Mother diagnosed Stage 3c

My Dad was originally diagnosed stage II at age 81. We didn’t do the SNB to check his lymph nodes because he didn’t want a big surgery and I knew I’d never recommend Interferon for him at his age and given the stats. He’s stage III now with lymph node involvement and we are again contemplating surgery. However, it is 6 years later and there are more choices now for treatment. Clinical trials are worth checking into but be aware there may be age limitations and other disqualifying health factors. For my dad, age has probably been a good factor because things have moved quite slowly. He won’t be pursuing ant treatment other than surgery at this point and even that is questionable. Good luck on finding something that makes sense for your Mom. The standard of care isn’t always the best choice for everyone including the older population. Is she seeing a melanoma specialist?
Best wishes,
Janner

My Dad was originally diagnosed stage II at age 81. We didn’t do the SNB to check his lymph nodes because he didn’t want a big surgery and I knew I’d never recommend Interferon for him at his age and given the stats. He’s stage III now with lymph node involvement and we are again contemplating surgery. However, it is 6 years later and there are more choices now for treatment. Clinical trials are worth checking into but be aware there may be age limitations and other disqualifying health factors. For my dad, age has probably been a good factor because things have moved quite slowly. He won’t be pursuing ant treatment other than surgery at this point and even that is questionable. Good luck on finding something that makes sense for your Mom. The standard of care isn’t always the best choice for everyone including the older population. Is she seeing a melanoma specialist?
Best wishes,
Janner

My Dad was originally diagnosed stage II at age 81. We didn’t do the SNB to check his lymph nodes because he didn’t want a big surgery and I knew I’d never recommend Interferon for him at his age and given the stats. He’s stage III now with lymph node involvement and we are again contemplating surgery. However, it is 6 years later and there are more choices now for treatment. Clinical trials are worth checking into but be aware there may be age limitations and other disqualifying health factors. For my dad, age has probably been a good factor because things have moved quite slowly. He won’t be pursuing ant treatment other than surgery at this point and even that is questionable. Good luck on finding something that makes sense for your Mom. The standard of care isn’t always the best choice for everyone including the older population. Is she seeing a melanoma specialist?
Best wishes,
Janner

I'm sorry to hear of your mom's diagnosis.

Is she being seen at a melanoma center? If not, then it won't hurt for her to get a second opinion from a doctor at a melanoma center (i.e., MD Anderson, Moffitt, Johns Hopkins, Sloan Kettering, etc.). The doctors there are going to be the most up to speed on treatments and be able to give her information on clinical trials for which she may qualify.

I'm surprised that Yervoy was not offered as an option for your mother.

The only melanoma vaccines I'm aware of are available only through a clinical trial. I'm Stage III and am on one now for a vaccine but that trial is no longer accepting new patients. The side effects are very tolerable.

Johns Hopkins is holding a trial for a vaccine:

J1112: A FEASIBILITY AND TOXICITY STUDY OF A GM-CSF SECRETING ALLOGENEIC MELANOMA VACCINE (MELANOMA GVAX) ADMINISTERED ALONE OR IN COMBINATION WITH CYCLOPHOSPHAMIDE IN SUBJECTS WITH SURGICALLY RESECTED AT-RISK MELANOMA
This melanoma vaccine trial is a phase I study for patients with stage IIB, IIC, III or IV melanoma who have undergone complete surgical resection but who are at risk for developing recurrence of their disease.  Melanoma GVAX is an investigational vaccine designed to teach the immune system to recognize and eliminate melanoma tumors, which may persist at a microscopic level after surgery.  In this study, some patients will receive Melanoma GVAX alone (low dose or high dose), while others will receive Melanoma GVAX plus low-dose cyclophosphamide. Cyclophosphamide is a chemotherapy frequently used in cancer treatment.  In this study, it will be given at a low dose to try to augment the effects of the vaccine.  The purpose of this study is to find the optimal dose of Melanoma GVAX, with or without cyclophosphamide, that is safe and that produces an immune response.  The vaccine will be given in the skin monthly for four doses.  Eligible patients must be ≥18 years old with melanoma arising in the skin or mucous membranes (such as the nostrils, mouth, or rectum) that has been completely resected at least 2 weeks but no more than 6 months prior to receiving the first treatment on this trial.  Patients with melanomas arising in the eye (ocular) are not eligible.  Participants must not have hepatitis, HIV, or any history of an immune disorder.  Patients must not have received any type of cancer immunotherapy, such as interleukin-2, interferon alfa or other melanoma vaccines.  Patients will be evaluated on this trial for 6 months and then followed yearly for 5 years

 

If your mom's melanoma is considered advanced and her tumor has the BRAF mutation, she might qualify for this trial. I copied this from Johns Hopkins' web site so I don't know if other hospitals are having the same trial:

J10122: An Open Label, Dose Escalation, Phase I Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics and Clinical Activity of the BRAF Inhibitor GSK2118436 in Combination with the MEK Inhibitor GSK1120212 in Subjects with BRAF Mutant Metastatic Melanoma
The purposes of this study are: 1) to test the safety of the drugs GSK1120212 and GSK2118436 taken separately and together, and 2) to examine how well these drugs work together in mediating tumor regression in patients with locally advanced or metastatic melanoma.  Individually, both drugs have been shown in previous studies to cause the regression of advanced metastatic melanoma. Scientific evidence suggests that the combination may improve outcomes.  Eligible subjects must have measurable metastatic melanoma tumors that contain the BRAF V600E mutation. Patients will be assigned to one of three treatment groups: BRAF inhibitor only, BRAF inhibitor plus high dose MEK inhibitor, or BRAF plus low dose MEK inhibitor.  Both medications are orally administered and need to be taken every day.  Patients will be seen every two weeks for the first month and then monthly thereafter.

The following conditions may exclude enrollment in this study:
• Prior exposure to BRAF or MEK inhibitors
• On warfarin (Coumadin)
• Certain ophthalmologic (eye) problems
• Uncontrolled hypertension, diabetes, hyperlipidemia, coagulopathy or NYHA Class II, III, or IV heart failure
• HIV, Hepatitis B or Hepatitis C infection
• Untreated or symptomatic melanoma metastases in the central nervous system (brain, spinal cord)
• Pregnancy
• Glucose-6-phosphate-dehydrogenase deficiency (G6PD deficiency)

I'm sorry to hear of your mom's diagnosis.

Is she being seen at a melanoma center? If not, then it won't hurt for her to get a second opinion from a doctor at a melanoma center (i.e., MD Anderson, Moffitt, Johns Hopkins, Sloan Kettering, etc.). The doctors there are going to be the most up to speed on treatments and be able to give her information on clinical trials for which she may qualify.

I'm surprised that Yervoy was not offered as an option for your mother.

The only melanoma vaccines I'm aware of are available only through a clinical trial. I'm Stage III and am on one now for a vaccine but that trial is no longer accepting new patients. The side effects are very tolerable.

Johns Hopkins is holding a trial for a vaccine:

J1112: A FEASIBILITY AND TOXICITY STUDY OF A GM-CSF SECRETING ALLOGENEIC MELANOMA VACCINE (MELANOMA GVAX) ADMINISTERED ALONE OR IN COMBINATION WITH CYCLOPHOSPHAMIDE IN SUBJECTS WITH SURGICALLY RESECTED AT-RISK MELANOMA
This melanoma vaccine trial is a phase I study for patients with stage IIB, IIC, III or IV melanoma who have undergone complete surgical resection but who are at risk for developing recurrence of their disease.  Melanoma GVAX is an investigational vaccine designed to teach the immune system to recognize and eliminate melanoma tumors, which may persist at a microscopic level after surgery.  In this study, some patients will receive Melanoma GVAX alone (low dose or high dose), while others will receive Melanoma GVAX plus low-dose cyclophosphamide. Cyclophosphamide is a chemotherapy frequently used in cancer treatment.  In this study, it will be given at a low dose to try to augment the effects of the vaccine.  The purpose of this study is to find the optimal dose of Melanoma GVAX, with or without cyclophosphamide, that is safe and that produces an immune response.  The vaccine will be given in the skin monthly for four doses.  Eligible patients must be ≥18 years old with melanoma arising in the skin or mucous membranes (such as the nostrils, mouth, or rectum) that has been completely resected at least 2 weeks but no more than 6 months prior to receiving the first treatment on this trial.  Patients with melanomas arising in the eye (ocular) are not eligible.  Participants must not have hepatitis, HIV, or any history of an immune disorder.  Patients must not have received any type of cancer immunotherapy, such as interleukin-2, interferon alfa or other melanoma vaccines.  Patients will be evaluated on this trial for 6 months and then followed yearly for 5 years

 

If your mom's melanoma is considered advanced and her tumor has the BRAF mutation, she might qualify for this trial. I copied this from Johns Hopkins' web site so I don't know if other hospitals are having the same trial:

J10122: An Open Label, Dose Escalation, Phase I Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics and Clinical Activity of the BRAF Inhibitor GSK2118436 in Combination with the MEK Inhibitor GSK1120212 in Subjects with BRAF Mutant Metastatic Melanoma
The purposes of this study are: 1) to test the safety of the drugs GSK1120212 and GSK2118436 taken separately and together, and 2) to examine how well these drugs work together in mediating tumor regression in patients with locally advanced or metastatic melanoma.  Individually, both drugs have been shown in previous studies to cause the regression of advanced metastatic melanoma. Scientific evidence suggests that the combination may improve outcomes.  Eligible subjects must have measurable metastatic melanoma tumors that contain the BRAF V600E mutation. Patients will be assigned to one of three treatment groups: BRAF inhibitor only, BRAF inhibitor plus high dose MEK inhibitor, or BRAF plus low dose MEK inhibitor.  Both medications are orally administered and need to be taken every day.  Patients will be seen every two weeks for the first month and then monthly thereafter.

The following conditions may exclude enrollment in this study:
• Prior exposure to BRAF or MEK inhibitors
• On warfarin (Coumadin)
• Certain ophthalmologic (eye) problems
• Uncontrolled hypertension, diabetes, hyperlipidemia, coagulopathy or NYHA Class II, III, or IV heart failure
• HIV, Hepatitis B or Hepatitis C infection
• Untreated or symptomatic melanoma metastases in the central nervous system (brain, spinal cord)
• Pregnancy
• Glucose-6-phosphate-dehydrogenase deficiency (G6PD deficiency)

I'm sorry to hear of your mom's diagnosis.

Is she being seen at a melanoma center? If not, then it won't hurt for her to get a second opinion from a doctor at a melanoma center (i.e., MD Anderson, Moffitt, Johns Hopkins, Sloan Kettering, etc.). The doctors there are going to be the most up to speed on treatments and be able to give her information on clinical trials for which she may qualify.

I'm surprised that Yervoy was not offered as an option for your mother.

The only melanoma vaccines I'm aware of are available only through a clinical trial. I'm Stage III and am on one now for a vaccine but that trial is no longer accepting new patients. The side effects are very tolerable.

Johns Hopkins is holding a trial for a vaccine:

J1112: A FEASIBILITY AND TOXICITY STUDY OF A GM-CSF SECRETING ALLOGENEIC MELANOMA VACCINE (MELANOMA GVAX) ADMINISTERED ALONE OR IN COMBINATION WITH CYCLOPHOSPHAMIDE IN SUBJECTS WITH SURGICALLY RESECTED AT-RISK MELANOMA
This melanoma vaccine trial is a phase I study for patients with stage IIB, IIC, III or IV melanoma who have undergone complete surgical resection but who are at risk for developing recurrence of their disease.  Melanoma GVAX is an investigational vaccine designed to teach the immune system to recognize and eliminate melanoma tumors, which may persist at a microscopic level after surgery.  In this study, some patients will receive Melanoma GVAX alone (low dose or high dose), while others will receive Melanoma GVAX plus low-dose cyclophosphamide. Cyclophosphamide is a chemotherapy frequently used in cancer treatment.  In this study, it will be given at a low dose to try to augment the effects of the vaccine.  The purpose of this study is to find the optimal dose of Melanoma GVAX, with or without cyclophosphamide, that is safe and that produces an immune response.  The vaccine will be given in the skin monthly for four doses.  Eligible patients must be ≥18 years old with melanoma arising in the skin or mucous membranes (such as the nostrils, mouth, or rectum) that has been completely resected at least 2 weeks but no more than 6 months prior to receiving the first treatment on this trial.  Patients with melanomas arising in the eye (ocular) are not eligible.  Participants must not have hepatitis, HIV, or any history of an immune disorder.  Patients must not have received any type of cancer immunotherapy, such as interleukin-2, interferon alfa or other melanoma vaccines.  Patients will be evaluated on this trial for 6 months and then followed yearly for 5 years

 

If your mom's melanoma is considered advanced and her tumor has the BRAF mutation, she might qualify for this trial. I copied this from Johns Hopkins' web site so I don't know if other hospitals are having the same trial:

J10122: An Open Label, Dose Escalation, Phase I Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics and Clinical Activity of the BRAF Inhibitor GSK2118436 in Combination with the MEK Inhibitor GSK1120212 in Subjects with BRAF Mutant Metastatic Melanoma
The purposes of this study are: 1) to test the safety of the drugs GSK1120212 and GSK2118436 taken separately and together, and 2) to examine how well these drugs work together in mediating tumor regression in patients with locally advanced or metastatic melanoma.  Individually, both drugs have been shown in previous studies to cause the regression of advanced metastatic melanoma. Scientific evidence suggests that the combination may improve outcomes.  Eligible subjects must have measurable metastatic melanoma tumors that contain the BRAF V600E mutation. Patients will be assigned to one of three treatment groups: BRAF inhibitor only, BRAF inhibitor plus high dose MEK inhibitor, or BRAF plus low dose MEK inhibitor.  Both medications are orally administered and need to be taken every day.  Patients will be seen every two weeks for the first month and then monthly thereafter.

The following conditions may exclude enrollment in this study:
• Prior exposure to BRAF or MEK inhibitors
• On warfarin (Coumadin)
• Certain ophthalmologic (eye) problems
• Uncontrolled hypertension, diabetes, hyperlipidemia, coagulopathy or NYHA Class II, III, or IV heart failure
• HIV, Hepatitis B or Hepatitis C infection
• Untreated or symptomatic melanoma metastases in the central nervous system (brain, spinal cord)
• Pregnancy
• Glucose-6-phosphate-dehydrogenase deficiency (G6PD deficiency)

I was originally diagnosed stage 3c and also chose not to do interferon. I have a friend who tried Yervoy for adjuvant therapy, he was surgically NED, maybe that is an option. Also be sure her tumor cells are tested for BRAF mutations so you’ll know the options there ahead of time if you need it.

I was originally diagnosed stage 3c and also chose not to do interferon. I have a friend who tried Yervoy for adjuvant therapy, he was surgically NED, maybe that is an option. Also be sure her tumor cells are tested for BRAF mutations so you’ll know the options there ahead of time if you need it.

I was originally diagnosed stage 3c and also chose not to do interferon. I have a friend who tried Yervoy for adjuvant therapy, he was surgically NED, maybe that is an option. Also be sure her tumor cells are tested for BRAF mutations so you’ll know the options there ahead of time if you need it.