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Interferon and immunocompromised

Interferon and immunocompromised

Posted By
Anonymous
9/12/2019 8:11am
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Replies: 10

Hey guys!

Newly diagnosed stage 2b, looks like I will be starting interferon alpha 2 and I was wondering if that treatment makes you immunocompromised like other chemos ? I work in the lab of a hospital and that’s not a great place to me if my immune system is at risk. I have option for going on leave but I don’t know if I want to. Any advice ?

Andy

Hi Andy, could you give us some more information please about your tumor and what part of the world you are located in. Interferon can kick the shit out of most patients during the high dose phase (personal experience back in 2012) but as a general rule today it isn't used any more based on lack of any data that supports any survival improvement at all. There is some data that it delays the melanoma from coming back a few months with sub population of trial that had ulcerated deep primary tumors. The recent trend for high risk stage 2b patients is clinical trials of either targeted therapy drugs (braf mutation) or immunotherapy drugs like Ipi, Nivo or Pembro and some combination trials are being looked at as well of low dose ipi + regular dose nivo. I am going to give you a video link to last June oncologist talking about what is new in this area of neoadjuvant research in melanoma from Onclive web site.https://www.onclive.com/peer-exchange/malignant-melanoma-management/stag... https://www.onclive.com/peer-exchange/malignant-melanoma-management/pool...

Link to findings of trial of Interferon showing no survival improvement vs observation along with second link to mental health issue associated with use of interferon ( a lot of folks have become depressed on this drug). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455684/ https://current-oncology.com/index.php/oncology/article/view/3685/2597

Anonymous - (9/12/2019 - 11:20am)

Hi Ed,

Thanks for your response. I’m in Canada. I’m going to bring all this information with me to my appointment next week! I would prefer not to put my mental health at risk, I already suffer from anxiety and have been on medication for 13 years now.

Do you know if immunotherapy in general would make you more susceptible to illness?

There is a pretty good read from Niall McGee a writer at the Globe and Mail from a couple of years ago and his experience with Interferon. I am also in Canada in the Ottawa area and did Interferon back in 2012 and it put me in a pretty dark place as well at that time. The drug has kind of gone the way of the doe doe bird in most circle in the melanoma world especially since there is no survival benefit vs observation. If you are 2b and have ulcerate primary then oncologist might want to be aggressive since risk of it coming back is higher. There are trials out there, just have to look and maybe be willing to travel to get access to the new generation of immunotherapy drugs (Pd-1 or CTLA-4 also called check point inhibitors Pembro, Nivolumab or the combination of low dose Ipi+ Nivo). I have been on Nivo for a few years now and my health in general is good, dealing with some side effects of fatigue and some sore joints mainly. I consider myself to be really luck especially having had 3 brain mets treated by cyberknife and two lung mets back in summer of 2013. I have been on clinical trial called checkmate 067 and I would look to see if there is anything (trials) being offered at this time. Did they test your tumor to see if you have Braf+ mutation, if they did and you have the mutation then a whole other area opens up of targeted therapy (pills) vs immunotherapy which patients get via IV at hospital. Here is the link to article. https://www.theglobeandmail.com/life/niall-mcgee-didnt-believe-in-depres...

Good lord Andy! Like Ed just asked, PLEASE provide us more about you and your Melanoma history, if your starting off with Interferon (assuming your newly diagnosed) i wanna hear your doctors reasoning for giving you this, dont get me wrong, studys show tumor shrinkage with Int. A2 but "med to low" Overall Survival benefits (ancient med) theres better drugs out there and you wont be so sick! Please provide us more info! "And"! If you can create a Fictitious name for yourself instead of Anonymous, we have to many here, hard to differ between all of em!! Example: MelanomaAndy, DandyAndy, AndyWithAPlanD....your in good company here brother...

Melanoma Will Not Beat Me or my MRF Family!
www.wespark.org
www.covvha.net

Whoever this doctor you're seeing is, doesn't sound like he's a melanoma specialist because he's recommending an outdated treatment. It would not hurt to seek out a melanoma specialist for a second opinion. Here's a list of melanoma specialists who are in Canada: https://www.melanomanetwork.ca/melanoma-treatment-centres-and-practition...

Targeted therapy and immunotherapy are the weapons of choice against melanoma. Here's some more info on them:

https://www.cancer.gov/about-cancer/treatment/types/immunotherapy
https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies

Stage IIIB, Unknown Primary; 1 positive node in left axilla. Diagnosed December 2010.

I agree that interferon is generally viewed as passé and I’d assume you are not seeing a specialist. I would bet the issue is you need a better referral. Canadian health coverage for some popular first line coverage is detailed here

https://www.melanomanetwork.ca/immunotherapies/

Also the drug websites list Canadian coverage by province.

I won’t get into whether interferon is the right treatment for you but I always thought it stimulated your immune system and therefore made it stronger. . But really I don’t know if that makes sense I’m just guessing. My son did a year of interferon in 2009 and never got sick that year ( except the interferon made him feel sick especially at the beginning)

Andy, like Ed and I and others as well you are Canadian and the drug access for adjuvant treatment is from another age because of our Health care System. Like Ed said, go for clinical trials to get some immunotherapy or targeted therapy. I was finally diagnosed with stage 2b in July 2016 (after a serious misdiagnosis of my lymph node basin) and I am thankful to have found this forum explaining the real situation with interferon. I refused it and here I am now, 3 years NED with initial surgery as my only treatment. Please do tell more about your situation. Look up the links provided by Ed and also read about microbiome (thus diet) and exercise (moderate weight training). You are early stage -thank God - so reverse your condition with everything possible INCLUDING clinical trial therapies offered for stage 2 now. If I had had access to this 3 years ago, I would have not gone into severe depression I think. Good luck. With a bit of luck you’ll be fine. And stay in touch.

Andy, you have been given good info here. Ask more questions as you have the need. I wish you my best. AND..... A little off topic....but good vibes and appreciation are always "on topic", right??? I just wanted to say to Sole - You have become such fabulous resource of calming support and wisdom to so many on this forum!!! THANKS!!!!!!!!!!!!!!!!! You rock!!! love, c