Dr. Lin ADAPT

[Cb75]

I spoke with Dr. Lin earlier today. He was kind enough to call me ahead of my scheduled visit. After going though my circumstances and situation (without reviewing my file and CT), he believes I am an idea candidate for his trial. However, I am in Toronto and it would require a once a month visit to Seattle, which is not easy. He is willing to work with my oncologist. This is likely what I will do. I do need to go and see him, but he wants a more recent scan. My last was six weeks ago. The hope is to get to as much as a response I will get with chemo, then 'maintenance' on his plan with him consulting from time to time, should I desire his input. He mentioned that his preliminarily results from his Phase II trial are very promising, where 90 percent have done well. He also mentioned he has patients many years out on this protocol (three or four years).

What I found interesting were his comments on FOLFOX. He mentioned some new research that shows FOLFOX to be less effective for lung mets. So, getting FOLFOX would not do a very good job 'mopping up' cells in the lung. He seemed to indicate that FOLFIRI could have been a better option, especially if there is any fear of lung involvement. I had never heard this before. I found it very interesting and perhaps something others should look into when starting chemo, if they have lung involvement.


There was some mention before about Dr. Lin not seeing patients. I asked his office. They advised that he is now focusing only on crc, and no longer GI in general. So, he is no longer taking GI patients ONLY crc. This is a good thing for us!

cb <3

[stevieb]

Please let me know how things proceed as I may be interested after I finish mop up chemo with Folfiri!

[CRguy]

Very happy you are moving forward Carm, sounds promising and very ++++POSITIVE !

BUTT ......as a pseudoadjuvant ( controversial ) FOLFOX patient for a lung met .... still NED 4 years out, I admit I have not heard of FOLFOX being inferior as a chemo for the Lung Thang Gang ... except to say everyone's situation is different and needs to be taken into consideration with their own Oncs.

PLEASE keep us in the loop and MEGA Cheers and Harmony my fellow Canuckian !
(( PS love your new signature line ..... WORD ! ))
On the journey
CRguy

[FatBob2012]

Please do keep us updated since it may be an outlet for others in the future.

[rp1954]

Carm,
The areas least practically discussed are the particular risks and mitigations of the -coxib class generally, which are lower for celecoxib. Newbies probably want estimates for actual cv "events" to compare with the ordinary celecoxib use vs while on xeloda for lower grade CRC cases. The relative risks almost seem like a no-brainer for IVb or advanced mCRC if the biomarkers improve, and the risks are mitigated. Dr. Lin's clinical impression of the event numbers and risk factors would be good to hear and discuss. Also his thoughts on blood thinning as a mitigation strategy of the -coxib risks e.g. fish oil+gs polyphenols etc vs. low MW heparins vs. oral drugs.

[janderson]

When I saw Dr. Lin back in July he told me the same thing about FOLFOX.

[singingholly]

Very interesting, thank you for updating.
Olivia

[BrownBagger]

Dr. Linn's work and ideas sound encouraging.

I'm currently on Irinotecan and Xeloda, which is essentially Folfuri, and it (along with Erbitux) has been keeping my lung mets stable for more than a year.

I always sort of expected (dreaded) having to go back on oxi at some point, but there may be no point. Don't know if that's good news or bad. Probably bad, since it's one less option, but the prospect of going back on oxi isn't particularly attractive.

Anyway, my experience tends to bear out Linn's theory, at least in part.

[eleven11]

Thanks so much for sharing. What is your current situation cb? Do you presently have any mets in your lungs or are you NED and considering ADAPT as maintenance? How many lung mets have you had and how many times?

Please keep us in the loop and best of luck to you.

[KWT]

Has dr Lin seen your genetic testing results yet?

[eleven11]

He mentioned that his preliminarily results from his Phase II trial are very promising, where 90 percent have done well. He also mentioned he has patients many years out on this protocol (three or four years).

What does he mean by 90% have done "Well?" Does that mean complete remission for those on the ADAPT therapy while NED?

This article states that:
"About 40 percent of Dr. Lin’s patients have achieved complete or near complete responses, which means there is little or no detectable presence of cancer."
http://www.gatewaycr.org/DrLin_CROYA

[Cb75]

He mentioned that his preliminarily results from his Phase II trial are very promising, where 90 percent have done well. He also mentioned he has patients many years out on this protocol (three or four years).

What does he mean by 90% have done "Well?" Does that mean complete remission for those on the ADAPT therapy while NED?

This article states that:
"About 40 percent of Dr. Lin’s patients have achieved complete or near complete responses, which means there is little or no detectable presence of cancer."
http://www.gatewaycr.org/DrLin_CROYA

To be honest, I missed something there when he mentioned some stats pretty quickly, almost in passing. I think the 90 percent is stable or no progression or maintained NED. I'll find out more as I research this.

I have sent my medical records, however, the initial post was based on an initial review of some records and my discussion with him. I dont believe he had the pathology yet, but I have seen my path reports and know what it says regarding genetic markers. I only seem to have the KRAS mutation. I am also MSS stable.

My current situation is that I have lung mets, that have responded well to eight months of FOLFORI. The goal is to get to NED or ask close to NED as possible with surgery and a strong chemo, then go to the maintenance to keep things under control and to kill off any stem cells.

Hope this help. I really appreciate anyones thoughts. Its a hard decision when you go outside of your doctor and his/her recommendations.

cb

[Awreed]

I met with Dr. Lin Tuesday (2nd appt.). I just completed 4 cycles of Folfiri and had a PET/CT which shows NED with the exception of possible disease in spleen leftover from ablation in September, I am meeting with Interventional Radiologist who performed ablation tomorrow. He will have the best handle on whether the pet activity is from ablation or cancer. Either way both Lin and my local Onc in Wash. DC, Dr. Marshall at Georgetown's Lombardi Cancer Center, agree that my next steps will be ADAPT. I did have genetic testing done at Seattle Cancer Care Alliance and I evidently have a mutation that responds well to ADAPT. So happy they are in agreement. If Spleen does have cancer I will have radiation while taking ADAPT. Will keep anyone following ADAPT posted on how it goes. Good news is my insurance approved both Xeloda and Celebrex for a year with zero co-pay...yay! Also, just a personal plug that both Lin and Marshall are TOP NOTCH:
Smart, Passionate, great sense of humor, Lin has left coast "optimism", Marshall more East coast "direct"... both brilliant usually with same message but interesting (and refreshing) to have the two delivery styles...

[eleven11]

Does anyone know anything about KRAS Mutation and ADAPT? Is it as effective for those that have this mutation?

[sdp]

Hi
Does anyone know if Dr lin can have a patient from overseas ?
I had mcrc with mets only to liver and have had four recurrences after curative resection -
Is there a way to send my current reports for a possible consult A email or phone

I can pay the consult charges myself -
If someone can guide me as to how I can do this I would appreciate