have been going on for nearly two scan cycles my team seems to think it is not pancreatitis. I have asked them to test for it as you suggested in my next labs. I also understand that actue pancreatitis can look relatively 'normal' on scans early on, one other element of this is that the pain only last for 2 hours at the most.

              It could be as you said, the Keytruda is really 'working over' my stomach/intestines.

               

              Thanks for your notes, have a great weekend!

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