ADAPT - Dr. Lin ONGOING Thread

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lilacbreastedroller
Posts: 90
Joined: Thu Sep 05, 2013 10:25 am

Re: ADAPT - Dr. Lin ONGOING Thread

Postby lilacbreastedroller » Sun May 17, 2015 6:53 pm

My oncology practice is running a celebrex + chemo trial for stage IIIs only. fOLFOX only, no avastin.


Trial Number: CALGB 80702
Trial Title: A Phase III Trial of 6 versus 12 Treatments of Adjuvant FOLFOX plus Celecoxib or Placebo for Patients with Resected Stage III Colon Cancer
CALGB 80702 is a trial for patients with stage III colon cancer whose tumor has been completely resected. This trial has two main objectives. The first objective is to evaluate the benefit of adding 3 years of celecoxib to standard chemotherapy for colon cancer. Celecoxib is a non-steroidal anti-inflammatory drug that inhibits a family of enzymes, the COX family. The study is looking to determine whether the addition of celecoxib to chemotherapy reduces the risk of colon cancer recurrences. The standard chemotherapy for colon cancer is FOLFOX, which includes three drugs: 5-fluorouracil, leucovorin, and oxaliplatin. The second objective of the trial is to determine whether receiving FOLFOX chemotherapy for 6 treatments (12 weeks) is as good as 12 treatments (24 weeks) in preventing recurrence of colon cancer. Currently, the standard of care for stage III colon cancer is 12 treatments with FOLFOX. The trial also will look at whether the side effects of the chemotherapy treatment can be reduced with fewer treatments. Patients participating in this trial are randomized (a computer chooses) to one of four groups: 1. 12 cycles of FOLFOX plus Placebo daily for 3 years
2. 12 cycles of FOLFOX plus Celecoxib daily for 3 years
3. 6 cycles of FOLFOX plus Placebo daily for 3 years
4. 6 cycles of FOLFOX plus Celecoxib daily for 3 years
Eligibility Timeline: Patients are eligible to enroll 3 to 8 weeks after the resection of their tumor.

I looked this study up on the NCI database, and it says you take the celebrex with the Folfox - says nothing about continuing to take celebrex alone for three years. I'm confused. But anyway,

hmm.
Karin
dx 6/1/12@45yo
RT, 4 liv, 5 lung
7/12 FOLFOX
2/13 Xeloda 4k mg/d
7/13 DC VAX,1k mg/d metro Xel
11/13 Erbi, Irino
6/14 clinical trial lirilumab, nivolumab
9/14 Stivarga
1/15 clinical trial immunotherapy (young TILs)
RT, mets to liv, lung, adrenal, lns

gator.girl
Posts: 37
Joined: Thu Sep 05, 2013 1:05 pm

Re: ADAPT - Dr. Lin ONGOING Thread

Postby gator.girl » Mon Jun 22, 2015 7:28 pm

Has anyone seen *new* data from the ADAPT protocol? Was anything presented at ASCO?
Dx 8/13 @ 40
Stage IV - innumerable mets to liver
12 rounds of Folfox + Avastin
8 months on maintenance
11/14 Y90 to right side of liver
01/15 Gallbladder removal and colon resection
02/15 Mets to lungs
Now on Folfiri

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: ADAPT - Dr. Lin ONGOING Thread

Postby rp1954 » Fri May 11, 2018 10:58 am

I am re-surfacing this ADAPT thread for new members about an important treatment component, celecoxib. Please read it all if you haven't already, especially if you need more chemo or chances.
-----------------------
Note: Many of my wife's supplements and her cimetidine have been at stronger doses in peak years, some more targeted than others ever attempt, with or without chemo. My wife has never used oxi-, iri-, Avastin, or Erbitux, we have addressed those by other means.
----------------------
My wife started 400 mg of celecoxib in Feb 2013, along with her existing oral 5FU-LV chemo, IV vitamin C, cimetidine, 1/4 aspirin, PSK, and other high strength supplements. We did this to reverse a CEA/CA199 excursion caused by earlier supply problems. The 400 mg (200 am+200 pm) of added celecoxib often shows as extra stress on her normal liver markers as well as driving down markers. This dose is frequently reduced to 300 mg average; 200 mg celecoxib is simply too little and the cancer markers rise.

5+ months later, she temporarily suspended celecoxib for 2 months for hypercoagulabilty; her cancer markers rose while we worked on coagulation values. For unclear reasons, she stopped getting many of her supplements in the middle of recovery and her markers rose again. Only with both celecoxib and strong nutraceuticals did the markers halt and reverse back down.

Over the years, my wife's markers have shifted as she slowly reduces her pill load and IV vitamin C frequency, substantially in aggregate. This, with fewer pills, creates pressure for better pills and more optimal vitamin C infusions. These days I worry more about her CA199 and AFP than CEA, whether she will do enough IV vitamin C and supplements to control the CA199 and AFP markers better, as they are responsive to enough supplements, when combined with the chemo-celecoxib backbone. ~2 years ago, she stopped everything for 9 days and her CA199 doubled. There is some inflammatory component in that, with the temporary lack of anti-inflammatories. Still, it's not so reassuring in the search for NED, wherever he is...

Some of the other, earlier, NED forum members still appear to lurk here on occasion, but haven't said anything for a while.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

mhf1986
Posts: 158
Joined: Sat Mar 11, 2017 8:30 pm
Location: near DC

Re: ADAPT - Dr. Lin ONGOING Thread

Postby mhf1986 » Fri May 11, 2018 12:16 pm

Could you elaborate on "extra stress to liver markers"? DH's bilirubin is up to 4.5 and he is extremely fatigued. I don't want to impact it further. I thought about buying a box of Tagamet but haven't so far. Have been giving him extra Vitamin D along with regular vitamins and extra juice. CA199 is 621 but this is the first test and we don't have anything to compare that number to.

Thanks,
M
Caregiver to DH, dx @ 50, mets to liver/lungs, MSS, wild
9/16 CEA 114, blockage, left hemi, perm. colostomy
11/16 port in, FOLFOX + Avastin
6/17 CEA 15, 5FU + A only due to neuropathy
11/17 CEA 38, CAPOX + A
1/18 CAPOX = hi bilirubin/bad hfs, back to FOLFOX + A
5/18 growth; Vectibex + 75% Irinotecan
7/18 CEA 23, shrinkage
10/18 CEA 28, growth of 2 liver tumors/shrinkage of few and lung nodes
11/18 Lonsurf, looking at spheres, proton, trials
11/19/18 Peace

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: ADAPT - Dr. Lin ONGOING Thread

Postby rp1954 » Fri May 11, 2018 3:53 pm

mhf1986 wrote:Could you elaborate on "extra stress to liver markers"?

My wife's liver panels have typically been pretty well in the normal range, and we aim to keep them there, stepping on serious deviations by withdrawing something suspicious or adding nutrients or intensifying immunochemo. I think all her bilirubin values are under 1. We used a few hundred mg of dirt cheap taurine to offset oral 5FU effects, where drs in japan used more for bilirubin excursions caused by chemo. Some liver panels, after a CRC diagnosis, have extra meaning even in the upper 1/3 of the normal range.

DH's bilirubin is up to 4.5 and he is extremely fatigued. I don't want to impact it further.

Your husband sounds pretty fragile and needs professional advice here for remediation. There are a lot of liver support or repair nutrients that might do wonders as a coherent formulation on the fatigue and the bilirubin, depending on chemo damage vs tumor load. e.g. what dose coQ10, vitamins B, C, K2, silymarin, selenium, R-lipoic acid, N-acetylcysteine etc, do they recommend. Finding the real McCoy alt MD/ND with a great plan that is affordable is an issue, the individual nutraceuticals are not fundamentally expensive.

thought about buying a box of Tagamet but haven't so far.

No, I wouldn't. Cimetidine's benefits are mostly documented for patients' first weeks following diagnosis, the big kahuna before and after surgery, and separately, as targeted (CA199+CSLEX1) immunochemo following surgery the first 1-3 years when their WBC and differential cell fractions are in better initial shape to respond. I am also concerned whether Kras quad wild is accurate/complete and would keep an eye on vectibix's results.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements


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