Can i get Opdivo Every Two Weeks if on Prednisone?

Posted By
Sharon93065
9/8/2017 8:16pm
View other posts by
Activity
Replies: 12

Thank you in advane for the help you are going to give  me, you always do.  My liver panel was thru the roof so sadly my 4th Opvio/Yervoy was cancelled and put on the Prednisone 5pack.  5 for 5 days 4 for 5 days eetc. Yesterday I was on the 1/2 for 3 more days.  Had my weekly blook work done.  Then my Dr called to say my liver numbers were up slightly and put me on Prednisone, 3 per day until he tells me otherwise. 20 mg each.  The queston is do you know i you that will delay the Opdivo every two week maintenance?

i just saw white spots on my hands, i hope I am not starting to get Vitiligo Might be scarring from all the itiching when i was getting rashes. 

Sharon

 

 

Hi Sharon, I'm on the extended access Opivo/Yervoy trial so when my liver numbers peaked, plus fatigue, rash and pneumonitis, I skipped the third dose and went onto prednisone, 75mg, tapered down over 6 weeks, then rec'd the 4th dose late, the trial rules were a max of 10mg prednisone.

I'm now on Opivo maintenance, and when the Vitiligo appeared on my hands the onc was very happy as its regarded as a sign the treatment is working, also my eyebrows are turning white and my hair is thickening, apparently all good signs.

Hang on in there and keep on smiling, Tony

 

Tony -  IV - Ipi/Nivo (Yervoy/Opdivo); now on Nivo maintenance

That is very good to hear, i do have a few white eyebrows, but I am 70, and don't know if they were there before a not, will have to pay closer attention.  

Off trial you should be able to have nivo treatments while on prednisone once the side effects are under control.  I was on 20mg daily for most of my nivo treatments.  I did not have liver issues however.

I recently asked my husband's onc about concurrent Keytruda + Prednisone. He said the two drugs "kind of" do the opposite, so there isn't much point in taking them together. That's why people usually suspend immunotherapy while taking Prednisone.

Hi Sharon, as you can see from the posts already there seems to be different approaches to the steroid question. I was watching a presentation with Dr. Mario Sznol and Dr. Postow that is pretty detailed on IRAE's for Melanoma and Immunotherapy in general. Here is a link to I hope the question section and the overall presentation.http://learn.peerviewpress.com/p/index.html?collection=150204255-2-2&pre... and start of presentation link http://learn.peerviewpress.com/p/index.html?collection=150204255-2-2&pre...  

Thank you, I did watch it.  Interesting hear them talk about it.

 

From my understanding, low doses of prednisone (<11mg) are used by the body and do not impact the immune system. Higher doses suppress the immune system (temporarily ending immunotherapy side effects until the immunotherapy effects on the immune system wear off). So you wouldn't want to be on a dose of prednisone >15mg/day while getting new doses of immunotherapy.

Jan‘17 Mel. 3B unknown primary. Neck dissection Feb’17 (tongue atrophy from surgery). Ipi Mar‘17-May’17(Hypophysitis), recurrence Sep’17(nodes behind ear&parotid). Pembro Oct‘17-

Thank yo everyone for your help and advise.  When 5 days befroe what would have been my 4th combo treatment my liver numbers spiked.  He put me on 50 per day for 5 days, then 40 for days etc until I was on the 5 for 5 days, then went the numbrs went up just a little he called and put me on 30mg a day until further notice.  I have Petscan Monday, appt 1 week after that.  I just didn't want another delay before Opdibo maintenance if that's what I really get to have.  That's what he said before.  My rashes are gone, but of course i am on prednisone, fatigue still there, and insominia.  Very fortunate not to get the fever, nausea, bowel probems (knock on wood, thank you Lord!) that I read a lot of you have had. The Forum helps me more than  you know, it helps us all!!

Sharon

I just looked at Prescription, each pill is 20mg. So i started on 100 a day for 5 days, then 80etc.

So now i am on 3 pills a day = 60mg.   More than i thought. 

Dear Sharon -- the answer might also depend on your liver numbers, not just the prednisone. My ALT hit close to 180 when taking pembro only (no ipi) - I think just below grade III AE. So they put me on prednisone and no more pembro. But the liver numbers came down with the prednisone, then they waited while i was off prednisone to see if the liver numbers stabilized (I think ALT around 60) then I went back on pembro.

What I dont understand is that after another six months of pembro my ALT is now back down to 35 (normal), whereas in my first three months of pembro ALT shot up to 180.

To keep ALT down I have been told no tylenol and no alcohol. So Ihave been tee total for a year (may a small sip on new years eve).

Am interested in others' experience -- for me I had to wait until I was off prednisone before being allowed back on pembro. And also for my ALT AST to be not too far off normal. And weekly bloodwork while my ALT was high to check its path. Was my doctor too strict? Or did he save me from side effects? Anyway am glad I made it back on to pembro and also that my ALT now normal (I dont understand these drugs)

Good luck Mark

I took prednisone pills and received Opdivo infusions for 6 weeks, while I recovered from my first Yervoy/Opdivo treatment.

I had 2 bouts of hypophysitis and both times had to go on heavy doses on prednisone.  the 2nd time the doc said that once I got down to 10 mg she would try Nivo (not ipi again).  I have been on daily 5mg and been doing nivo every two weeks since November 2016