Wewillfight wrote:If you guys were to take a shot at one of these combos which would it be?
Avastin or Stivarga / Pembo
Is there any indication that Avastin instead of Stivarga could be more beneificial
Obviously it is a roll of the dice but hoping to weight the dice in favour especially if throwing 20-50k at it
I’m assuming you’re MSS in this response...
I’m not aware of any suggested synergy between Avastin and Opdivo or Pembro. Obviously Avastin is a good drug so no reason not to take it, however also no reason to expect it would make a PD-1 inhibitor work in an MSS patient.
Pembro (Keytruda) and Opdivo are both PD-1 checkpoint inhibitors, so in theory Rego could have a similar sensitising effect with Keytruda that it appears to with Opdivo. There are trials underway now to test this. However given it’s currently untested and you’d be gambling with your own money, I’d personally preference Opdivo.
There are a couple of other things you could consider alongside a PD-1 inhibitor:
1) radiation therapy - there is suggestion (and several trials) that radiation to tumour areas (anywhere in the body) may sensitise the immune system to previously ‘cold’ tumour cells, allowing a PD-1 inhibitor to have therapeutic effect
2) Pixatimod - which is currently in trials with Opdivo with some very early but encouraging results.
Best of luck,