Cure Alveolar Soft Part Sarcoma International (iCureASPS)

Abstract
Immune checkpoint inhibitors (ICI) are revolutionizing care for cancer patients. The list of malignancies for which the Food and Drug Administration is granting approval is rapidly increasing. Furthermore, there is a concomitant increase in clinical trials incorporating ICI. However, the safety of ICI in patients undergoing surgery remains unclear. Herein, we assessed the safety of ICI in the perioperative setting at a single center. We conducted a retrospective review of patients who underwent planned surgery while receiving ICI in the perioperative setting from 2012 to 2016. We collected 30-day postoperative morbidity and mortality utilizing the Clavien–Dindo classification system. We identified 17 patients who received perioperative ICI in 22 operations. Patients were diagnosed with melanoma (n = 14), renal cell carcinoma (n = 2), and urothelial carcinoma (n = 1). Therapies included pembrolizumab (n = 10), ipilimumab (n = 5), atezolizumab (n = 5), and ipilimumab/nivolumab (n = 2).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466999/

It is an interesting subject. Ivan has a hernia in his spine - some inside fat tissue squeezed itself into the small cut that Dr.Walz created to access the pancreatic met from the back, so there is now some fat fill in the spine muscle in that area. It creates a problem for his weight lifting. We consulted the VATS surgeon locally as how to potentially remove it - he is saying he can do it safely from his end, but how the body would react on the surgical wound while under Keytruda PD-1 receptor block and the immune system runs uncontrolled? According this article the surgery is safe, but what about the efficacy of the Keytruda, it can potentially interfere to creating an active target for the immune system...

Olga
That’s interesting that your doc brought that up ..
I wonder what autoimmune response could slow down the healing ? Maybe a possibility of an inflammatory response overload to organs ?
With the ICIs I guess it could be possible ?

https://www.sciencedirect.com/science/a ... 1208000768

The above is for major surgeries.
Would the hernia of been laparoscopically performed anteriorly as well?

The prior link mentioned the possibility of
“the immune boosting mechanism of these monoclonal antibodies can produce severe autoimmune adverse effects, such as pneumonitis, arthralgia, pyrexia, colitis, dermatitis, hepatitis, endocrinopathy, and neuropathy “
which maybe in addition to the possible surgery COULD result in a unwanted side effect?
The doctor was erring on the side caution ,maybe ?