Two trials available, which first? TIL vs BRAF/MEK/PD-L1 combo

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5/10/2014 8:53pm
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So of the trials available, those two seem like the most promissing. I am currently stage III, but am preparing for the inevitable IV, which is when I'll be ellegible. 

I'm thinking of first going with BRAF/MEK/PD-L1 combo because it seems like it's less drastic (TIL trial involves first nuking my entire immune system and being a bubbleboy for a month). 

From lurking around the forum, it seems like BRAF/MEK combo is almost always a temporary bandaid, and the cancer tends to come back. Is this always the case? Is the combination with PD-L1 meds more likely to result in long-term remission, or should I go straight to TIL?

How effective is BRAF/MEK/PD-L1 and TIL at preventing brain mets? This is my worst fear. Given my line of work, even mild cognitive impairment could ruin me.

Anyone who's been through either is welcome to share their experience. How'd it turn out? What side effects did you get?

My personnel preferences would be IF the NON-inevitable Stage IV does occur and the melanoma world stands still until that time and if you know which DNA mutation your tumors have, then by being vigilant as  you are being to have your thoughts lined up.  I will stress that nothing is inevitable with melanoma (If so then I dead and just don 't know it!) 

    The BRAF targeted chemo alone will have a high rate of tumor advancement in time (50% in the first year.)  I have not yet heard of statistics on the combo with MEK for a long term prognosis.  Time will tell for this.  If a re-occurance is a rapidly expanding tumor load, then the BRAF/MEK would be a good way to reduce the then tumor load.  If time permits, my thought is that based on the current expections for PD-1 I would want to jump on it both as a quick readtion treatment that also offers the possibility of long term sucess. 

   If the PD-1 doesn't provide a quick response then I would be looking hard at the TIL/ACT process before I went too far downhill.    TIL is rough and as with all the rough processes the better shape one is in when starting them the more likely one is to survive the negative side effects.

   Keep learning and being watchful.

I'm me, not a statistic. Praying to not be one for years yet.

Ditto what Jerry said.