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December 22, 2012 at 5:31 pm #20867patiParticipant
I wanted to write a little note to update everyone, I am now officially not on the anti-PD1 trial and have started re-induction with zelboraf. I hope to have access to the combination with MEKi one way or another (this part is not yet clear).
So in the last year or so I wanted to shared what I have learnt about re-inducing with braf inhibitor even after you have progressed with zelboraf…
It actually seems to have some activity (this can buy you time, a bridge, a slow down, or however it may work on your path)
1) my oncologist published 2 cases of when it works again, – including Quentin’s case – published and lots of anecdotical reports from docs who are doing this with their patients on and off again, Keith Flaherty also has presented some data using the combination dabra/mek from GSK on people who progressed on zelboraf/dabra alone and a decent number of patients get some benefit “again”, for those interested I keep the slides of that presentation
2) it does not a 100% mean the second time around the response will be shorter! though that is what seems to happen most often… but my oncologist has a patient who had zelboraf after 3 months she progressed, then off and then on again she got 9 months, she then progressed she then went to Weber (she had a brain met so could not start another trial there) back onto zelboraf and is responding again! For those interested the cases are published on melanoma research
3) there seems to be lots of excitement around a paper in press and accepted on nature (mouse model) using zelboraf on and off to avoid resistance – now for those of us who have had zelboraf continuously then progressed this is not relevant but seems promising for how zelboraf and dabra and other BRAFi like novartis one will be used in the future. For those interested I have the poster on which the paper is based.
So I am curious how many of you have gone the “Quentin’s” way of re induction, I did take zelboraf after I progressed again but only for 10 days before I started anti-PD1 wash off and the tumors went down again so I am hoping to see this again this time…
Share here so that we know how many of us are already doing this,
PatiDecember 23, 2012 at 9:04 am #58120GillyParticipant
Thanks Pati – Thats useful to know – my hubby is just starting the first lot of Zelboraf – I hope Quentin’s way will help many – hoping you have a great Xmas en famille and lots of treatment success in 2013 with the re-induction and the MEK1- love and thoughts – Gilly xxDecember 24, 2012 at 1:30 am #58121Melamom91Participant Pati,
I am back on vemurafenib/Zel after stopping 29 oct and was told I was still responding – had 1 4 mm brain met resolved by Zel and a met inside my right aorta reduced to 7×11 mm. I had my four rounds of Ipi, but in the middle had SRS for a 6 mm ( old, supposed to be resolved by Zel, now back) met and a 4 mm met. That was between round 1 and 2. Then before round 3 I was told cardiac met has mushroomed – 42x42x24!! Restarted Zel, finished Ipi.
I am confirmed still responding to Zel but having lots of liver toxicity from both drugs – keep having to cycle off Zel when the toxicity builds up – a week on or so and now on steroids for awful muscle pain. My dr says his goal is to get me to one week on/one week off Zel. Full scans soon to see if any/all this Ipi+SRS+ Zel is working.
Would love if you could point me to the info you’re referring to about the mouse models and use of Zel on and off.
Thanks so much!December 24, 2012 at 2:44 pm #58122SharmonParticipant
Hi, I would like to ask about the GSK MEK trial. Brent began progression a little at a time in this trial and we swithed to Anti pd 1. he gets his 3rd infusion on the 26th. But should we be thinking about trying MEK again. Would need to get accepted into another trial unless it gets FDA approval early in 2013> Are there any reports out on reintroducing MEK?
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