Brain mets

[shonnat]

Just hoping that maybe there are some suggestions out there we haven’t tried or some experience that can help us.

My husband was diagnosed with 3 brain tumors he took Zeloboraf but he was a non responder. Had WBR and then stereotactic surgery to the one large tunor that was causing symptoms but the edema caused problems afterwards.

Now 7 months later all three tumors have grown a little and he has 10 small new ones.

He is on Temodar now, started last month. Ipi is on the back burner because of of his high steroid use since the tumors grew as they work against immuntherapy. Are there any clinical trials that include brain mets? Advice/suggestions am desperate.

Anne

[Catherine Poole]

Temodar really hasn’t been proven effective, but a small study did show dabrafenib as having brain activity. Here is a list of trials, and the first one is with dabra (another braf agent)

http://clinicaltrials.gov/ct2/results?term=melanoma+brain+mets&Search=Search

[shonnat]

I know that Temodar has a low response rate but our medical oncoligist said some of her patients had a good response to it – so its worth a try.

Dabrafenib is a good idea, if it is different to Zelboraf – its worth trying anything as Melonoma is unpredicatable.

Thanks for the suggestion.

[kylez]

Just saw Dr. Jeffery Weber talk here in SF last weekend. About the BRAF inhibitors, he said he would always prescribe the BRAF/MEK combo now rather than BRAF alone. He said the combo (e.g. newly approved dabrafenib/trametinib combo) usually combats resistance better, and best if the combo is right from the rather than starting with a single agent… he said if he were a patient, that’s what he would do FWIW…

Fingers crossed for a good treatment for your husband.

-Kyle

[shonnat]

Thanks Kyle for your input. I hope we can find something to keep the mets at bay.

I’ll be asking his oncologist again about the combo – she doesn’t think it will work as the Zelboraf he took didn’t. But as its not exactly the same drug, I think one needs to try anything different!

[Catherine Poole]

There are different BRAF/Mek combos, but the GSK did have a small sample showing some brain met activity. There is also (in trial) the Novartis combo that is looking very promising. I know many docs are switching their Zel patients to the combo. The MEK does an additional job!

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