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Keytruda and recurrence

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Keytruda and recurrence

Posted By
betsyl
6/15/2020 7:58pm
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Replies: 2

Hi there,

Been a long time since I was here. I have a question for you.

How often is melanoma less responsive after a recurrence as opposed to treatment-naive situations? Always less responsive after recurrence? Usually? Sometimes?

Does anyone have stories of:

1. Achieved NED through combination of surgery + Keytruda. Stayed NED for ~18 months.
2. Recurrence.
3. Back on Keytruda (or Opdivo).
4. Become NED again? Or rather than becoming NED again, has it stayed stable for a really long time (years) after going back on Keytruda or Opdivo?

My husband's recurrence is taking the form of multiple small subcutaneous nodules. Very scared.

Thanks for providing this space. Best wishes to you all.

Bubbles - (6/15/2020 - 8:45pm)

Sorry you and your husband are dealing with all this, betsyl! Melanoma is never easy. Responses are variable - always. However, here is a report that addresses some of what you are asking:

http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2020/05/how-to...

Ultimately, this report indicates that starting ipi/nivo in patients who have been or are currently being treated with anti-PD-1 (Opdivo or Keytruda) alone when they progress provides the best results.

Another thing you may want to ask your doc about if your husband's recurrence is only in sub q nodules is something called intralesional therapy. This is medication that is injected directly into melanoma tumors (therefore they must be accessible to the process - and sub q lesions certainly would be). We have found that when intralesional therapy is combined with systemic therapy results can be very good with the injected tumors being done away with along with "by-stander" lesions as well. There are many different products. Here are a zillion reports: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=intr...

Another option if your husband's tumors are BRAF positive, targeted therapy may be a treatment option as well.

Here is a primer that addresses all of this that you might find helpful: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melan...

Hope all this is of some help. I know there are those on this board who have responded to immunotherapy after progressing on it and perhaps some of them will chime in. I wish you and your husband my best. Celeste

ed williams - (6/15/2020 - 8:46pm)

The following study was presented at ASCO this year and has Dr. Long of Australia involved. There has been some data over the last couple of years of pd-1 progression and retreatment mainly with Pembro (Keytruda) but the result were not great, and the group or sample size was small and data based on keynote 006 trial patients who stopped at two years and then were followed. Here is link to ASCO article. https://meetinglibrary.asco.org/record/185644/abstract