Opdivo Quit Going from One Immunotherapy To Another

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October 24, 2016 at 10:24 am  #1288988    


I’ve had 34 treatments of Opdivo and all tumors were gone except for the primary which has continued to shrink or remain stable. Sept. 16th scan results. I read the report and it sounds bad but then at the end it says “close continued radiographic follow-up recommended”. I’ll post the parts of the scan that don’t sound very good but my questions are any advice?? Anybody else have this?? What options are out there and what questions should I be putting on my list to ask my onc? Should I get someone else to read my scan? Here’s the highlights of what the scan says:
There is a increasing nodular region posterior to the right hilum measuring 2.1 x 1.8 this is concerning for progression of disease.
New nodular foci measuring 1.4cm.
One of the discrete nodules previously indentified has disminished.

I will have another scan this week and if it shows that Opdivo has quit working I will need to decide what my next step will be. My Onc gave me the options of chemo, ( which I haven’t had much luck with), or Keytruda or now possibly Tecentiq/Atezolizumab . His thoughts were to try Keytruda, I guess the thought sometimes is if you responded to one immunotherapy you could respond to another. Has anybody done this? Anybody want to give me their opinions on what you would do? Thanks

October 24, 2016 at 3:27 pm  #1288989    
catdander forum moderator
catdander forum moderator


I don’t know that doctors have tried consecutive immunotherapies but I’ll ask one of our faculty to weigh in on it. As far as the scan results it’s important that you go over the results with your oncologist. The report is written by a radiologist who doesn’t see patients but has extensive training in reading scans so it’s up to your oncologist to interpret the report and possibly look at the scan or confer with the radiologist about the report. It’s common to be confused about a scan report and most oncologist try to deliver the report/scan findings to keep stress from misunderstanding scan reports.

I hope you do well and best of luck,

October 24, 2016 at 3:51 pm  #1288990    
Dr West
Dr West

To my knowledge, there is no evidence to speak to how likely it is that someone will respond to another immunotherapy agent after previously responding to another but then progressing. It’s not surprising that someone would feel tempted to try it, but I have never heard of any results from even a case, and I don’t think we have any reported results of this approach tested in a meaningful way.

Good luck.

-Dr. West

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