Stage 4a

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  • Post
    • October 3, 2015 at 8:42 pm
    Christine.P
    Participant

      I just found out yesterday that my melanoma has spread to a tumor near my sternum and I will have a biopsy of another tumor in my breast on Tuesday. (My surgeon was able to do the biopsy on my sternum, but wants a radiologist to do the one in my breast because the ultrasound equipment at the hospital is clearer…)

      As I have been doing continued research and reading, I find that I am mainly just overwhelmed and haven't been able to find any clear information about the actual drug treatments for my stage. I know everyone is different and I know it depends on whether I have the BRAF gene, etc. but if anyone can simplify the options/standard treatments for 4a, it would be helpful. 

      I meet with the medical oncologist for the first time on Monday and I know I will get more information then, but I want to know as much as I can before I go in so I can ask better questions. 

      Some stats: 2 primary sites – rght calf (very deep; skin graft; no spread) and left elbow; full axillary dissection; one large positive lymph node with 20 total removed); and now spread to sternum and possibly breast. (MRI and CT scan showed no mets to brain, lungs, or liver). 

      Even you can just share your stage 4a stories, it would be helpful. Thank you all for being here for us newbies…

    Viewing 2 reply threads
    • Replies
        • October 3, 2015 at 11:26 pm
        arthurjedi007
        Participant

          A quick summary is:

          braf – zelboraf/vemurafenib,  tafinlar and mekinist combo

          immunotherapy – yervoy/ ipilumanib, opdivo/nivolumab, keytruda/pembro

          Ipi and nivo combo.

          One thought is to save braf for higher tumor burden. Also must have the braf mutation.

          Recently some doc's seem to skip ipi and start with either nivo or keytruda.

          The ipi nivo combo is very toxic but has high response rate.

          Rarely is the old il2 done outside of a tcell trial.

          Thats pretty much it for FDA approved.

          Lots of trials. One trial thought is trying to figure out what works best in combo with pd1.

          Hope that helps.

          Artie

          • October 3, 2015 at 11:26 pm
          arthurjedi007
          Participant

            A quick summary is:

            braf – zelboraf/vemurafenib,  tafinlar and mekinist combo

            immunotherapy – yervoy/ ipilumanib, opdivo/nivolumab, keytruda/pembro

            Ipi and nivo combo.

            One thought is to save braf for higher tumor burden. Also must have the braf mutation.

            Recently some doc's seem to skip ipi and start with either nivo or keytruda.

            The ipi nivo combo is very toxic but has high response rate.

            Rarely is the old il2 done outside of a tcell trial.

            Thats pretty much it for FDA approved.

            Lots of trials. One trial thought is trying to figure out what works best in combo with pd1.

            Hope that helps.

            Artie

            • October 3, 2015 at 11:26 pm
            arthurjedi007
            Participant

              A quick summary is:

              braf – zelboraf/vemurafenib,  tafinlar and mekinist combo

              immunotherapy – yervoy/ ipilumanib, opdivo/nivolumab, keytruda/pembro

              Ipi and nivo combo.

              One thought is to save braf for higher tumor burden. Also must have the braf mutation.

              Recently some doc's seem to skip ipi and start with either nivo or keytruda.

              The ipi nivo combo is very toxic but has high response rate.

              Rarely is the old il2 done outside of a tcell trial.

              Thats pretty much it for FDA approved.

              Lots of trials. One trial thought is trying to figure out what works best in combo with pd1.

              Hope that helps.

              Artie

          Viewing 2 reply threads
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