jack14 Posted February 20, 2021 Share Posted February 20, 2021 Does anyone know if Keytruda can shrink a tumor for awhile, and after another set of infusions, have no effect on it, and then after another round, shrink it again, or show no growth again? In other words, can it's effects be intermittent? The side effects certainly vary and are intermittent. Anyway, I asked my PA Oncologist and all she said was "if Keytruda stops working, and we discontinue it, we never return to it". So, I guess that suggests that once it stops working, it is no longer effective? Of course, at 15 thousand dollars a dose, or whatever it is, I bet the insurance carrier is all for "moving on". I would like to add that, although my knowledge of pharmacology is somewhat limited, what I do know, tells me that drug efffects can be easily altered by storage temps, preparation, manufacturing snafus, and sometimes they just don't result in the same effects or actions that we desire. I also know that Keytruda for instance, is mixed up a few minutes prior to infusion and that it is not to be shaken, and even when it isn't, it can form air bubbles in it and that is something that the maker has warned about. Maybe, there are some things that are happening behind the scenes that are causing this drug to not work as it should. I once asked the RN who was terminating my infusion if I could have the infusion set for a momento and she said said "sure" let me disconnect the bag and you can have the set. I said, it was the empty bag that I wanted, and she replied, "oh, no, that has to be turned in to the pharmacy". She added, that it was policy. . Link to comment Share on other sites More sharing options...
LouT Posted February 21, 2021 Share Posted February 21, 2021 Wow Jack, you've got me with hat question, but I'll be watching to learn the answer. Lou Link to comment Share on other sites More sharing options...
LexieCat Posted February 21, 2021 Share Posted February 21, 2021 Sounds to me like you're asking, what are the chances a dose just went bad, and that's why there's no response? I suspect one reason that's unlikely is that the efficacy of the drug lasts beyond the time between doses. That's why, sometimes, patients take a break from immunotherapy and then go back to it. I've read that what's already in your system keeps working for some time after the last infusion. My GUESS (not being a medical professional) is that if the cancer is actually progressing, it isn't just because of one bad dose. We don't get scans every single infusion, either, so what shows up on the scan might have been going on for like 9 weeks. Probably all three doses (at least) would have to be "bad" for that to happen. Link to comment Share on other sites More sharing options...
Jennedy Posted February 21, 2021 Share Posted February 21, 2021 Could the difference actually be in the scan? How it was sliced or difference in machinery? Link to comment Share on other sites More sharing options...
jack14 Posted February 21, 2021 Author Share Posted February 21, 2021 I ran across an interesting comment from a cancer patient in the UK while discussing this a few minutes ago. Here is what she said verbatim: "I just discussed this with my oncologist. There are trials taking place looking at ‘Rechallenged Pembrolizumab’ The findings so far are that 40% of people have a renewed response when Pembrolizumab is restarted."-NS I hope that the FDA approves this if there's any truth in it, for those of us who might benefit. Link to comment Share on other sites More sharing options...
jack14 Posted February 21, 2021 Author Share Posted February 21, 2021 36 minutes ago, LexieCat said: Sounds to me like you're asking, what are the chances a dose just went bad, and that's why there's no response? I suspect one reason that's unlikely is that the efficacy of the drug lasts beyond the time between doses. That's why, sometimes, patients take a break from immunotherapy and then go back to it. I've read that what's already in your system keeps working for some time after the last infusion. My GUESS (not being a medical professional) is that if the cancer is actually progressing, it isn't just because of one bad dose. We don't get scans every single infusion, either, so what shows up on the scan might have been going on for like 9 weeks. Probably all three doses (at least) would have to be "bad" for that to happen. Yes, that sounds reasonable to me. I haven't considered that possibility. Link to comment Share on other sites More sharing options...
jack14 Posted February 21, 2021 Author Share Posted February 21, 2021 38 minutes ago, Jennedy said: Could the difference actually be in the scan? How it was sliced or difference in machinery? Oh yes, the size is an estimate and can vary somewhat between different assessors. I became somewhat adept at reading my own aortic aneurysm measurements during reviewing serial CT Scans to monitor a AAA, a few years ago. I had a friend who was a radiologist give me a copy of the program that allowed me to measure it. I had to choose which section to measure across and the choice was somewhat subjective. Not always a straight line, in fact most of it was diagonal. I would like to try doing it with this, but it did stress me out a bit. Especially when my aneurysm got large. There is some peacefulness in ignorance. Link to comment Share on other sites More sharing options...
jack14 Posted February 21, 2021 Author Share Posted February 21, 2021 1 hour ago, jack14 said: I ran across an interesting comment from a cancer patient in the UK while discussing this a few minutes ago. Here is what she said verbatim: "I just discussed this with my oncologist. There are trials taking place looking at ‘Rechallenged Pembrolizumab’ The findings so far are that 40% of people have a renewed response when Pembrolizumab is restarted."-NS I hope that the FDA approves this if there's any truth in it, for those of us who might benefit. Here is something I just found:https://clinicaltrials.gov/ct2/show/NCT03526887 Link to comment Share on other sites More sharing options...
jack14 Posted February 21, 2021 Author Share Posted February 21, 2021 Anyway, having studied this, I am not sure that there is much good news to be found about revisiting the same immunotherapy compounds that had stopped working. Most of the reimplementation of these therapies purported successes, if I am reading it correctly, occured when they were stopped because of intolerable side effects, toxicity, etc. and later reintroduced. So, back to the drawing board as they say. Link to comment Share on other sites More sharing options...
TJM Posted February 21, 2021 Share Posted February 21, 2021 Darn. I was going to keep that one in my back pocket if correct. I am pretty sure I have read that they may reccomend rechallenge using Chemo if a recurrence happens 6 months or longer after treatment had occured. Keep looking and keep sharing! Peace Tom Link to comment Share on other sites More sharing options...
Robert A. Posted February 22, 2021 Share Posted February 22, 2021 When my wife was on Keytruda for about6 months and we found this article, I don't know that it answers your question. https://www.cancercenter.com/community/blog/2018/09/tumor-growth-sometimes-its-a-good-thing Link to comment Share on other sites More sharing options...
jack14 Posted February 23, 2021 Author Share Posted February 23, 2021 6 hours ago, Robert A. said: When my wife was on Keytruda for about6 months and we found this article, I don't know that it answers your question. https://www.cancercenter.com/community/blog/2018/09/tumor-growth-sometimes-its-a-good-thing Thanks Robert Link to comment Share on other sites More sharing options...
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