The Currently Incurable Scientist: Turning a Cold CRC Tumor Hot

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DK37
Posts: 510
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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: 1001
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 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & Celebrex
3/16 Ovarian mass removed. Benign fibroid
9/16 clean scope
4/18 clean CT
Ongoing Celebrex, Tagamet & 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, 1.3, 1.4, 1.6, 2.2, 2.4
Mom to a 4 & 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
Posts: 312
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 28 yrs. kids: 22, 19, 15, 11, 9
SE Michigan home schooler, unemployed 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: 771
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
7/17 four years....NED
8/18 five 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
7/18...PET scan...NED


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