BRAF vs Anti PD1

Posted By
3/10/2014 3:19pm
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Replies: 3

Hello,

I haven't posted in a very long time.  I am now stage 4 with a recurrence to the pancreas.  I am BRAF positive.  I am just getting up to speed on the treatment options available.  I believe there is a trial here in Toronto for the Anti PD1 drug.  I am BRAF positive so I know that I qualify for that treatment.  If I am given the option of doing either, is one better than the other?  I feel like I am leaning towards anti-PD1 based on what I have read.

Thanks

Mark

kpcollins31 - (3/10/2014 - 4:17pm)

Sorry to hear about the recurrence. If you have an option to get into a anti pd1 trial, that would be my recommendation. Being BRAF positive gives you access to some other treatment options, but I would save those for later if they are ever needed... they tend to work quickly in reducing tumor burden, but their effectiveness averages maybe only 6 months or so. Keep in mind those treatments can work much longer for some people though.

Kevin

 

arthurjedi007 - (3/10/2014 - 5:57pm)

I agree. I'm BRAF positive as well but if the recurrence is not serious yet (as if there is such a thing) but meaning you can put up with it easily and it is not endangering you then PD1 is the best choice in my opinion. In my opinion BRAF meds should be used if you need a quick tumor shrinkage. For example they tried it for my tumor that was close to pressing on my spinal cord even after radiation but unfortunately I was one that zelboraf shrank nothing. Then they did yervoy(ipi). Now the tafinlar/mekinist combo except for a break while I do radiation again. If I had it to do over I would have opted for a nivolumab trial but you never know.

Tina D - (3/13/2014 - 9:09am)

Hi there, I personally agree with the above 2 posters. If the tumor burden is not imminently threatening or causing great distress, I think I would opt for the PD1 if it is available. But, what does your specialist say in regards to your current tumor situation? I actually got a fairly rapid respone on the PD1 ( 67% shrinkage in the 1st 12 weeks), but there would have been a time in my journey when that could have been too long of a stretch of time to wait for a response. So it really depends on how rapidly you are needing something to work. When I took the vemurafenib, my situation was grim at that very moment, with imminent threats to vital things from tumors, so it was the best choice for a quick response at that time ( and I was NED after 8 weeks on the vemurafenib!). Anti PD1 has more of a likelihood for durable response ( though there are indeed those with durable response to the vem) and the side effects are less severe for most folks.

Just some thoughts..

Tina