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Peginterferon recommended? 4+mm/ulcerated primary. Micrometastasis in SN. I’m surprised.
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Peginterferon recommended? 4+mm/ulcerated primary. Micrometastasis in SN. I’m surprised.

› Forums › General Melanoma Community › Peginterferon recommended? 4+mm/ulcerated primary. Micrometastasis in SN. I’m surprised.

  • Post
    • December 13, 2017 at 8:16 pm
    Jimchief
    Participant

      Hoping Celeste or some others who have been down the path can give me guidance.

      First melanoma. 8 mm primary with ulceration in L thigh. WLE done October 3rd. Due to infections/complications, haven't started any adjuvant treatment. 

      SLNB shows only two individual cells. So it's like a submicrometastasis. So I'm either Stage 3A or 2C depending on whether or not you believe you can be "a little bit pregnant" with a tiny metastasis in sentinel node. (Luckily no other mets on Brain MRI and first PET scan.)

      Currently at MD Anderson for 2nd opinion. Doc at home (melanoma specialist at CI-certified hospital) had originally talked about various immunotherapy options but ended up recommending "watch and wait."

      Medical oncologist yesterday at MDA threw me for a loop saying she would recommend pegylated interferon. Self-injected for a year.

      I was just sure that everyone thought any interferon was off the table. She said that the key for me was ulceration. She said that peginterferon is the only treatment with data showing an effect on those who had a thick primary tumor that was ulcerated.

      I'm curious if anyone else has had this recommended in the last couple of years.

      Thanks for any help/advice. Researching hard but everything seems to be based back in the "olden days" (i.e., more than five years ago) when all the new options were not available yet.

      For those who have been down the path, what are the side effects and for what percentage of folks?

      You guys rock!

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    • Replies
        • December 13, 2017 at 8:27 pm
        SABKLYN
        Participant

          Hi Jim,

          Maybe it is the fact that it's ulcerated, but I, like yourself thought interferon to be an outdated adjuvant treatment modality.  One of the more expert board members I'm sure will offer their own opinion.  Good luck with the decision!!

          Stan

          • December 13, 2017 at 8:54 pm
          Janner
          Participant

            If you look at some of the trial info for interferon, ulcerated primaries were really the only who had ANY benefit.  However, I don't remember it being peg intron.  However, I still don't think the benefit was that great.  I would be looking to compare that data with Yervoy and ulcerated primaries for adjuvant.  Yervoy, I believe, still boasts higher %s that Interferon for ulcerated primaries but not sure if that characteristic was broken out in clinical trials.  I'd definitely research that.

            • December 13, 2017 at 9:04 pm
            Bubbles
            Participant

              The advice you were given contains one small nugget of truth.  In the zillions of studies that now clearly demonstrate that interferon provides NO clinically significant benefit in melanoma…the only subgroup who showed an improvement of any sort was those with ulcerated lesions.  HOWEVER!!!!!!!!!!!!!!!!!! – this response was NOT as good as that which can be obtained with ANY of the targeted or immunotherapy drugs currently recommended for folks with melanoma.   

              Here are about a zillion interferon related posts:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=interferon  

              Here is a post that reviews melanoma treatments:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melanoma-intel-primer-for-current.html  

              Hope this helps.  Melanoma is not easy.  Not only must we fight for our lives…we have to fight for access to appropriate care.  (One in the same, I guess  – but the last seems incredibly unnecessary!!!)  I wish you well.  Celeste

              • December 14, 2017 at 1:48 am
              ed williams
              Participant

                Hi JimChief, as always the links that Celeste has to her blog and recent studies are great, I would just like to add that any Oncologist still advocating for this shit (Drug) Interferon to be used for some one in the adjuvant setting after the approval of Ipi and the data from last summer on Nivo vs Ipi see link below should really have there medical ethics questioned.http://www.nejm.org/doi/full/10.1056/NEJMoa1709030 

                • December 14, 2017 at 2:41 am
                Joycem
                Participant

                  Hi Jim, 

                  I had a very thick primary with ulceration in July of 2016. Very alarming. SNB was clear, (2C)  and my onc. recommended interferon. I declined partly due to dubious effectiveness, and partly due to anticipation of side effects interfering with caring for parents w end stage Alzheimer’s, and teenage and college age kids. I am on watch and wait, so far so good. 

                  I feel like if it recurs/spreads (likely) the options for treatment are getting better all the time. For now I do what I can to reduce stress, eat healthy, exercise to keep my immune system in best shape possible. 

                  Best wishes to you, for healing and health. 

                  • December 14, 2017 at 3:26 am
                  Brian j
                  Participant

                    I think this board is invaluable for sharing experiences, but I think it a little dangerous making medical recommendations without a license. There is a lot of information on the Web, scientific as well as charlatan, current as well as dated. We're all passionate in our battle with this monster. It seems though that we should all take caution when making recommendations and leave the decision making process between patient and qualified health professionals. 

                     

                      • December 14, 2017 at 3:38 am
                      jennunicorn
                      Participant

                        We only base our opinion on the same medical data that the doctors are looking at. Being an informed patient is key in this game. Thankfully we have awesome people like Celeste and Ed to give us the links and break down the data for us to better understand. We only want to help give information to take to appointments to discuss with the professionals. Having been a clueless patient and had that bite me in the butt, I think it is always a good idea to take in all the info we can to be prepared at appointments for these big life changing decisions.

                        • December 19, 2017 at 4:10 pm
                        Cooper
                        Participant

                          Only go to the sites that have the HonCode designation.  You will know that they are trustworthy for scientific valid info.  NCI, ACS, and Mayo clinic are good examples. Also melanomainternational.org

                          Honcode is a non profit international agency that provides safety on the web for medical information

                          • December 19, 2017 at 4:27 pm
                          ed williams
                          Participant

                            Sounds like you are in sales buddy, sorry I mean "Anon", for one or both of those organizations!!!!

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