Isolated Limb Infusion

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Isolated Limb Infusion

Postby PWood » Mon Aug 28, 2017 4:42 am

Hello to you all! My sister has Stage IIIC melanoma (BRAF Wild Type, NRAS Q61 mutant) and is being treated at a cancer-specific hospital in Melbourne, Australia. It is thought (after 12 months) to be still confined to her ankle and foot (lymph and pelvic nodes were removed and one positive was found in each area) although she is due for another PET scan to confirm this. She was treated with surgery, 4 rounds of Keytruda (which did not work) and has completed two cycles of IPI/NIVO. She was hospitalised with serious side effects just prior to her scheduled third cycle. Her oncologists have said she will not tolerate further cycles of IPI or NIVO. They are now now considering radiation, and ILI (subject to consideration by a surgical team) - and looking at trials.

Has anyone had ILI? I would appreciate hearing of your experience and the outcome. Thank you and best wishes to you all.
PWood
 
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Re: Isolated Limb Infusion

Postby jennunicorn » Tue Aug 29, 2017 12:29 am

Here in the US it is not uncommon for patients to be unable to do all 4 Ipi/Nivo combo infusions. Ipi is the mean drug in the combo as it causes the most of the major side effects of any of the immunotherapy drugs. If a big side effect comes up that needs medical attention early on in the treatment, generally they stop infusions, treat the side effect(s) and then try to continue on with Nivo alone maintenance doses once the patient is feeling better and lab results are in normal range. My 4th dose of Ipi/Nivo left me sick with a fever, high liver enzymes, enlarged spleen, and overall not well for 3 weeks, basically my entire birthday month, it was one way to turn 30, hah! Once I was able to get through the fevers and liver numbers went back to normal and was feeling better I was able to start Nivo only infusions and have not had any major side effects since, plus, as of last scan, the stubborn tumor that would not shrink FINALLY shrunk down. Sometimes these drugs take some time to kick in and we have to be patient with them. If I were your sister I would be asking my oncologist about trying Nivo only infusions (No more Ipi) and seeing how that goes. I don't know anything about ILI so I can't comment on that, I am not sure how frequently that is performed anymore.

Wishing the best for your sister.
jennunicorn
 
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Re: Isolated Limb Infusion

Postby Catherine Poole » Tue Aug 29, 2017 11:06 am

There are issues with isolated limb infusion since it doesn't take care of any other mets but those locally affected. I think most have changed to isolated perfusion, a bit different. But these are very taxing and require general anesthesia. PD1 alone might be an option to try with far less toxicity. Let us know how things are going.
Catherine M. Poole, President/Founder
Melanoma International Foundation
Catherine Poole
 
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Re: Isolated Limb Infusion

Postby Catherine Poole » Tue Aug 29, 2017 11:06 am

There are issues with isolated limb infusion since it doesn't take care of any other mets but those locally affected. I think most have changed to isolated perfusion, a bit different. But these are very taxing and require general anesthesia. PD1 alone might be an option to try with far less toxicity. Let us know how things are going.
Catherine M. Poole, President/Founder
Melanoma International Foundation
Catherine Poole
 
Posts: 10775
Joined: Wed Jan 02, 2008 12:09 am


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