Expert: Claes-Gustaf Nordquist, M.D. - 3/1/2011

Question
QUESTION: My husband, 43 yrs, has stage 4 metastatic brain melanoma. We found this out 3 1/2 weeks ago. He has had 13 wb radiations, doing great. They recommend trail drug everolimius in combo with chemo drugs paclitaxel and carboplatin. My question is what is your opinion of this trial? what about ipiluminab, or GSK2118436 trials? I really appreciate your time, thank you

ANSWER: Unfortunately so far most malignant melanomas have been quite insensitive to radiation therapy and chemotherapy. Interesting studies are going on with immunotherapy but they are still experimental. So unfortunately I do not have any really good news to report. Not as far as I know anyway.




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---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your answer. By saying "quite insensitive to radiation therapy..." do you mean the positive effects of his radiation will not last, and any positive effects of chemo might not last? He is doing so well now, even wants to go back to work part-time until chemo (3 weeks from now). The oncologist will not answer my question when I ask what his chances of survival. All he says is that "he might not survive this" What do you say? Thank you

Answer
Unfortunately, based on experience, I have to be quite pessimistic. Stage 4 malignant melanomas that have spread to the brain usually have a very bad prognosis.



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