intermittent treatment of dabrafenib and tetrametinib

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jualonso
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intermittent treatment of dabrafenib and tetrametinib

Post by jualonso » Sun Jun 29, 2014 7:46 pm

Hi, im from spain and first so sorry because my english is no so good.
Im stage iv melanoma since feb 2014, im right now taking trametinib and dabrafenib, and after few months disease is under control, but i have a question.

Is someone taking these drugs intermittenly to avoid or at least delay the resistance.?
I have read that it could be usefull and also i read a post in other place someone who was taking a drug holiday 1 out 4 weeks.

Thanks so much and lets go to fu.... the melanoma

MathewR
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by MathewR » Mon Jun 30, 2014 11:11 am

I'm also on the combo (since August 2013). Several months ago, my oncologist (a melanoma specialist) raised intermittent dosing as a possibility down the road. I asked about it at my most recent appointment earlier this month. Based on discussions she had with colleagues at ASCO, she said folks generally weren't doing it (so, therefore, I'm not doing it).

Catherine Poole
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by Catherine Poole » Mon Jun 30, 2014 11:45 am

I think it is fine to lessen side effects, but I agree, probably should be kept up unless you have a recurrence. Plan B. is always useful in that instance.
Catherine M. Poole, President/Founder
Melanoma International Foundation

jualonso
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by jualonso » Mon Jun 30, 2014 2:24 pm

Thanks to all of you for your reply. :D

Did you hear about someone who stop voluntary the combo to go into inmumotherapy and after fail on it came back to combo with succes?
Im thinking to do that, because im afraid that after fail inhibitors inmunotheraphy could be less efective.
I read a lot about that and is very scary. ...

MathewR
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by MathewR » Mon Jun 30, 2014 4:29 pm

Yes, I did a form of what you describe--I worked in ipi earlier this year (stopped after 3 infusions due to moderate, but persistent colitis).

jualonso
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by jualonso » Mon Jun 30, 2014 4:58 pm

Hi MathewR
Did you stop because an advice of your doc?
And what was the reason? How was your evolution whit tumors during the period of ipi?
And now when you returned, is working again the combo?
:) im very sorry for all these questions but you are very close to my position
I have tumors in lung and axile
In the case i stop i would go directly to pembro
Thanks a lot for your answers

MathewR
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by MathewR » Mon Jun 30, 2014 5:37 pm

Jualonso, I'll email you offline, but the long and the short of it is that I raised the issue with my doctor and I am uncertain as to whether I am an ipi responder. From your prior post, it appears that you'd prefer to move from the combo to Merck's PD-1. From what I've read, you're required to have failed ipi as a condition to eligibility for Merck's EAP.

Gilly
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by Gilly » Tue Jul 01, 2014 3:19 pm

Jualonso - we are in France - officially you need to fail Ipi to get the Merck anti pD1 - the EMA will be deciding at the end of the year on whether it can be a treatment line - my husband is just failing zelboraf/Vem and we were hoping to avoid Ipi and go straight onto the anti Pd1 - but it looks unlikely - my husband was stage 3c in the axilla too - and now has chest mets and new in transit sub cutaneous mets - where are you treated ?

jualonso
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by jualonso » Tue Jul 01, 2014 6:34 pm

Hi Gilly,
In Spain is now in compassionate use and in second line, after ipi OR after braf inh. But honestly i dont know situation in France. Here your husband could go directly to pd1.
Im now whith a normal oncologist in Elche(Alicante) but thinking on the next future going to hospital universitario de valencia where there is an especialist doc Berrocal i heard is very good.

Keep going strong

Gilly
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Re: intermittent treatment of dabrafenib and tetrametinib

Post by Gilly » Wed Jul 02, 2014 4:11 am

that is interesting, Jualonso, because - in France with the expanded access the failure of a Braf is not necessary (if you have the Braf mutation) but Ipi is still first line - I might push the specialist a bit - I think it is always best to be at a specialist centre for Melanoma especially if you have one fairly close.
All the best

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