Keytruda - year 4: So I’m pretty much... - Advanced Prostate...

Advanced Prostate Cancer

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Keytruda - year 4

Chugach profile image
13 Replies

So I’m pretty much closing the book on my 4th year on Keytruda (pembroluzimab). I’ve recently completely my 33rd Pembro infusion. Keytruda was my Hail Mary after running through most other SOC. My PSA was rising while on chemo the second time when I found out I had the markers that made me eligible for pembro. Pembro crushed my PSA from 86 to undetectable (<0.01) in just a couple cycles. It remained undetectable for yr 1, over the next 2 1/2 years I had a slow rise to 1.2. Finally I was able to get a PSMA Pet scan to ID the source of the PSA. I had trouble getting support for more radiation, but finally got it zapped. Palliative of course! Following the high dose proton beam radiation my PSA has been reduced to 0.01.

Each of these infusion cycles (every 6 weeks) bills at over 100k, most recently at about $120k; insurance negotiates it to more like 38K; needless to say I I hit my maximum out of pocket expenses for the year every January. Merck has a co pay assistance program. But they changed the rules to only allow its use for the first 2 years, because of a hospital error I only was able to use it in year one. Any of you guys on Keytruda having issues with copay assistance? Not trying to complain- happy to be alive, but this liquid life is expensive!

stay strong!!

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Chugach
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13 Replies
Vindog29 profile image
Vindog29

My husband as I've told before ONLY had 2 doses of Keytruda never got anymore and now entering his 4th year undetectable so never had to deal with expense wish I could help in that category. But so happy it continues to work for you.

Chugach profile image
Chugach in reply toVindog29

such great news!!! I’ve heard similar from others. Early on, they said I had a lot of genetic diversity in my cancer- I suspected that the cancer that was recently hit with radiation didn’t have the MSI-h markers and was just slowly building over the last few years. While I don’t want to ‘rock the boat’, pembro and probably more notable- Lupron, are probably not necessary any longer. Does your husband still take Lupron?

If you would DM me the name of your husband’s medical oncologist and hospital- I’d appreciate another opinion on this course of treatment.

Vindog29 profile image
Vindog29 in reply toChugach

My husband gets a shot in his stomach every 3 months I think it is Lupron I will double check and Dr Michael Morris was his Dr at Memorial Sloan Kettering NYC but working now in Washington D C I believe with MSKCC for the government. He still is avail in the event my husband needs him. Another Dr has taken his place but just telehealth calls since then.

ImDD profile image
ImDD

Congrats. It seems odd something so effective would be limited to cases where all else fails since the "else" is much more intrusive. I want to see if I can push for immunology treatment earlier vs. later.

Chugach profile image
Chugach in reply toImDD

It was more of a case of not being aware of the right markers early enough- but I do recall at the beginning asking about immunotherapy and being told that I was not ‘sick enough. I’m also not sure pembro was SOC for PC when I was first diagnosed (2016). But earlier the better!!!!

ImDD profile image
ImDD in reply toChugach

Did you go to or were you referred to a specialist in immunology? Any recommended doctor or hospital? I wonder if immunology is a choice before radiation?

Chugach profile image
Chugach in reply toImDD

I was not referred to a specialist, rather all managed by my Med Onc

Chugach profile image
Chugach in reply toImDD

Radiation and immunotherapy can be complimentary. I’m not sure of the mechanism, but it basically helps expose the cancer so that the immunotherapy can find it.

rsgdmd profile image
rsgdmd

Congrats. Unfortunately, I fall into the category where, despite all the biomarkers, Keytruda has not worked. In fact, I'm part of a small percentage where there is hyper-progression on checkpoint inhibitors. Stopped after 3 infusions as my PSA went up rapidly & recent PSMA PET shows many more mets. Will be starting Pluvicto in 2 weeks.

Chugach profile image
Chugach in reply torsgdmd

I’m sorry to hear that didn’t work for you. Stay strong brother!!! I hope Pluvicto brings you some better results!

rsgdmd profile image
rsgdmd

Me too, thanks.

j-o-h-n profile image
j-o-h-n

Well Chugach.......You probably have seen my many posts regarding my Keytruda treatments for my Lung melanoma metastasis. It worked......

Inasmuch as you're an outdoor guy and miss Alaska.....we may be able to get you a spot on the TV show "Naked and Afraid".........

Take care and keep on outdooring.....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 10/23/2023 5:35 PM DST

Chugach profile image
Chugach in reply toj-o-h-n

Nice to see a note from you John - hope you are well

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