What comes after Keytruda?

This moderated forum is to support the needs of patients with stage III melanoma, as well as to answer questions about treatment options and what to expect.

What comes after Keytruda?

Postby PWood » Sat Jun 17, 2017 7:44 pm

Hello to you all. I am new to the site. I am seeking some information for my sister who has unresectable Melanoma Stage 111B in her left leg and foot. She has had four infusions of Keytruda and is due for a scan next week. If Keytruda is not working, she will possibly go on to another form of immunotherapy. We suspect it is not working as numerous new melanomas have grown on her leg since she started Keytruda.

Has anyone had a similar experience of moving from Keytruda to another form of immunotherapy? And, has anyone had isolated limb perfusion?

We would very much appreciate your advice. Thank you, Patricia.
PWood
 
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Re: What comes after Keytruda?

Postby Catherine Poole » Sun Jun 18, 2017 9:18 am

Your sister is certainly fortunate to have you looking out for her. So where did her melanoma start? I wonder about the staging because if she has lesions (in transit types) that might be stage 4 and few patients are able to get Keytruda for stage IIIb. Anyway, isolated limb perfusion isn't well proven because it doesn't take care of the satellites that may be floating elsewhere in the body. So a recurrence is likely. It is also a very serious procedure with full anesthesia etc. What BRAF type is she? Do you have her original pathology report? That might help. Where are you going for therapy? I hope we can help you further hang in there.
Catherine M. Poole, President/Founder
Melanoma International Foundation
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Re: What comes after Keytruda?

Postby PWood » Tue Jun 20, 2017 10:31 pm

Thank you so much Catherine. My sister is BRAF Wild Type, NRAS Q61 mutant. The first melanoma was found on her ankle in August 2016 (Stage 1B). It was surgically removed. In September, she had groin lymph nodes removed (2/17 positive) and pelvic lymph nodes (1/12 positive). Another melanoma on the same ankle was surgically removed in Jan 2017. More melanomas appeared on foot and ankle in Feb. As surgery was not possible, she commenced Keytruda in March. We live in Australia - since late 2016 Keytruda has been available free of charge for people with unresectable melanoma. She is Stage 111C and was eligible.
PWood
 
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Joined: Sat Jun 17, 2017 7:33 pm

Re: What comes after Keytruda?

Postby Catherine Poole » Sat Jun 24, 2017 6:40 am

Keytruda is one of the most effective therapies we have right now. Do you know if she was tested for NRAS? The subcutaneous mets are often difficult to get rid of with surgery being optimal.
Catherine M. Poole, President/Founder
Melanoma International Foundation
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Posts: 10775
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Re: What comes after Keytruda?

Postby Catherine Poole » Sat Jun 24, 2017 6:43 am

Another thought, although maybe not approved in Australia is TVEC with Keytruda. Here is some further info on that: http://www.medscape.com/viewarticle/845504
Catherine M. Poole, President/Founder
Melanoma International Foundation
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Posts: 10775
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