Immunotherapy Drugs

This topic contains 4 replies, has 2 voices, and was last updated by  cards7up 3 months ago.

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April 19, 2017 at 2:53 pm  #1290610    

cards7up

I’m seeing this more and more and wanted an opinion from the oncologists. Someone had one immunotherapy drug like Opdivo and it didn’t work, so they’re going to try another one like Tecentriq? I’ve also read that if one doesn’t work, it’s not likely another one will. Clarification, if you have any answers. Thanks!
Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

April 19, 2017 at 6:58 pm  #1290611    
JimC Forum Moderator
JimC Forum Moderator

Hi Judy,

Dr. West has written about this question:

“It remains to be seen whether you can treat a patient with a PD-1 inhibitor like Keytruda, like Opdivo, and then get a good result once they show progression because you’ve given them a PD-L1 inhibitor, but for all intents and purposes, the results in terms of efficacy and also side effect profiles are remarkably similar and most specialists feel they are really essentially interchangeable until we see evidence showing otherwise.” – http://cancergrace.org/lung/2016/

From that statement, it appears that while the trial evidence isn’t available, most oncologists would not expect success after progression by switching from (for instance) one PD-1 inhibitor to another, but switching from a PD-1 to a PD-L1 inhibitor might be effective.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

April 20, 2017 at 4:49 pm  #1290617    

cards7up

Thanks Jim! wonder why when I searched this didn’t come up. Do you also know if it works with EGFR/ALK mutations, as I’ve read that it doesn’t? Take care Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

April 21, 2017 at 6:41 am  #1290621    
JimC Forum Moderator
JimC Forum Moderator

Hi Judy,

If your questions is whether an EGFR- or ALK-positive patient should switch from an ineffective PD-1 inhibitor to a PD-L1 inhibitor (or vice-versa), I think there would be less enthusiasm for that, since the response to either type of immunotherapy agent tends to be low (although not zero) in such patients. Switching from one agent with a low probability of success to another one with similar prospects would probably not be the first choice.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

April 21, 2017 at 12:15 pm  #1290626    

cards7up

No, my question is whether it’s been shown to work for those with these mutations, as I’m reading that it’s not. And you ended up answering this question either way! Thanks again!
Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

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