my wife aged 29 has melanoma stage IV (for about a year now) and is taking sutent after micro array analysis (target now MPI) showed sutent as an active target.
she had upregualted vegf en pdgf.
melanoma type: aggressive with high number of subcutaneous mets and two in lungs and 7 or more small ones in brain.
she previously received:
phase III trial : ticilimumab vs dacarbazide (she was in the dacarbazide arm) stopped after two cycles with mixed results.
temodar : partial response with 3 or 4 months of tumor decline.
brain radiation in combo with temodar. causing stabilisation of CNS dissease.
tcell transfer therapy (took almost 1 year to grow tcells) and received only one batch which didnt do anything. Not recommended for aggressive dissease.
carbo taxol combination chemotherapy. LDH levels normalised however didnt do enough to reduce dissease on ct scan.
started recently with experimental sutent taxotere (docetaxel) combination therapy after microarray analysis of sq met(strongly recommended :cheap and gives a lot of info on your melanoma) showed multiple sutent targets upregulated.
after 3 weeks of 37,5 mg sutent plus docetaxel combination therapy servere edema of the abdomen formed. her weight was 114.4 lbs and went to 154 lbs in three weeks. causing her stomach to be compressed and have hick ups all day. she couldnt take in any more fluids or solids. she was hospitalised and they gave her diuretics and stopped sutent for wo weeks. they also took a ct scan showing rapid decrease in organ mets. So the sutent was definitly working. this is big since melanoma is highly resisent to all chemo and radiation and no effective therapy exists (other than dacarbazide or temodar or IL2 with very low succesrates)
because she stopped with sutent the tumor started growing again rapidly (probably some mechanisms were upregulated because of sutent) however she regained her apetite and started losing peripheral
edema fast at a rate of 11 lbs a week with the help of diuretics.
because of the disease progression sutent was started again without the docetaxel but with diuretics. her edema contiued to decline peripherally however her abdomin quickly became bloated with fluids again. her weight remained at 110 lbs. losing peripheral and gaining abdominal edema. after 1,5 weeks she is now back at the starting point of not being able to eat without vomiting imediatly.
does anyone have an idea how to get rid of the abdominal edema. as her docter said that the diuretics only work for peripheal edema. isnt there some drug out there that drains abdominal fluids?
we want to continue sutent but at this rate we cant.