Stubborn Liver Levels after Nivo/Ipi ?

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1/10/2014 5:06pm
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Hey Friends,

An update on my husband Scott's status:
Scott received 6 doses of Nivolumab, but only 2 of 4 scheduled doses of
Ipilimumab while on the BMS Nivo/Ipi trial at UVA. (The last dose
administered on October 30th, 2013). He was unable to receive the final
two, as his liver AST and ALT levels were vascillating between Grade
2-Grade 4 adverse effect reaction. Corticosteroids (prednisone) were
begun in mid-November 2013 (after a very odd 4-day
hospital-stay-requiring and as-yet-still-undetermined high fever
episode in Los Angeles). We saw results and began tapering (with the
hopes of rejoining the trial protocol as soon as levels equalized).

Scott's scans of December 27th revealed yet another 50% reduction in
his lung tumor size in the two more formidable locations...the largest
of which is now a mere 4.5mm, the smaller 2.5mm! One has resolved
nearly completely...and a few others seem "dead in the water,"
unchanged in nearly a year!

However, his bi-weekly lab work this week revealed his liver levels (at
our tapered down to 60mg a day dose) ascended DRAMATICALLY to nearly
14x the norm. Our fantastic oncologist, Dr. Grosh at UVA immediately
has bounced us back to a full 200mg daily, and Scott consulted (at Dr.
Grosh's behest) today with liver specialist Dr. Caldwell at UVA. We're
looking forward to seeing a perceptible drop in AST & ALT tomorrow when
we do labs. Our fondest hope is to rejoin the BMS trial with two years
of "maintenance" Nivolumab once his liver is "back to normal," as it
clearly is working so well for Scott and so many others.

We wanted to bring you all up-to-speed---as well as to see if you have
any insight/advice into this profoundly stubborn liver reaction to the
sequential Nivo/Ipi combination.

WIshing us all health and happiness and hope-
Cheryl Lage
Wife of Scott, Stage IV since Feb 2012
(Diagnosed in 2005 at 2a, 4 recurrences---surgeries, radiation, 27 bags of IL-2, two clinical trials and scans beyond counting and he's here and FIGHTING and LIVING!)