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Opdivo without Chemo first


renij

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Dad went for 12 week checkup today - has been on Opdivo and has been feeling pretty good.  However, he hasn't been on any chemo yet.  

 

Everything I read about Opdivo says that it is for "those who have previously been on platinum-based chemo."  The doctor, who has been the only oncologist that my Dad has seen, seemed to think that Dad had been on some chemo previously.

 

I'm concerned that the doctor hasn't been paying attention, since he never prescribed chemo, just Opdivo - and I'm worried about what the concequences of having not had chemo on his prognosis.  

 

Any thoughts from the group?

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Renij,

 

Welcome here.  Has your father had any in process diagnostic scans during his treatment with Opdivo?  You asked a very good question and I went to the National Cancer Institute (NCI) here - http://www.cancer.gov/about-cancer/treatment/drugs/nivolumab  - to look for an answer.

 

The NCI information is confusing.  Under their heading "Use In Cancer" they state : "Nivolumab [Opdivo] is approved to be used alone or with other drugs to treat:"  But then in a subparagraph identifying Non Small Cell Lung Cancer, they say: "...that has metastasized.  It is used in patients whose disease got worse during or after treatment with platinum chemotherapy...." 

 

So I'm confused, and I'm not a doctor.  I do think given the apparent conflict in the NCI drug data sheet, you should present this question to your dad's doctor.  It might be a good idea to accompany him during his next consultation to ask the question for him.

 

Stay the course.

 

Tom

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  • 3 weeks later...

​A second opinion might be a good idea too! Is there a cancer center nearby? I would see if they could do a second opinion for him. I am guessing that when something is new, some docs might try things that are not "the usual" but I would want more than one doc to say it's a good idea first.

 

​Be well,

Mary

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  • 2 weeks later...

We were told that immunotherapy drugs were very expensive and that insurance dictated we try chemo as a first line an if that stops working then they would look at immunotherapy. We are waiting now to see if my husband qualifies for a trial where they use a immunotherapy drug (doesn't have a name yet) along with a milder dose of chemo. From what our Dr. seemed to present, it may be the preference to jump to the immunotherapy. That is just my impression on what we heard.

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