The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

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DK37
Posts: 510
Joined: Tue Sep 17, 2013 8:31 am
Location: San Diego

The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby DK37 » Fri Jul 24, 2015 8:24 am

I wanted to let everyone know that a new 2-part “The Currently Incurable Scientist” column has been posted on the Fight Colorectal Cancer Website titled: “Turning a Cold CRC Tumor Hot”.

Part 1 discusses the issue that recent immunotherapies breakthroughs have encountered in treating most (particularly MSS) CRC cases.
http://fightcolorectalcancer.org/resear ... ot-part-1/

Part 2 describes some experimental drug strategies currently in clinical trials attempting to solve this problem!
http://fightcolorectalcancer.org/resear ... ot-part-2/

I hope you find these interesting! I was very word-count limited in how much I could write, so if you have follow-up questions, PM me or put the questions in the comments below for everyone's benefit!

-DK
6/4/2012 Dx Stage 3C CRC @ 40 yo. MSS, KRAS-WT, BRAF-WT, p53-mut
7/12 FOLFOX/FOLFIRI
2/13 NED!
8/13 Enlarged lymphs - Stable
10/14 Stage IV. Lung & Lymph mets. 5-FU+bev
3/15 Cetuximab
11/15 FOLFIRI + bev
11/16 Signs of FOLFIRI resistance (Lymph mets)
1/17 Palliative radiation for resistant mets
2/17 FOLFIRI + bev + Maraviroc (off-label)
3/17 FOLFIRI + Erbitux + Maraviroc (off-label)
MSS-CRC Clinical Trial Finder: http://trialfinder.fightcrc.org/
2016 Colondar 2.0 Model
DK37 Science Posts List

lpas
Posts: 991
Joined: Wed Nov 19, 2014 11:11 pm

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby lpas » Fri Jul 24, 2015 9:51 am

Very, very interesting. Looking forward to your next column. Thanks again for doing this!
11/14: Dx sigmoid CC @ 45yo
12/14: laparoscopic colectomy, hysterectomy
T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15: XELOX, celecoxib & many supplements
3/16: Ovarian mass removed. Benign fibroid
9/16: clean colonoscopy
3/17: clean CT
Ongoing: celecoxib, cimetidine & other carefully-targeted supplements
Post-chemo CEA: 3.0, 2.5, 2.3, 2.0, 1.6, 1.3, 1.8, 2.1, 1.8, 2.0, 1.8, 1.9, 1.7, 1.5, 1.6, 1.5, 1.4, 1.4, 1.3, 1.3, 1.6, 1.6
Mom to a 3 & 6yo

Ceebo
Posts: 132
Joined: Sat Feb 14, 2015 9:15 am
Location: Southwest Michigan

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby Ceebo » Fri Jul 24, 2015 1:17 pm

You do such a good job of explaining complex medical information. Wish some of the trial sites were closer to Michigan!
DH 64 Stage 4 on 4/14 ; cecal tumor; 5+ nodes ; mets to liver; colon resection
5/14 FOLFOX
9/14 - Liver surgery aborted; peri mets
10/14 CT mult.1-2 mm lung mets; FOLFIRI & Avastin
1/15 CT -liver & lung mets shrinking
3/15 PET - ? New met. site colon; CEA rising
7/15 Chemo has failed; looking for clinical trial
9/29/15 started TAS-102 trial
KRAS mutant; MSS

JENNJ
Posts: 115
Joined: Tue Feb 17, 2015 8:00 pm

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby JENNJ » Fri Jul 24, 2015 5:05 pm

Thank you so much for all the info. My Dad is MSS so I'm on the lookout for any therapy that may help him!
Thank you again
Katy

jillbugs4110
Posts: 266
Joined: Thu Jul 31, 2014 3:36 pm

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby jillbugs4110 » Fri Jul 24, 2015 6:28 pm

I think I may be a cold tumor person so this is very interesting I hope to get more insight on where I stand to know what may be coming down the pipe line. As always I appreciate you......you are a gift.
Live One Day At A Time
I Abandon myself to God
46 6 yo.....9yo...
stage 1V liver mets :-(
my one prayer to got to sustain me to raise my two babies this is my only wish then take me out if needed.

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Sleen
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Joined: Tue Jan 14, 2014 7:41 am
Location: Detroit
Contact:

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby Sleen » Sat Jul 25, 2015 7:43 pm

jillbugs4110 wrote:you are a gift

Could not agree more. Thank you for sharing your smarts with us!

Celine
my blog: Cancer Riot

NED since April 2016!
April 2016: lower left lung lobectomy. NED
8 mo. f/u: 1 of 7 tumors progressed.
6 mo. f/u PR confirmed (Jan 2016)
Jul 2015: NIH TIL trial NCT01174121 NCI/NIH Surgery Branch FAQ
Dec 2015 stage IV w/bilateral lung mets
FOLFOX + Radiation (bladder)
KRAS G12D :: MSS
dx Sep 2013 @47yo: IIIc T4b N2b MX [bladder invasion, 17/21 lymph nodes]

Married 26 yrs. kids: 21, 18, 15, 10, 8
SE Michigan home schooler, mechanical engineer, and programmer.

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Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby Nik Colon » Sun Jul 26, 2015 7:32 am

Thanks DK, you are awesome :mrgreen:
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

smalltownmess
Posts: 84
Joined: Mon Aug 04, 2014 2:09 am

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby smalltownmess » Sun Jul 26, 2015 4:08 pm

This is awesome, thanks DK!
Mom diagnosed Stage 4 with Liver mets 7/2011
July 11: Xeloda and Avastin
August 13: Irinotecan
June 14: Disease Progression
August 14: SBRT
October 14 - December 14: RRX-001
January - May 15: Irinotecan
May 15: One week Stivarga -- stopped b/c DRESS Syndrome
July 15: Disease progression
July 15: Start Xelox

Vol
Posts: 26
Joined: Thu Jul 23, 2015 3:57 am

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby Vol » Sun Jul 26, 2015 7:08 pm

Great post. I'm a IT guy by trade, but went to school for nuclear engineering. Love Science!!! Any thoughts on the value of Stanford's Folding@home project?

Vol
Dad - 51
Father of 3 girls (27, 26, 20)
08/15 - Resection 08/15
08/15 - Dx - Stage 2A - High Risk (perf colon), 0 of 27 nodes
08/15 - Start - 8 cycles Xeloda, first 4 with Oxaliplatin (done in February)

sjring
Posts: 181
Joined: Mon Jun 30, 2014 3:16 pm
Location: Philadelphia, PA

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby sjring » Mon Jul 27, 2015 6:00 pm

I too enjoyed the blog posts. Although I work in the clinical trial field, I'm a finance guy so more than a bit of the technical medical jargon and almost all of the biostatistical jargon are over my head. I really appreciated the plain English explanations, and the off0-handed Star Trek reference in Part 1 didn't hurt!
50 YO Husband & father of 2 teenagers.
DX 9/9/13 Stage 4 cc (at age 48)
16 Rounds FOLFOX + Avastin (Oct-13 to May-14)
Maintenance chemo - Avastin & 5-FU infusions (Jun-14 to Jul-15)
Jul-15: Mets to lymph nodes, resuming FOLFOX
Sep-15: MRI showed stability, back to maintenance chemo.

jillbugs4110
Posts: 266
Joined: Thu Jul 31, 2014 3:36 pm

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby jillbugs4110 » Mon Jul 27, 2015 6:35 pm

How far out until those of us with cold tumors can be offered clinical trials unfortunately I think I may fall under this category
Live One Day At A Time
I Abandon myself to God
46 6 yo.....9yo...
stage 1V liver mets :-(
my one prayer to got to sustain me to raise my two babies this is my only wish then take me out if needed.

Jacques
Posts: 408
Joined: Sun Dec 28, 2014 10:38 am

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby Jacques » Tue Jul 28, 2015 2:37 am

DK37 wrote:... so if you have follow-up questions, PM me or put the questions in the comments below for everyone's benefit! -DK

Thank you for sharing your knowledge here. I noticed in your most recent post that there was a reference to "CEA-binders" and "CEA-expressing tumors". I have a couple of questions in this regard.

Frequently here we see members stating something like, "CEA is not a good marker for me", but statements like this are rarely followed by any scientific explanation.

My questions are: Why is CEA expressed in the case of some colon cancer patients, but not in the case of others? Is there a scientific explanation for this, and if so, can patients be tested at an early stage to see if they fall into the "CEA expressed" category instead of the "CEA not-expressed" category.

Do you have any thoughts on this issue?

Thank you.

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DK37
Posts: 510
Joined: Tue Sep 17, 2013 8:31 am
Location: San Diego

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby DK37 » Tue Jul 28, 2015 7:46 am

Jacques wrote:
My questions are: Why is CEA expressed in the case of some colon cancer patients, but not in the case of others? Is there a scientific explanation for this, and if so, can patients be tested at an early stage to see if they fall into the "CEA expressed" category instead of the "CEA not-expressed" category.

Do you have any thoughts on this issue?

Thank you.


Hi Jacques - To the best of my knowledge, there isn't a clear explanation why some some CRC tumors express CEA and some don't (perhaps GrouseMan knows?). In terms of testing early - I strongly advise people to get tested prior to their primary tumor resection surgery. This will give a "baseline value" and help you and your medical team know whether it is likely that CEA will be a useful blood test marker to look for recurrence. I know for the particular trials I mentioned, they require tumor tissue biopsy - which may imply that in their experience CEA expression on a tumor may not correspond to how much is seen in the blood.

Hope that partial knowledge helps a little-

-DK
6/4/2012 Dx Stage 3C CRC @ 40 yo. MSS, KRAS-WT, BRAF-WT, p53-mut
7/12 FOLFOX/FOLFIRI
2/13 NED!
8/13 Enlarged lymphs - Stable
10/14 Stage IV. Lung & Lymph mets. 5-FU+bev
3/15 Cetuximab
11/15 FOLFIRI + bev
11/16 Signs of FOLFIRI resistance (Lymph mets)
1/17 Palliative radiation for resistant mets
2/17 FOLFIRI + bev + Maraviroc (off-label)
3/17 FOLFIRI + Erbitux + Maraviroc (off-label)
MSS-CRC Clinical Trial Finder: http://trialfinder.fightcrc.org/
2016 Colondar 2.0 Model
DK37 Science Posts List

JDinNC
Posts: 765
Joined: Fri Jul 05, 2013 9:49 pm
Location: Murphy, N.C.

Re: The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

Postby JDinNC » Tue Jul 28, 2015 2:49 pm

Thank you so much for writing something that's so easy to understand. Even after two years, I still don't understand half the stuff folks talk about on this board. Your examples are appreciated. I look forward to reading and learning from your future blogs..

Thank you
61 y/o female @ DX...........
T3N0M1
6/13 DX- stage 4
Sigmoid colon cancer.
One met to lung
7/13 colon resection
8/13 lung resection
FOLFOX with avastin
7/17 four years....NED

MELANOMA
63 y/o @ DX
6/15 stage 2a
7/15 surgery on arm
7/15 NED
4/16 recurrance
5/16 remove metastasis from back
5/16. Started immunotherapy
8/16 discontinue treatment


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