Home Forums Melanoma Diagnosis: Stage IV melanoma in the brain

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  • #22172
    hass71
    Participant

    hello

    we did a stereo tactic radio surgery in the brain for three lesion a month ago, and now after the second portion of the Yervoy, we did an MRI for the brain to find out many other lesion that progressed in the last month to about 8mm the biggest, so the doctor now wants to start radio therapy for the whole brain and it seems that the situation is getting worse, so if the yervoy is working in body what can be the most efficient treatment for the brain?

    #65433
    Catherine Poole
    Keymaster

    Radiation treatment and sometimes surgery will help, there really isn’t any systemic agent that crosses that barrier into the brain. Sometimes with multiple mets, you can have a few sessions of stereotactic rather than whole brain. Where are you going for treatment?

    #65434
    hass71
    Participant

    the last radio surgery was for three lesion, and now a month later , the MRI showed many other lesion that are progressing, and the doctor sees that it’s better to go for therapy for the whole brain(14 sessions) but in the same time she’s taking the yervoy, doesn’t it interfere with each other?

    we’re doing the therapy in Beirut, Lebanon at AUBMC

    #65435
    Catherine Poole
    Keymaster

    There is some speculation that Yervoy and radiation work together and might help the situation.

    #65436
    hass71
    Participant

    hello

    we’re starting radiotherapy sessions today, are there any advices to reduce the side effects or to cope with it

    #65437
    gostan
    Participant

    Best of luck with the additional SRS treatments. My brain leisons stopped me from an anti PD1 clinical trial and even from getting on Ipi in the summer of 2013. After 2 SRS treatments I had multiple (8 or 9 ) new elisions and my neurologist at BWH said WBR was the way to go. I was able to start Ipi a few weeks after completion of the WBR and the combo has left me Cancer free in the brain. No doubt that the combo worked miracles for me. for what it is worth, in my situation, the SRS was easily tolerated when compared to the WBR. Hopefully, the side effects from SRs will be minimal. Where is the treatment taking place?

    #65438
    hass71
    Participant

    she had a month ago an SRS for 3 brain lesion but the scan showed multiple progression of others so we started the radiation for the whole brain today and she’s taking yervoy at the same time, so what’s happening with you now? hope you have control of the cancer.

    we’re in Beirut, Lebanon

    #65439
    gostan
    Participant

    Best of luck to your wife, you and your family as you go down this unknown path.

    For me, The daily trips into Boston for the WBT for two weeks were very draining. I can only imagine what it would be like to be undergoing both the radiation and Yervoy at the same time, but in my case my radiologist is sure that the combo (my treatments were not simultaneous) definitely did the trick and that the Ipi passed the blood brain barrier. Twelve months later my brain is clear of cancer and I am now on Braf/Mek to shrink the body leisions, with no progression right now. My wife’s family is from Lebanon so she and I wish yours’ success through these treatments.

    #65440
    JBunyan
    Participant

    In Nov 2013 I started 4 doses of Ipi – finished 2nd Jan 2014 (Was M1(c)). On 4 Dec 2013 had SRS for 2 small brain mets whist still on Ipi. Just had second CT scan and my torso is now clear of Melanoma (for now) and a brain MRI says the brain mets are virtually gone. Therefore I see no reason why Ipi and SRS, at least, are incompatible – quite the reverse. I am lucky that a) The Ipi had few side effects b) It seems to be working, so far c) The SRS was , seemingly, successful, so I live to fight another day! I am still unsure how long lasting Ipi is in boosting the immune system – hopefully for a longish time. I am in UK where NHS funding is an issue, but luckily my Oncologist is the head of experimental Oncology at a University Hospital specialising in this area .

    #65441
    Anonymous
    Guest

    It’s so wonderful to see people having such good responses to this combination.

    The idea is that as the tumors die back with the radiation, they produce antigens that attract your immune system that has been super charged by the IPI.

    To be clear, the IPI itself is not a direct agent against the cancer and does not cross the blood-brain barrier. Rather the IPI “takes the self-regulating brakes off of the immune system” by allowing expansion of the killer T-cells and supression of the regulatory T cells (the ones that tell the immune system to slow down). It’s the killer T cells that cross the blood-brain barrier and attack the cancer. The idea is again, that the cancer cells killed by the radiation leave a “scent” in the blood (the antigens) that attracts the killer cells.

    Hope this helps.

    Jeff

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