Stage 3B - Targeted therapy ( tablets) or immunotherapy?

Hi Joolskigirl, I’m sorry to hear about your husband’s diagnosis, good news on his clear scan and that it sounds like he just needs adjuvant treatment for a year. You were asking for experience I’ve had Dabrafenib (before Tramatenib was available with it outside a clinical trial) and I’ve had Pembrolizumab both were not for adjuvant treatment but because not all the cancer could be surgically removed. 

I’ve had little in the way of side effects from either treatment and the list of possible side effects is very similar for both. Drs won’t know who will react more to the drugs side effects or who they will work best for, but with BRAF positive you can have if necessary one after the other. So you could look at it just from which method suits your husband and your life style best. For side effects, the tablets can be stopped for a few days, and for the iv treatment a dose can be delayed if a spare slot can be found and he’s assessed as well enough. Decisions could be based on time spent travelling and hanging around the hospital, work hours missed, how he will cope with cannulas going in, or not eating and drinking for certain hours. Which ever is chosen you get used to it and it becomes normal. Covid also may come into the equation, minimising mixing with others or the need for tests and isolating before iv’s, although different hospitals may have different procedures. 

If you have any questions fire away, or we can just listen to you working through your thoughts. 

• Wow that is so helpful! Thanks very much  - you make some great points there about the practical issues and the cannulas too which I hadn’t considered.
• We’ve read both advice booklets and the list of side effects is quite scary but everyone’s experience is so different we understand they’ve got to cover all bases.
• It’s a good point that he might end up trying both over the years that come. I think for now he’s edging towards the tablets as there’s still a lot of travelling we’d like to do and things on the bucket list (covid-allowing). Thanks again for taking the time to share your thoughts  

Hello Joolskigirl,

My fiancé was offered a pembro treatment trial following a wider exision and 2 lymph nodes removed. He was also diagnosed Braf positive. This was by IV treatment every 3 weeks for 1 year.

He found the first few treatments worst but manageable with diarrhoea and severe tiredness. We holidayed abroad after 3 treatments fitting it in between the treatments. After that the side effects were mainly tiredness. 

Unfortunately he had a year without treatment and the melanoma came back but each time removed with surgery.

He is now on dab and tram taken as tablets from home, and visits his consultant every 28 days to renew tablets, and blood tests, with scans ecery 2 months, and side effects mainly tiredness. He is continuing with everyday tasks, but as he is retired can rest if he needs to. 

We have found it best to ask as many questions as you need answers to, as you go along, and make sure you report any skin changes asap.

Best wishes

Thank you Margyy really appreciate your response. I think at the moment he’s veering towards the tablets as it’s more convenient and we want to travel! Everyone’s experience is so different. That’s what scares me as you don’t know what the side effects or outcome will be…. 

Every story I read on here seems to include the cancer coming back which makes me sad. I’m really hoping there are some good news stories where it doesn’t. 

my husband will only have the tablets for 12 months which surprised me as I presumed you’d take them the rest of your life if their role was to inhibit the growth of cancer cells. But I presume they stop and start treatments depending on what the side effects and results are. 

I’m certainly going to be very vigilant re any lumps and bumps. It’s such a horrible condition. 

Good luck to your fiancé. Take care and thanks again. 

I think everyone's situation is different. I think you can only take Dab and Tram initially for 12 months. Then if you can cope with the treatment and it is working ok, you can go back on it, after a period of time off it, or if needed there are other treatments available.

I have only just joined this forum, and I think it is helpful to follow others & to see what treatment is offered.

Good luck

Thank you Margyy yes I’m finding this forum useful already just to hear about others experiences and it makes you feel not quite so alone! It’s always good to hear from people who are going through what you’re going through, supplemented my medical advice! 

Good to know that you may be able to repeat treatments past the initial 12 months depending on how you get on. Thanks again! Take care and keeping my fingers crossed for you. 

Hi Joolskigirl,

Just thought I would up date you, my fiancé had his first scans last week after 2 months on dam and tram. The results came back today, the 2 tumours in his liver and lung have gone  & 1 in a lymph node in his chest has shrunk.

We are so ecstatic at this news, that the treatment has worked so quickly, just before Christmas too. 

All the best

Margyy

Really good news Marggy, so pleased for you and your fiancé 

So nice to hear good news xx 

That’s fabulous Margyy  what great news before Xmas! I can understand how delighted you must be. My husband had decided to take the targeted therapy tablets route and now has them to start on Boxing Day. He’s nervous about the possible side effects but pleased to be taking some action. He also had his check up with dermatologist which was fine so that’s positive news. We still find the whole experience a bit of an emotional rollercoaster. Stopping ‘googling’ as I find that very depressing! Thanks for sharing your news - I’ll pass that on as that will cheer him up! Take care and have a lovely Xmas!