More biochemo

Posted By
thrashter
4/10/2013 8:11pm
View other posts by
Activity
Replies: 11

Well today was mixed met with Oncologist and after removing another (7) clump of lymph nodes back to more biochemo sessions. Did (3) sessions already. She doesn't think radiation at lymph node area is much worth doing but will let me visit with radiation oncologist after next two bio sessions. This gets kinda old. 

Phil S - (4/11/2013 - 8:10am)

Unfortunately, for most of us on this Board, fighting melanoma is a day to day battle, with our physical and emotional health in the balance. We all accept days of discouragement, fear, and anger, it's part of fighting cancer. So, have your bad day wondering why, and feeling sorry that you have to do more treatment . Then, pick yourself up and BATTLE with all your might, we all want you to win against this disease. All the best and keep us posted, Valerie (Phil's wife)

Tina D - (4/13/2013 - 9:44am)

The rollercoaster is something we are all all too familiar with. It is a challenge to take in what you hear, and make decisions, and then live one day at a time, focusing on the blessings. It is ok to feel overwhelmed and tired from time to time... give yourself permission to do that. Sometimes it takes a few days to get your head around the newest bend in the road - that is to be expected. But then, back to one day at a time :)

Tina

Anonymous - (4/14/2013 - 10:11am)

Biochemo is old, a very old therapy not proven to work that well.  Have you looked at other therapies and are you going to a melanoma center?  This is toxic stuff and there are so many new things that work better.  Do some research and you may find a great alternative.

kylez - (4/14/2013 - 1:53pm)

Keep strong and hang in there with whatever treatment plan makes sense to you

I almost never post about stage III treatments, because I have no personal experience. I do have an interest in biochemo mainly because I it was 1 of 2 choices I was given in 2010 with lung mets. The other choice was IL2. 

I know the reputation of biochemo in the past as 'unproven in phase III trials. However that has apparently changed. See the article below from ASCO 2012 on results of a new phase III trial of biochemo -- the results were positive. 

Flaherty LE, Moon J, Atkins MB, et al: Phase III trial of high-dose interferon alpha-2b versus cisplatin, vinblastine, DTIC plus IL-2 and interferon in patients with high-risk melanoma (SWOG S0008):An intergroup study of CALGB, COG, ECOG, and SWOG. J Clin Oncol 30:541s, 2012 (suppl; abstr 8504)

"Two months of biochemotherapy provide significant survival advantage over 1 year of high- dose interferon therapy
One year of high-dose interferon alfa-2b is a standard postoperative (adjuvant) treatment for high-risk melanoma. However, currently, it is estimated that fewer than one third of eligible patients receive adjuvant therapy for melanoma because of concerns about the adverse effects of interferon and its low benefit. 

Results of a phase III trial, released this year, point to a shorter and potentially more effective alternative treatment regimen for these patients. The treatment—termed biochemotherapy, because it combines chemotherapeutic (cisplatin, vinblastine, and dacarbazine) and biologic drugs (interleukin-2 and interferon alfa)—extended recurrence-free survival in 432 patients with advanced melanoma by a median of 2.1 years compared with high-dose interferon. This is the best survival outcome ever reported in patients with stage III high-risk melanoma. Furthermore, only 2 months of biochemotherapy resulted in the same overall survival (56%) at 5 years as 1 year of high-dose interferon. The rates of serious adverse effects were similar between the two treatment arms. These trial results indicate, for the first time to our knowledge, that a treatment other than high-dose interferon could be used as an effective adjuvant therapy for those with high-risk melanoma. These findings will likely make many oncologists rethink the way they are treating these patients."   

Source: http://www.cancerprogress.net/pdf/CCA_2012.pdf

2 primaries; lung/brain mets in past; paratracheal lymph node currently; participating in  Opdivo/Lirilumab trial

Anonymous - (4/14/2013 - 2:33pm)

Interesting but not very good study comparing biochemo vs. interferon.  Neither of these drugs proven to extend overall survival.  Interesting to see biochemo against IPI or PD1 however or zelboraf..  The docs that continue to prescribe these do so for their own reasons.  But top places like Moffitt, and Sloan Kettering don't prescribe it anymore.  With Braf drugs and immunotherapies (and you don't need to be in the hospital for thousands of dollars a day) why use something of the past that is so toxic.

  I agree everyone has to make their own choice, but they need to do the research with the top melanoma specialists first.

kylez - (4/14/2013 - 5:13pm)

There's a lot of posts here on the dilemma of choosing treatment for stage 3. I've not been in that situation.

Anonymous, none of the newer treatments you mention (Z, IPI and anti-PD1) are approved for stage 3. While I don't try to keep up with clinical trials for stage 3, the only one of those drugs that I know for sure is in trial for stage 3 somewhere is IPI (probably with an interferon arm). From what I hear about Z, I would be surprised if it would be recommended for stage 3 today, as a monotherapy, even in a trial, because of the resistance issue.

2 primaries; lung/brain mets in past; paratracheal lymph node currently; participating in  Opdivo/Lirilumab trial

kylez - (4/14/2013 - 5:30pm)

And to prove myself further wrong, from Janner, " Zelboraf isn't approved for stage III unless the lesions are unresectable."

2 primaries; lung/brain mets in past; paratracheal lymph node currently; participating in  Opdivo/Lirilumab trial

kylez - (4/14/2013 - 5:43pm)

And to prove myself one step further wrong, it sounds like Yervoy is approved for some stage III situations as well. 

I don't know enough about Stage III a/b/c, so I better get out of the way and let any stage III-experienced folks respond with better information.

- Kyle

2 primaries; lung/brain mets in past; paratracheal lymph node currently; participating in  Opdivo/Lirilumab trial

kylez - (4/14/2013 - 5:28pm)

And to prove myself wrong, I went and looked on clinicaltrials.gov and did see some trials for stage III patients with Vemurafenib eg. Zelboraf.

-Kyle

2 primaries; lung/brain mets in past; paratracheal lymph node currently; participating in  Opdivo/Lirilumab trial

kylez - (4/15/2013 - 10:08pm)

Thrashter, 

I've spent some time at Kaiser Riverside (for IL-2). I hope the biochemo works for you. It's no doubt a good idea to keep your eyes open for any other opportunites depending on what treatments are considered standard of care for your situation.

I understand biochemo, like interferon, is a tough regimen. I hope you feel supported in your efforts there. Let us know how you are doing.

-Kyle

 

2 primaries; lung/brain mets in past; paratracheal lymph node currently; participating in  Opdivo/Lirilumab trial

Anonymous - (4/16/2013 - 6:55am)

I think a second opinion is definitely an option at a leading melanoma treatment center if you can. Are they thinking you are just stage III?  It seems like they are treating you for stage IV.  Whatever, it sounds like you need a better doctor/patient relationship and don't forget who hired who!