Tafinlar/mekinist ? Can anyone share on this Topic?

Your tumors need to have genetic testing done to see if he is BRAF+.  This will determine if this treatment line is an option.  These treatments work fast for many people, but the treatment is short lived for most, the melanoma finds a way around the drugs.  

Your tumors need to have genetic testing done to see if he is BRAF+.  This will determine if this treatment line is an option.  These treatments work fast for many people, but the treatment is short lived for most, the melanoma finds a way around the drugs.  

Your tumors need to have genetic testing done to see if he is BRAF+.  This will determine if this treatment line is an option.  These treatments work fast for many people, but the treatment is short lived for most, the melanoma finds a way around the drugs.  

Tafinlar/ Mekinist combo is specifically indicated as a combination therapy for patients with melanoma whose tumors express gene mutations called BRAF V600E and V600K. If Charles is BRAF positive he could be a candidate for this.  But talk to your doctor about starting ipi/Yervoy first especially if Charles has brain mets.  

My Mom is BRAF positive V600E and we've not started this due to her results with SRS and Yervoy. It is in "our back pocket" to use if she needs it. at some point.

If Charles can have SRS and ipi/Yervoy I'd recommend that option. – And make sure that Charles has MRI of his brain regularly to make sure he does not have brain mets later, if he is clear now.  Any symptoms of brain mets needs to watched for. May people never have symptoms, but some do and it is important to understand what they are and have a MRI done.

My Mom had SRS treatment for 8 brain mets 4 days before staring Yervoy and all the tumors on her head and neck started reacting 3 or 4 days later. By the time she should have had her 2nd infusion many subcutaneous tumors were much smaller, they were harder and itched.  By the time she was to have had her 3rd infusion the large tumor on her neck and most of the tumors on her head were gone and the doctor was asking me if I had taken any photos of her head for comparison….  He admitted that ipi and SRS were working on her. Every tumor she had reacted and either disappeared or was significantly smaller.  Because of the colitis CT scans were done early and all the tumors in her trunk were shrinking.  She did get more brain mets because the first radiologist only treated 8 of 9 tumors and a new radiologist oncologist (Dr. Eric Chang at USC in Los Angeles) treated 17 new brain mets 4 months after the original SRS treatment.  

I've been told that Yervoy seems to work on the brain "last". It may help keep things in check after SRS treatment in the brain and prevent other brain tumors later, but really works on the tumors not in the brain first.. I've been told that Keytruda seems to work on the brain and other areas at the same time.  Both Yervoy and Keytruda increase T-Cell activity and therefore "pass" the blood barrior, but Keytruda may just work faster on the brain in most responders.

There is significant evidence that having SRS treatment while on or just prior to treatment with Yervoy. I understand that when combined they can increase response rates up to 40%, – if I recall correctly.  Bonus with this, is if he "fails" he can get access to Keytruda.

Good Luck!

Brief History:

She was diagnosed in November 2013 as Stage IV with brain mets (diagnosed later/originally said brain was clear). 

SRS  was on 12/09/13 with Yervoy started on 12/12/13.

She had 2 treatments of Yervoy and then was taken off due to colitis.

She had 1 more infusion of Yervoy the last week of March of 2014 and got colitis again.

She had SRS treatment again on 4/15/15.

Tafinlar/ Mekinist combo is specifically indicated as a combination therapy for patients with melanoma whose tumors express gene mutations called BRAF V600E and V600K. If Charles is BRAF positive he could be a candidate for this.  But talk to your doctor about starting ipi/Yervoy first especially if Charles has brain mets.  

My Mom is BRAF positive V600E and we've not started this due to her results with SRS and Yervoy. It is in "our back pocket" to use if she needs it. at some point.

If Charles can have SRS and ipi/Yervoy I'd recommend that option. – And make sure that Charles has MRI of his brain regularly to make sure he does not have brain mets later, if he is clear now.  Any symptoms of brain mets needs to watched for. May people never have symptoms, but some do and it is important to understand what they are and have a MRI done.

My Mom had SRS treatment for 8 brain mets 4 days before staring Yervoy and all the tumors on her head and neck started reacting 3 or 4 days later. By the time she should have had her 2nd infusion many subcutaneous tumors were much smaller, they were harder and itched.  By the time she was to have had her 3rd infusion the large tumor on her neck and most of the tumors on her head were gone and the doctor was asking me if I had taken any photos of her head for comparison….  He admitted that ipi and SRS were working on her. Every tumor she had reacted and either disappeared or was significantly smaller.  Because of the colitis CT scans were done early and all the tumors in her trunk were shrinking.  She did get more brain mets because the first radiologist only treated 8 of 9 tumors and a new radiologist oncologist (Dr. Eric Chang at USC in Los Angeles) treated 17 new brain mets 4 months after the original SRS treatment.  

I've been told that Yervoy seems to work on the brain "last". It may help keep things in check after SRS treatment in the brain and prevent other brain tumors later, but really works on the tumors not in the brain first.. I've been told that Keytruda seems to work on the brain and other areas at the same time.  Both Yervoy and Keytruda increase T-Cell activity and therefore "pass" the blood barrior, but Keytruda may just work faster on the brain in most responders.

There is significant evidence that having SRS treatment while on or just prior to treatment with Yervoy. I understand that when combined they can increase response rates up to 40%, – if I recall correctly.  Bonus with this, is if he "fails" he can get access to Keytruda.

Good Luck!

Brief History:

She was diagnosed in November 2013 as Stage IV with brain mets (diagnosed later/originally said brain was clear). 

SRS  was on 12/09/13 with Yervoy started on 12/12/13.

She had 2 treatments of Yervoy and then was taken off due to colitis.

She had 1 more infusion of Yervoy the last week of March of 2014 and got colitis again.

She had SRS treatment again on 4/15/15.

Tafinlar/ Mekinist combo is specifically indicated as a combination therapy for patients with melanoma whose tumors express gene mutations called BRAF V600E and V600K. If Charles is BRAF positive he could be a candidate for this.  But talk to your doctor about starting ipi/Yervoy first especially if Charles has brain mets.  

My Mom is BRAF positive V600E and we've not started this due to her results with SRS and Yervoy. It is in "our back pocket" to use if she needs it. at some point.

If Charles can have SRS and ipi/Yervoy I'd recommend that option. – And make sure that Charles has MRI of his brain regularly to make sure he does not have brain mets later, if he is clear now.  Any symptoms of brain mets needs to watched for. May people never have symptoms, but some do and it is important to understand what they are and have a MRI done.

My Mom had SRS treatment for 8 brain mets 4 days before staring Yervoy and all the tumors on her head and neck started reacting 3 or 4 days later. By the time she should have had her 2nd infusion many subcutaneous tumors were much smaller, they were harder and itched.  By the time she was to have had her 3rd infusion the large tumor on her neck and most of the tumors on her head were gone and the doctor was asking me if I had taken any photos of her head for comparison….  He admitted that ipi and SRS were working on her. Every tumor she had reacted and either disappeared or was significantly smaller.  Because of the colitis CT scans were done early and all the tumors in her trunk were shrinking.  She did get more brain mets because the first radiologist only treated 8 of 9 tumors and a new radiologist oncologist (Dr. Eric Chang at USC in Los Angeles) treated 17 new brain mets 4 months after the original SRS treatment.  

I've been told that Yervoy seems to work on the brain "last". It may help keep things in check after SRS treatment in the brain and prevent other brain tumors later, but really works on the tumors not in the brain first.. I've been told that Keytruda seems to work on the brain and other areas at the same time.  Both Yervoy and Keytruda increase T-Cell activity and therefore "pass" the blood barrior, but Keytruda may just work faster on the brain in most responders.

There is significant evidence that having SRS treatment while on or just prior to treatment with Yervoy. I understand that when combined they can increase response rates up to 40%, – if I recall correctly.  Bonus with this, is if he "fails" he can get access to Keytruda.

Good Luck!

Brief History:

She was diagnosed in November 2013 as Stage IV with brain mets (diagnosed later/originally said brain was clear). 

SRS  was on 12/09/13 with Yervoy started on 12/12/13.

She had 2 treatments of Yervoy and then was taken off due to colitis.

She had 1 more infusion of Yervoy the last week of March of 2014 and got colitis again.

She had SRS treatment again on 4/15/15.

Here is a link to some general info:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/02/braf-inhibitors-for-melanoma-dabrafenib.html

Initially, patients taking BRAFi were usually faced wtih tumor work-around within 6-9 months.  By adding MEKi and using intermittent dosing schedules, that time frame has been much extended and side effects decreased.  Using these techniques, some patients are being well maintained on these drugs for years.  Additionally, some docs use these drugs to rapidly shrink tumors and/or tumor burden in patients before surgery or switching patients to immunotherapy.

Here is a link to some new BRAFi combo's out of ASCO this year.  The jury has not completely ruled on them yet as they are new…but it might be worth thinking about:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/05/asco-2015-new-braf-inhibitor-combos-for.html

Wishing you my best.  Celeste

Here is a link to some general info:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/02/braf-inhibitors-for-melanoma-dabrafenib.html

Initially, patients taking BRAFi were usually faced wtih tumor work-around within 6-9 months.  By adding MEKi and using intermittent dosing schedules, that time frame has been much extended and side effects decreased.  Using these techniques, some patients are being well maintained on these drugs for years.  Additionally, some docs use these drugs to rapidly shrink tumors and/or tumor burden in patients before surgery or switching patients to immunotherapy.

Here is a link to some new BRAFi combo's out of ASCO this year.  The jury has not completely ruled on them yet as they are new…but it might be worth thinking about:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/05/asco-2015-new-braf-inhibitor-combos-for.html

Wishing you my best.  Celeste

Here is a link to some general info:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2014/02/braf-inhibitors-for-melanoma-dabrafenib.html

Initially, patients taking BRAFi were usually faced wtih tumor work-around within 6-9 months.  By adding MEKi and using intermittent dosing schedules, that time frame has been much extended and side effects decreased.  Using these techniques, some patients are being well maintained on these drugs for years.  Additionally, some docs use these drugs to rapidly shrink tumors and/or tumor burden in patients before surgery or switching patients to immunotherapy.

Here is a link to some new BRAFi combo's out of ASCO this year.  The jury has not completely ruled on them yet as they are new…but it might be worth thinking about:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/05/asco-2015-new-braf-inhibitor-combos-for.html

Wishing you my best.  Celeste

Hi Rita & Charles, 

My husband is BRAF+ as well how we started with SRS     for his brain mets, then moved on to IPI. When we found out IPI failed we looked at Taflinar/Meckinist however decided to keep that in our back pocket given  his low tumor burden due to surgical intervention. Best of luck today! 

Hi Rita & Charles, 

My husband is BRAF+ as well how we started with SRS     for his brain mets, then moved on to IPI. When we found out IPI failed we looked at Taflinar/Meckinist however decided to keep that in our back pocket given  his low tumor burden due to surgical intervention. Best of luck today! 

Hi Rita & Charles, 

My husband is BRAF+ as well how we started with SRS     for his brain mets, then moved on to IPI. When we found out IPI failed we looked at Taflinar/Meckinist however decided to keep that in our back pocket given  his low tumor burden due to surgical intervention. Best of luck today!