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Chemo after immunotherapy

Dak82's picture
Dak82
Posts: 81
Joined: Dec 2020

Looking for anyone with this experience.

Since starting immunotherapy treatments in May--2 Pembro and 2 dostarlimab--my oncologist is considering moving me to Doxil due to disease progression. I had one X-ray and one chest CT that indicate very rapid pulmonary tumor growth--from 9mm to 3.8cm in 3 months--and now extensive mediastinal and hilar lymph node involvement. Our discussion yesterday centered on proceeding with one more dostarlimab or going directly to Doxil. I have had a disturbing break in the 3-week dostarlimab cycle due to hospitalization and surgery--the next CT scan on 20 Aug will have been nearly a full 6 weeks from my last treatment. The results of that scan will dictate direction taken. From  asymptomatic standpoint I am coughing much less than I was several weeks ago and any fatigue or weakness I feel is due to hospital stay--in my mind--since I lost nearly 8 lbs in 9 days.

I view a move to chemo as a last ditch effort to bring tumor growth under control and not a longer term solution although there is at least one paper I read about 6 patients who had been on immunotherapies for varying lengths of time who were subsequently put on docetaxel--with a 100% positive response. Interesting.

Thanks in advance!

Deb

TeddyandBears_Mom's picture
TeddyandBears_Mom
Posts: 1802
Joined: Jun 2015

Hey Deb, I don't have experience to offer but wanted to say that I'm thinking of you. I hope the scan offers some clarity in your next steps.

Love and Hugs,

Cindi

 

els19
Posts: 105
Joined: Jun 2014

I have seen postings on other sites where immunotherapy did not work and the person then had chemo with success. It seems that sometimes it's a matter of finding what works for each person. I know it must sometimes feel that you're a guinea pig that keeps trying new treatments but I think it also shows you have a very good doctor who's aggressively trying to find the right treatment. Stay strong! You've definitely shown you're a warrior! This is not an easy life we've been thrown into but we have to keep fighting. Sending prayers and positive thoughts your way.

Dak82's picture
Dak82
Posts: 81
Joined: Dec 2020

Really appreciate the encouraging words. My last scan to check for pulmonary blood clots (negative) showed very rapid growth of my lung nodules to tumor size with the imication being that the immunotherapy is not working. I told my oncologist I will accept whatever decision she thinks is best but she wanted me involved in the decision-making. I would prefer to give the dostarlimab another go but now I'm worried because my next infusion of whatever is scheduled for 6 weeks after the last one. And my scan isn't for another week. My hospital stay threw a monkey wrench into my schedule and My oncologist want me to gain some weight and strength before doing anything else. All I can think about are these dang tumors in my lungs growing like wildfire. So I'm hoping the immunotherapy has at least slowed it down because we don't have a good idea on growth rate. But it seems to be fast. I have to go by how I feel which isn't bad--no increased shortness of breath and my coughing has eased to almost nothing. Positive signs at least!

Hope everyone is having a peaceful and happy end of summer!

Deb

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