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June 13, 2013 at 5:38 pm #21368dkmcParticipant
I may have missed this info but was wondering: has anyone done a IPI reintroduction after being a total responder? And did you respond again? I can’t find any statistics with that info…
Thanks, KarenJune 13, 2013 at 6:10 pm #61325Celeste MorrisParticipant
I have never been given ipi, so I cannot answer your question in a personal way. However, this is what Sznol said in a conversation with Weber published Oct 31, 2012 –
“[Patients with an initial response to ipi…stable disease or some evidence of clinical regression….were allowed to receive another 4 induction doses of ipi if they had disease relapse or progression after 24 weeks.] It really suggests and it has actually been true in our own anecdotal experience that patients who have an initial response to ipilimumab or prolonged stable disease followed by disease progression can get additional benefit from another 4 doses of treatment.” The synopsis of their conversation is on my blog post Nov 25, 2012.
Another study that addresses this question is from the Journal of Clinical Oncology, 2012 Wilgenhof, et al
Single-center experience with ipilimumab in patients with pretreated advanced melanoma. They state: Disease control with ipi has been maintained in 8 patients (of which 4 received reinduction) after a median follow up of 17 months. Reinduction therapy seems important for long-term disease control in responding patients.
I’m sure there is additional data available…but this was the quickest data/report I could find. Sounds like good results are very possible.
Wishing you the best. cJune 14, 2013 at 1:01 am #61326JonathanParticipant
Just to add my personal experience to what Celeste has found in the literature, I had quite a good (but hardly total) response to Ipi 2 years ago, with a great deal of tumor regression. However, after 18 months, some tumors started growing again, and a second course of Ipi (again under Mario Sznol’s care) produced another reaction, but less marked. I subsequently needed other treatments (mainly radiation to 2 large tumors, separately) and tried yet a third course of Ipi combined with peg interferon, which made me pretty sick and I didn’t finish the 4th dose. The results of that round didn’t look as effective as the prior two Ipi rounds, but the truth is, my disease seems to be almost stable now, with some very minor tumor growth.
So the take-away is that Ipi often can be effective in subsequent cycle, but not necessarily as effective as the first cycle. And given the hype going around about the combo Ipi/anti-PD1 trial, getting anti-PD1 promptly after Ipi (or vice-versa) should be an attractive alternative path – perhaps you can find a trial seat. The immunological drugs would seem to complement one another.
JonathanJune 14, 2013 at 1:20 am #61327Shirley ZParticipant
Its good to hear from you. I am really happy to hear you are stable. Hope it continues for you.
I just remembered that you have a grandbaby now. I’m sure you and the wife are enjoying every minute of being grandparents.
Shirley ZJune 14, 2013 at 3:12 pm #61328dkmcParticipant
Thank you for the replies…it inspired me to get back online & do some more research & it does sound positive. I will keep doing trial searches for the combo re introduction IPI & PD1 or PD1 after IPI as there seems to be more trials coming up with different slants… ahhh timing is everything in this little world we inhabit : ) Karen
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