So fabulous! Congratulations! You give me (us) hope that one day, we too may be able to make such a declaration...! smile

I did IMRT with 5-FU (oral) at Mayo Clinic in MN for 8 weeks in 2015. Unfortunately it didn't eliminate my peritoneal recurrence. It did, however, damage my pancreas. I now need to take Creon with meals for proper digestion. We did unusually high doses of IMRT in an attempt to cure vs. palliate.

3

(357 replies, posted in Introductions!)

Thank you all for the well wishes!

This update is a bit late...

LFTs were high on a Wed as stated previously. I went in the following Fri and AST/ALT were down a bit but Alk Phos was up a bit. Feeling a bit better about those results, we left for a week of vacation as planned.

After getting home, 8 days later, I went in for labs Mon morning and everything was back to normal without any intervention.

I'm beginning to think the spikes aren't the Keytruda but perhaps linked to drinking alcohol in moderation. I was never a heavy drinker, maybe 4 drinks a month... after diagnosis I stopped almost completely, but on occasion I'll have a drink and these spikes seem to happen after that. Maybe a coincidence, maybe not. I've now stopped ALL alcohol and will see... I won't miss it a bit.

I'm scheduled for Keytruda #10 this Wed.

-Matt  smile

4

(357 replies, posted in Introductions!)

Went in for Keytruda infusion #10 on May 25, 2016 and had labs before the infusion, as usual. My liver function tests are high sad

Alk Phos - 167
ALT - 108
AST - 145

This is the second time this has happened on Keytruda. The first time was in January, after about 3 infusions.

This time, the numbers aren't as bad as they were in January, but still not good. It indicates that the Keytruda is likely causing my immune system to attack not just the cancer, but my liver too.

Skipping treatment today and will come back for labs in two days to see if they are getting better or worse. If they are worse, I will start prednisone (steroids) again to knock back my immune system for a bit.

Welcome Annie - I'm sorry to have you in "the club" but so glad you've introduced yourself and shared your story. This forum and the foundation are a great source of information and support, as you said. I look forward to meeting you in person at the next conference!  -Matt

6

(357 replies, posted in Introductions!)

No side effects to speak of... amazing!

7

(357 replies, posted in Introductions!)

After 8 infusions of Keytruda, I had abdominal and pelvic MRIs and a chest CT scan last week. Results show no evidence of disease! My CA 19-9 is also at another all-time low of 8. I plan to continue the Keytruda for at least one year, thru Oct 2016. One very happy camper here. smile

You are correct that it is not US FDA approved for CCA. It likely never will be due to the cost involved and the lack of associated revenue.

It is, however, able to be prescribed "off-label" by any oncologist in the US. The catch is that Insurance will likely not cover the cost in that situation.

I did not qualify for any trials so I'm taking it off-label.

Frank,

I have been taking Keytruda since October 2015 (6 infusions total so far) with great success. It took about 4-6 weeks to "kick in" to the point where I could see a drop in my CA 19-9 level.

You can see my whole story, including more details on the Keytruda experience here: http://www.cholangiocarcinoma.org/punbb … p?id=11456

I think it's too early for your wife to call it quits just yet. I hope the review board agrees!

Best of luck and keep us posted please.

-Matt

10

(357 replies, posted in Introductions!)

I've the most fantastic news to share...

I got my CA 19-9 results from this week just now and it's at 15. NORMAL

Now I know CA 19-9 is not always a good marker for everyone, but over the past 2+ years it's been a "spot on" marker, so I am now officially "cancer free". There is "NED" on both scans and blood markers!

I'm in shock...

CA 19-9 spiked at over 1,500 just 4 months ago and started coming down after just two infusions of Keytruda. I took a nearly 8 week break between infusion #5 and #6 and CA 19-9 continued to go down from 151 to 15 over that time period. The drug clearly has long-lasting impact.

Updated CA 19-9 charts attached.
http://s15.postimg.org/dvkfbqdxj/Screen_Shot_2016_03_04_at_11_39_15_AM.jpg

http://s13.postimg.org/r8f91z277/Screen_Shot_2016_03_04_at_11_40_51_AM.jpg

11

(357 replies, posted in Introductions!)

Keytruda infusion #6 was today, 3/2/2016.  Labs were normal. Will post CA 19-9 results when I get them.
http://s17.postimg.org/a62m1f0sr/image.jpg

12

(357 replies, posted in Introductions!)

God willing Marion, I'll be bringing  my wife next year and for the next 25 after that!  wink

marions wrote:

Matt......fantastic news.  The enclosed chart leaves nothing to imagination, it clearly supports your comments of continuous success with your treatment.
So happy to have met you in person.  Are you planning on attending next year's conference as well?
Hugs
Marion

13

(357 replies, posted in Introductions!)

Good news!  I had labs done this past Wednesday, 2/10/16, and my liver function test results are ALL perfectly normal now.

This is after taking steroids to put the breaks on my immune system after the Keytruda triggered an autoimmune hepatitis.

I continue to take 10mg of prednisone daily and plan to have my next Keytruda on 2/24/16.

My CA 19-9 continues to go down even though I haven't had a dose of Keytruda for over a month. The long-lasting effect of Keytruda I'm seeing is consistent with what I've read and heard from others.

http://s11.postimg.org/xzw943gxb/Screen_Shot_2016_02_12_at_11_00_38_AM.jpg
http://s2.postimg.org/rh15vqj2d/Screen_Shot_2016_02_12_at_11_00_12_AM.jpg

Does anyone here know of ANY patients who are or have taken Keytruda or Opdivo (pembrolizumab, nivolumab, MK3475), the anti-PD1 immunotherapy drugs?

I started Keytruda back in October 2015 and would like to network with others.

Thanks!

15

(13 replies, posted in Introductions!)

I'm taking Keytruda and not as part of a clinical trial.

You just need a doctor willing to prescribe it... that and be able to pay for it. Insurance won't cover it since it's not FDA approved.

A clinical trial is the way to go, if possible.

grsharp wrote:

Marions, we haven't asked why a positive biopsy is needed. I guess it just seemed normal that you would need to have a positive biopsy before starting treatment just in case it was not cholangio.

But is also makes sense that if you are 99% sure then why wait.

She had another attempt at a biopsy yesterday (the 1st one at Vanderbilt). The Dr said he took a needle sample thru the stent, a brushing and a sample with  forceps. We should hear something in 3-5 days.

I saw on this site that someone had good results using Keytruda. Does anyone know if you have to be in a clinical trial to get Keytruda now?

16

(357 replies, posted in Introductions!)

Had labs done today and my liver function test results are much better than they were a week ago. Some are perfectly normal now and others are moving rapidly in that direction. This is after taking steroids to put the breaks on my immune system. It appears that the Keytruda triggered an autoimmune hepatitis. I'll resume Keytruda in a few weeks. No need to fly out to Mayo Clinic tomorrow for an ERCP so I will be heading to the conference in Salt Lake City next week after all! Very happy!

17

(357 replies, posted in Introductions!)

Yes, I did Melinda - and I did have a minor (100F) temp the following day and that went away and morphed into a cold... I'm sure it's just a little virus. Labs this Wed will tell and I'll post results.

mbachini wrote:

Hi Matt,

Didn't you say you threw up during your MRI?? Maybe it is an infection, bug you are fighting??? Looking forward to repeat labs this week with all normal results!!! smile

Melinda

18

(357 replies, posted in Introductions!)

Hi Julie!

Yes, this is a known possible reaction to the Keytruda. My doctor has seen it before.

Thanks!!

Iowagirl wrote:

Matt.....Good to see your post.  There's the good news all the way through kind of neutral news to "What the heck" news in that post.   
  First.....CA19-9 continuing to go down....GREAT NEWS
  Second...No evidence of disease.....GREAT NEWS
  Third.....recurrence "might" still be there.....Still not bad....speculation that it is there at all
  Fourth....High Liver Labs....possible auto-immune response to the Keytruda.
      Question:   Has that been a known response for others taking Keytruda in the past?  It sounds logical.   The Prednisone certainly sounds like a logical attempt to dampen that response.   Hope that works and you can continue on once you get past this small hump.

Hope the labs look better next week and that you don't have to make the trip out to Mayo...and things can forge ahead with more Keytruda and continue to kill those beasties. 

Julie T.

19

(357 replies, posted in Introductions!)

This week I had an MRI to try to "see" and validate that the CA 19-9 drop since starting Keytruda is actually a good measure. Results are back and there is no evidence of disease. This is great news, but tempered a bit by the fact that my recurrence has only once been barely seen on a scan. It's just too small and in a crowded area of my peritoneal cavity so it's nearly impossible to see. I'm sure it's still there, at least a bit, based on my CA 19-9 still being above normal, but the Keytruda is working to bring that number down and, therefore, killing the cancer.

On another note, I had labs this week too and my liver function test results (ALT, Alk Phos, AST, and Billi) were alarmingly high. Higher than they have been since my resection two years ago. They spiked in less than 2 weeks. The previous labs were all normal. There's no sign of blockage anywhere so we suspect it's an auto-immune response to the Keytruda. I'm starting prednisone (steroid) today to put the breaks on my immune system and will skip my dose of Keytruda next week to see if that helps. I may go back out to Mayo Clinic for an ERCP to make certain that there's no blockage if the labs don't look like they're headed in the right direction when I get them checked again next Wednesday.

20

(82 replies, posted in Clinical Trials)

Let me know if you do start it - I'd love to know someone else taking it and would be happy to answer questions or compare notes. wink

21

(82 replies, posted in Clinical Trials)

Melinda,

Thanks so much for the update. Your long-lasting response to the treatment 27 months ago is still amazing.

If you've got a compatible mutation, why you wouldn't start the pembrolizumab/Keytruda immediately? 

-Matt

22

(357 replies, posted in Introductions!)

It is perfect timing, for me. I  couldn't be happier!

Lainy wrote:

Matt this is amazing! It is like a miracle and may the miracle continue!

23

(357 replies, posted in Introductions!)

Time to share still more good news.

Today I just got the latest CA 19-9 results and it's down to 151 from 160 three weeks ago. The Keytruda is still working.

I've now had a total of five infusions and will continue having them every three weeks until... Still no side effects to speak of too.

Here's my history showing the continued drop:

http://s2.postimg.org/dsd2y8byd/20160106_History.jpg

http://s13.postimg.org/ecgt67rn7/20160106.jpg

24

(357 replies, posted in Introductions!)

Time to share even more good news.

Today I just got the latest CA 19-9 results and it's down to 160. Previously it was 411.

There is no doubt now that the Keytruda is working!

I've now had a total of four infusions and will continue having them every three weeks until...

Zero side effects to speak of too.

Here's my history showing the continued drop:

http://s9.postimg.org/81dnmlhfv/20151216_CA199_Chart.jpg

25

(9 replies, posted in Chemotherapy)

Just for those searching the forum, I'll add that I was able to get my oncologist to prescribe Keytruda for me starting in November 2015. It's still not FDA approved for Cholangiocarcinoma so my insurance (Aetna) would not pay for it. I was, however, able to get Merck to give me the drug for free under their Patient Assistance Program (http://www.merckhelps.com/). I have the MLH1 gene mutation in my tumor and after just two infusions, my CA 19-9 is down 171% so it appears to be working for me.