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2nd Consultation at UCSF

Had a second consultation at UCSF today.
  • If the V600E BRAF mutation test is positive, my UCSF oncologist's recommendation would be to pursue experimental therapy with a B-RAF inhibitor first. The idea would be to try to keep me stable as long as possible, since there's a lot of promising experimental therapies in the pipeline, say, next year and beyond. He said there might be some role for DTIC (Dacarbazine) as well. He feels the experimental B-RAF treatments are more prolonging to my stability than IL-2 treatment in the short-term and, IL-2 could be done at any time, whereas experimental trials have more limited recruiting periods.

  • If the melanoma instead is a wild type, his recommendation would be look for C-KIT and N-RAS mutations next, which almost never co-exist with the B-RAF mutation. IL-2 would also be promoted at this point to, perhaps, a first-line therapy.

  • A treatment he doesn't believe in is biochemotherapy (a combination of low-dose IL-2 with other chemotherapy agents). Frying bone marrow is as bad as it sounds, and 5 randomized clinical trials to date have not shown a positive outcome. No reason to do something nasty just for the sake of doing something. I'm happy to scratch that one off the list.

  • Another doctor that was present indicated that some molecular / mutation profiling of my melanomas over time may be worthwhile at some point (2001, 2008 and 2010 tissue samples so far.)
The treatment planning will get more concrete once the V600E test comes back.
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