What to do when the best options are exhausted?
- preferably lower toxicity regimens as the quality of life is important
- status performance should be carefully considered
- bridge to other treatments
II. IL2 - seems less toxic
III. Surgical resection whenever possible
IV. Radiation therapy
CNS disease -radiation or surgery
Shorted courses of radiations more recommended -the same effect like long course of radio
V. Intratumoral treatments
T-VEC - 16% RR
IPI+T-VEC 38% RR
IPI+ HF10 41%
VI. Re-initiation of previous systemic therapies
a) Ipilimumab - the same response rate was observed at re-initiation
b) Braf/Mek- duration of re-challenge is shorter than first time
- intermittent dosing?
Steroids use during immunotherapy
Efficacy of immuno on corticosteroids not known, so oncs prefer NOT to have patients on high dose corticosteroids at the start of immuno.
Why two years duration for the treatment with immuno (as no data behind)? Oncs prefer to stay on the safe side because is less likely that after 2 years patients will progress.
- education of radiologists, surgeons, and other specialists working together- a must for better management of pts.
-immunotherapy -61 pts stopped the immuno -so far 2 years no one relapse (data from real life -France -Caroline Robert)
- relapse should be well documented by biopsy and pathologic test
- data to come on sequential treatment from the trial run by Paulo Ascierto et al.,(stopping Braf/Mek and switch to immuno , SECOMBIT, NCT02631447).
Thursday, 8 June 2017
J. Weber on the checkpoint inhibitors in Melanoma -what other cancers could learn from us Relevant for us and other cancers: -the ...
Only 2 more weeks till the next trip to the windy city so high time to check the ASCO abstracts here Same procedure as every ye...
work in progress Background Melanoma therapies have evolved enormously over the last very few years. From only 12% patients surviving th...
Last ASCO session this year and the session is jam-packed! work in progress Rational design of combination immune therapies Michael Pos...