Home Forums Melanoma Diagnosis: Stage IV Anti PD 1 didn’t work, starting chemo. Any good results?

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  • #21128
    Gabsound
    Participant

    Hi,

    I did 4 doses of Anti PD1. I had mets to bones and liver. During treatment found a subcutaneous tumor on my back that was clearly growing. Had .12 week scans post treatment and it shows further progression. Lesions in liver are larger, node in mediastinum, multiple enlarged lymph nodes in the region near the pancreas, lung tumor, large soft tissue tumor in left bicep and left thigh. Subcutaneous tumor on back even larger, plus another small one starting.

    Disappointing to say the least. I’m to start Abraxane, Avastin and Carboplatin today. Anyone done this regimen. My Oncologist said this may be more effective post PD1.

    I’ve previously done 1 month high dose interferon, biochemo, 2 rounds of Yervoy and Anti PD1. My onc is also waiting for MEK inhibitors to be approved. I was offered 2 phase 1 trials at Angeles clinic. One injects directly into palpable tumors and the second is attached to a virus. Both require about 40 visits to the clinic. I travel between Las Vegas and LA and am worn out from just going every 3 weeks for the PD1 treatments.

    I also just lost my sister to breast cancer 1 week ago.

    Any info on this treatment would be appreciated I.e. Side effects, treatment success (did it knock the disease down).

    Julie in Las Vegas

    #59777
    Gabsound
    Participant

    I should also mention I”m BRAF negative, I have the NRAS mutation.

    Julie

    #59778
    cyndikabza
    Participant

    Julie my sister Susan is BRAF negative as well. She just met a new oncologist yesterday and I can’t wait to talk to her about treatments. Please keep us posted here on you progress. Hopefully someone who has done the trial you are starting will see this and be able to give you feedback. I’m sorry about your sister. I can’t imagine losing mine 😥

    #59779
    Catherine Poole
    Keymaster

    If you are NRAS positive you may be able to get the MEK drug. The companies of GSK and Novartis have them and others are coming out. It is an oral drug and the GSK should be approved shortly so you don’t need a trial. Novartis is opening a trial in April but not sure it would include BRAf negative folks. The chemo can work for some but I would keep looking to clinical trials and newer therapies and enlist your doctor too!

    #59780
    kylez
    Participant

    Hi Julie,

    I’m BRAF- also and have an NRAS mutation (G12A). Apparently there’s multiple G12*, G13* and Q61* possible mutations in NRAS. I get the impression they currently may be all lumped together as “NRAS” but I don’t know for certain.

    From Catherine, and other web sites, some trials that look to be accepting NRAS positive, BRAF-/+ melanoma patients and are currently or soon to be enrolling are:

  • http://clinicaltrials.gov/ct2/show/NCT01781572” class=”bbcode_url”>http://clinicaltrials.gov/ct2/show/NCT01781572 A Phase Ib/II Study of LEE011 in Combination With MEK162 in Patients With NRAS Mutant Melanoma (the one Catherine mentioned!)

  • http://clinicaltrials.gov/ct2/show/NCT01320085” class=”bbcode_url”>http://clinicaltrials.gov/ct2/show/NCT01320085 A Phase II Study of Single Agent MEK162 in Patients With Advanced Melanoma
  • http://clinicaltrials.gov/ct2/show/NCT01763164” class=”bbcode_url”>http://clinicaltrials.gov/ct2/show/NCT01763164 Phase 3 Study Comparing the Efficacy of MEK162 Versus Dacarbazine in Unresectable or Metastatic NRAS Mutation-positive Melanoma (NEMO)
  • http://clinicaltrials.gov/ct2/show/NCT00866177” class=”bbcode_url”>http://clinicaltrials.gov/ct2/show/NCT00866177 Phase 2 MEK Inhibitor AZD6244 in Treating Patients With Stage III or Stage IV Melanoma
  • http://clinicaltrials.gov/ct2/show/NCT01363232” class=”bbcode_url”>http://clinicaltrials.gov/ct2/show/NCT01363232 Phase I Safety, Pharmacokinetics and Pharmacodynamics of BKM120 Plus MEK162 in Selected Advanced Solid Tumor Patients
  • http://clinicaltrials.gov/ct2/show/NCT01529593” class=”bbcode_url”>http://clinicaltrials.gov/ct2/show/NCT01529593 Phase I Temsirolimus in Combination With Metformin in Patients With Advanced Cancers
  • There might be a few more. I don’t know how promising each of these are. Maybe the combination therapy trials are the most interesting? I hope you and your doctors find a promising treatment option for you, and that’s suitable for your geographic/transportation situation as well which is important. Best wishes,

    -Kyle

#59781
Gabsound
Participant

Thanks for your replies. I’m a bit overwhelmed with my sisters death and I did start the chemo today.

I will look into these trials.

Thank you,

Julie

#59782
Catherine Poole
Keymaster

Julie,

Sounds like you have a great burden to bear right now. Can someone help you with the research? I also wonder if you can’t get another opinion. Chemo is probably fine for now until you find the next treatment. The options for Braf neg. are limited to immunotherapies such as Yervoy and PD1. Let us know what you are up to doing and whether we can help you.

PS A reinduction of Yervoy might be an option too since you didn’t do the full 4 infusions prior. There is some synergy between PD1 and Yervoy seen in trials. You could do the Yervoy close to home too.

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