LMighty wrote:MSI-H or not, our onc was really recommending Keytruda...
Maia wrote:LMighty wrote:MSI-H or not, our onc was really recommending Keytruda...
That is nice to hear from the doc : )
I tried to reply to your question in this other thread:
viewtopic.php?f=1&t=57995&p=456927#p456927
LMighty wrote:Talked to the onc just now. He said ascites implies a more life-threatening outlook, so to control the symptoms ASAP, Keytruda is worth trying, considering it's potential and minor side effects, regardless of the patient's MS status.
He is very willing to use Keytruda along with other drugs if the initial rounds with Keytruda alone do not produce favourable results. Apparently I was not aware that the use of drugs in my country (Hong Kong) is much more liberal...
So as Maia said, Keytruda would not be the last option. I just hope there is enough time left for Keytruda to work its magic.
Thanks again Maia. You have pointed us to the right direction and given us hope.
LMighty wrote:Update: The MS status test result won't be available until after a week at earliest. After discussing with the onc we decided to go for the first round of Keytruda on Monday anyway. We don't want to wait in fear of significant progression anymore.
Meanwhile we are considering trying this regimeni in the future if my mom's MS status turns out to be MSS:
http://oncologypro.esmo.org/Meeting-Res ... ancer-mCRC
Maia wrote:LMighty wrote:Update: The MS status test result won't be available until after a week at earliest. After discussing with the onc we decided to go for the first round of Keytruda on Monday anyway. We don't want to wait in fear of significant progression anymore.
That is so proactive from your mom's doc, how great.Meanwhile we are considering trying this regimeni in the future if my mom's MS status turns out to be MSS:
http://oncologypro.esmo.org/Meeting-Res ... ancer-mCRC
Of course. That regimen has been discussed extensively in different threads in this forum. We have a fellow, ACPdiddy, in that trial viewtopic.php?f=1&t=57849&p=455797
There are other similar trials ongoing. One that adds bevacizumab --Avastin-- to cobimetinib and anti PD-L1, NCT02876224; that is interesting because adds an agent that we know it is active on mCRC. Other trial for MSS NCT02060188 combines cobimetinib + anti PD-1 + anti CTLA4 --Yervoy, an already approved immuno for melanoma.
LMighty: atezolizumab/ Tecentriq is an anti PD-L1. Even if it has a slightly different mechanism of action than an anti PD-1 --as pembrolizumab/Keytruda or nivolumab/Opdivo are--, so far everything points to the fact that they have similar results.
So, the combination of Keytruda with cobimetinib --Cotellic-- or any other MEK inhibitor available in Hong Kong --like trametinib (Mekinist) should be equivalent.
Maia wrote:So, the combination of Keytruda with cobimetinib --Cotellic-- or any other MEK inhibitor available in Hong Kong --like trametinib (Mekinist) should be equivalent.
LMighty wrote:One thing -- did you mean even though we can't get Tecentriq in Hong Kong, the combination of Keytruda with Cotellic is thought to produce similar result without Tecentriq?
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