Protrude and ulcerative colitis

[Sunny44]

Does anyone have experience with Keytruda or another approved immunotherapy and its use in patients who previously have had ulcerative colitis? My mom (77) had an initial tumor removed in November, melanoma in her lymph nodes which were removed, clear pet and mri scans since but now a tumor in her groin has melanoma cells. We know she's not a candidate for most and maybe all clinical trials due to her ulcerative colitis which has been in remission for 50 years, most of that without any additional medical treatment. Now she takes a pill to keep it in remission. But what about Keytruda? I've seen articles where patients with UC have a 50% chance of a flare up, but the other half don't have any impact involving UC. Does an existing autoimmune disease, even in Remission, typically rule someone out from being a candidate for an approved immunotherapy?

[Sunny44]

Topic should have been "Keytruda and Ulcerative Colitis". Thanks spell check! Hopefully the keywords will clarify that.

[missyrand Ambassador]

Sunny44

We have had no GI side effects with 44 rounds of a Keytruda. I don’t know what the current state of UC is relative to a non-indicator for immunological or targeted therapy. Great question to take to researchers and providers. It may depend on the individual and status of the colitis

I’d be interested for you to share in this community what you learn and your journey. I wish you good health in your family

Missy

[Sunny44 in reply to missyrand]

Thanks, Missy. I will keep the board updated. Here's a link to the article I mentioned. immunosym.org/daily-news/im...

It seems Keytruda rather than Opdivo was tolerated better, and that any flare ups were managed successfully and/or stopping treatment resolved the issues. That sounded pretty hopeful to me. We are under care at a Melanoma Center of Excellence so I am confident we are getting good care. I've just learned a lot from this board about making sure you are informed and having an open mind. My biggest concern is that my mom may make a decision of not pursuing further treatment without being fully informed thinking she has no treatment options due to her UC past and that without prodding the doctors somewhat they might not suggest other treatment options if they think she doesn't want any. It's tough - we all will support her decisions. Already two surgeries and lots of scans since October and she is 77 and doesn't want the roller coaster to continue or get other side effects. And I'm not sure it's as easy as saying "just try this and if there's a flare up it will get treated and you'll be no worse off."

[missyrand Ambassador in reply to Sunny44]

I have posted similar thoughts on other threads, but I find it helpful to be clear about what the goals are of the patient so that decisions are made in alignment with those goals, so I really hear you as to considerations for your mom's age/ preferences/ tolerances as you support her in moving through the choices that are presented for treatment.

I have appreciated looking at the concepts of palliative care, which align with open discussions first for what the goals and preferences are for the person living with cancer as a guiding orientation. Perhaps reading through some of these ideas will be helpful as you partner with your mom?

emedicine.medscape.com/arti...

Asking about what the experience is with the care team around side effects with someone who already has her history of UC is a more exquisite conversation and I'm sure you will be asking

missy

[Sunny44]

Thanks, Missy. I do remember seeing some posts about palliative care and how enormously helpful that is. I'll go back and look again. I so appreciate this board and all the info and support!