Bubbles:
There are very few studies that actually show that steroids while on immunotherapy diminish response. In fact, most studies conclude that folks on steroids can attain and maintain good responses while on immunotherapy AND steroids. Further, apart from brain met folks with the necessity for steroids – immunotherapy itself can cause side effects that necessitate steroids in order to deal with them. SO….if you were to stop taking immunotherapy you will have the absolute KNOWN side effect from melanoma (and it ain’t good) or you can deal with side effects as you must with steroids and studies show that those patients still survive melanoma!!! In a perfect world, might it be best to take immunotherapy with NO steroids? Sure. But we melanoma peeps deal with what we must. And sometimes, steroids are a must. And the data shows, we can STILL gain and maintain a response to immunotherapy while on steroids. Here are a zillion articles looking at all of that: Steroids and immunotherapy
Yes. There are those in data (and folks I know in real life) who responded well to immunotherapy. Stopped. But, later due to progression needed treatment and repeated ipi/nivo or nivo or pembro alone again and gained a good response. A lot of the data indicates that immunotherapy naïve patients gain the greatest response, but it is clear that patients taking another round (or 2) can gain a response as well. Articles – Immunotherapy after progression
Hope that helps. The search bubble can be helpful. Let me know if you have other questions. Hopefully other peeps will comment in the coming week. Yours, c
