Hi Kim. I’m have been on Keytruda alone for a year now. My oncologist sent a tissue sample from my original tumor to Foundation One for genetic testing. It showed I have a high tumor burden. If the tb is 0 to five, treatment not likely to work. 5 to 10 , a good chance it will. Mine is 11. The year before I started this I was on gemzar/carboplatin, Avastin. Then carbo/Doxil, Avastin. They weren’t working. This has I believe, saved my life. I was diagnosed epithelial ovarian cancer 3C in 2019. The side effects from Keytruda for me have been minimal. Fatigue, a little achy. My ct shows cancer is greatly reduced. I hope this works for you, and wish you the best . Diane

Grace, have you begun this regimen? How is it going?

I was Stage 4 at diagnosis. My oncologist just recommended that combination for me in 6 weeks after new CT scans. Or else I can join a clinical trial. My current scans don't show disease progression, but my CA125 tells a different story. That means the Avastin-only treatment they've had me on since my last chemo of Carbo and Taxol in November doesn't seem to be working. She thinks the scans will eventually show progression. The Avastin has, however, helped continue to slow my pleural effusion fluid.

Keytruda is an immunotherapy. Avastin is an angiogenesis inhibitor. Cyclophosphamide is a low dose chemo pill. I'd rather skip the chemo pill, but don't know if that's an option. A girlfriend of mine with metastatic ovarian cancer is in a Keytruda clinical trial and she thinks it is working for her.

Ketruda is an immunotherapy drug. You need a tumor burden of 5 or higher for it to be effective. I have been on Ketruda alone for the past year and now most of the cancer is reduced or gone. My tumor burden is 11. The side effects are minimal, mostly a bit if fatigue. Most people can stay on the drug for two years, although I have read some are on it longer. Apparently it continues to work after you stop. I’m not a Doctor, I can only speak for my own experience. For me, I believe it has saved my life, or at least extended it.

I will be getting my 4th round of Keytruda/Avastin every 3 weeks with daily oral Cytoxan. My Ca125 has been slowly rising. My CT scan will be done this week before chemo. If there is progression my doc wants to try Elahere if I qualify. Aside from fatigue I’m tolerating this pretty well.

Tumor mutational burden (TMB) is a measure of the number of gene mutations (changes) inside the cancer cells. For me, this was determined by a tissue sample from my original tumor.(from Foundation One) Cells that have many gene mutations (a high TMB) might be more likely to be recognized and attacked by the body’s immune system. You can get more detailed information on Google, it’s very interesting.