Prospects of metastatic cure for CR cancers

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Bob_Weiss
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Prospects of metastatic cure for CR cancers

Postby Bob_Weiss » Thu Mar 15, 2012 3:06 pm

A solid review of treatments and outcomes for metastatic CR cancer published this month:

ABSTRACT: Significant advances have been made in the treatment of metastatic colorectal cancer (mCRC). Development of the targeted biologic agents and their integration with cytotoxic chemotherapy regimens has led to improvements in clinical efficacy. Despite these gains, the overall impact of these combination regimens in mCRC therapy has been relatively modest. While 2-year survival has improved, substantive gains have yet to be made in 5-year survival. However, a small subset of patients can be cured of their metastatic disease, with prolonged 5- and 10-year overall survival. This select group of patients includes those with metastatic disease limited to the liver or other organ-specific sites, as these patients are able to undergo surgical resection at the time of diagnosis or following conversion therapy with the appropriate integration of chemotherapy. A multimodality team-based approach involving medical oncologists, surgical oncologists, radiologists, and other healthcare providers is absolutely critical for the success of this therapeutic approach. This article reviews the main issues that must be considered from the surgical oncology and medical oncology perspectives, respectively

The complete article is available in MARCH 2012 "ONCOLOGY" journal which is posted on internet. Hopefully, the address below gets you there:

http://click.email.cmpmedica-usa.com/?q ... 0d71a2f038
Stage 3 R/C -1 node+ ( 7/09)
5 wks radiation, 2 wks chemo: 5FU (8-9/09)
Rectal surgery: tumor removal (11/09)
10 rounds Xeloda: 3000mg/daily 1 wk on/1 wk off (1/10-6/10)
Supplements: Aspirin, Calcium, Vit. D3
03/27/17: 7+ yrs. since surgery--still NED

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Canadianmom
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Re: Prospects of metastatic cure for CR cancers

Postby Canadianmom » Thu Mar 15, 2012 3:25 pm

Well it's good, but I've been hoping that the new research would have shown greater five year + prognosis'. Thanks for posting, I'll have to read the full article!
30/09/10 Dx mCRC/ 39 yrs old
08/11/10 liver met; Stage IV
23/11/10 PET 2 lit LNs
25/11/10 RFA to liver met
13/12/10 Folfox 6 plus Avastin.
15/03/11 After 7 rounds. NED. No further tx. 2014 still NED
Praying for patience and strength.

Bob_Weiss
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Location: Brooklyn, NY

Re: Prospects of metastatic cure for CR cancers

Postby Bob_Weiss » Fri Mar 16, 2012 8:19 am

Canadianmom wrote:Well it's good, but I've been hoping that the new research would have shown greater five year + prognosis'. Thanks for posting, I'll have to read the full article!


The article indicates that both surgery or ablation of liver mets can lead to cure, which I took as a positive. Liver mets are the most common type of metastases for CR cancer and many patients assume it isn't curable; possibly because the outlook for primary liver cancer has been so poor.
Stage 3 R/C -1 node+ ( 7/09)
5 wks radiation, 2 wks chemo: 5FU (8-9/09)
Rectal surgery: tumor removal (11/09)
10 rounds Xeloda: 3000mg/daily 1 wk on/1 wk off (1/10-6/10)
Supplements: Aspirin, Calcium, Vit. D3
03/27/17: 7+ yrs. since surgery--still NED

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Canadianmom
Posts: 603
Joined: Wed Nov 03, 2010 6:29 pm

Re: Prospects of metastatic cure for CR cancers

Postby Canadianmom » Sat Mar 17, 2012 1:26 am

That's my new fav word "cure"
30/09/10 Dx mCRC/ 39 yrs old
08/11/10 liver met; Stage IV
23/11/10 PET 2 lit LNs
25/11/10 RFA to liver met
13/12/10 Folfox 6 plus Avastin.
15/03/11 After 7 rounds. NED. No further tx. 2014 still NED
Praying for patience and strength.

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Terry
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Joined: Wed Oct 03, 2007 10:36 pm
Facebook Username: Terry Minor
Location: Silver Cliff, Wisconsin

Re: Prospects of metastatic cure for CR cancers

Postby Terry » Sat Mar 17, 2012 4:36 am

Thanks for posting MIke, I'll have to give it a read:)
DX 7/3/07
Chemo, radiation, 20 mo. chemo, IMRT, cyberknife, 6/11 lobectomy.
1/16 resection perm. colostomy intraop. rad.
PET 2/12 nose, thyroid, liver, lngs
Folfox 3/12
Lord I know You'll keep me here until
you know I cannot suffer any longer!

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dianetavegia
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Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia

Re: Prospects of metastatic cure for CR cancers

Postby dianetavegia » Sat Mar 17, 2012 8:24 am

Surgical resection outperforms radiofrequency ablation in single liver-only spread from colorectal cancer
Posted by Kate Murphy on May 18th, 2006

When colorectal cancer has spread to the liver only and nowhere else, removal or destruction of the liver tumors offers the best chance for a long term survival or cure....

Tumors recurred in the liver more often after RFA (37%) than hepatic resection (5%).
After 5 years, more patients who had surgery were free of liver mets (92% vs. 60%).
After 5 years, 50% of the surgical group were cancer-free compared to none in the RFA group.
After 5 years, 71% who had surgery were alive compared to 27% who had RFA.

Thomas A. Aloia, MD and his team at M.D. Anderson reported their results in the May 2006 Archives of Surgery. They concluded:

The survival rate following HR (hepatic resection) of solitary colorectal liver metastasis exceeds 70% at 5 years. Radiofrequency ablation for solitary metastasis is associated with a markedly higher LR (local recurrence) rate and shorter recurrence-free and overall survival rates compared with HR, even when small lesions (3 cm) are considered. Every method should be considered to achieve resection of solitary colorectal liver metastasis, including referral to a specialty center, extended hepatectomy, and chemotherapy


This report was with no follow up chemo and is from 2006.
Stage III cc surgery 1/7/09. 12 tx FOLFOX
Stage IV PET = 1.5cm liver met. HR 4/11/12

11 years since dx and 7 3/4 years post liver resection.
Pronounced CURED and discharged by onc

“O Lord my God, I cried out to You, And You healed me.” Psalms 30:2

Bob_Weiss
Posts: 743
Joined: Sun Apr 11, 2010 11:23 am
Location: Brooklyn, NY

Re: Prospects of metastatic cure for CR cancers

Postby Bob_Weiss » Sat Mar 17, 2012 9:04 am

The 2006 data show a great difference between liver surgery vs. ablation, so it's hard to see why any doctor would recommend ablation if the patient is suitable for surgery. Perhaps more recent follow-up data show improvement for ablation, especially for patients who get post-ablation chemo. I have not come across any recent data on this issue. Too bad, since ablation is so much easier than surgery for patients.
Stage 3 R/C -1 node+ ( 7/09)
5 wks radiation, 2 wks chemo: 5FU (8-9/09)
Rectal surgery: tumor removal (11/09)
10 rounds Xeloda: 3000mg/daily 1 wk on/1 wk off (1/10-6/10)
Supplements: Aspirin, Calcium, Vit. D3
03/27/17: 7+ yrs. since surgery--still NED

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CheeseHead
Posts: 1171
Joined: Sat Jul 31, 2010 2:36 pm
Location: Netherlands

Re: Prospects of metastatic cure for CR cancers

Postby CheeseHead » Sat Mar 17, 2012 10:40 am

Yep, I'm hoping the ablation figures will have improved since due to more experience with it, etc, likewise for stereotactic radiation...

Cheese
    2008
    10 Stg 4 colon srgry
    12 Xelox/Avast
    2009
    05 Liver srgry
    -12 Xelox
    2010
    05 Xelox
    08 Iri/Vect
    11 Liver srgry
    2011
    01-05 Iri,Vect,Xeloda
    09 CyberKnife
    2012
    03-07 Ph I trial
    08-11 Regorafenib
    2013-
    Xeloda
    Vecti
    Iri
    Xelox


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