Postby GrouseMan » Mon Aug 17, 2015 9:50 pm
Voxx - This combination might be a winner if Her2/Neu (ErbB2) is driving these ascites. This sounds very similar to the combination use of Cetuximab (Erbitux), and Panitumumab (Vectibix) for CRC that recently is finding some interest for people that after initially using Cetuximab developed resistance (maybe T790M mutation). Seems the two together seems to re-regulate the EGFr pathway again. Of course I am biased and I think you would likely benefit from Dacomitinib which inhibits EGFr, ErbB2 (Her2/Neu), and ErbB4 as well as the T790M, gatekeeper mutation, present in up to 50% of tumors that have acquired resistant to first-generation EGFr inhibitors.
http://www.ncbi.nlm.nih.gov/pubmed/23294134 Your oncologist may cite the failure of Dacomitinib in NSCL cancer but I believe it failed as the trial was poorly designed.
The rash can be managed, its uncomfortable, but in clinical testing with CI-1033 (another early EGFR inhibitor) we used Benadryl to help manage the rash. I think now there are good protocols for getting control of this rash issue.
A drug furthest along in the clinic (Phase III) that might target your FGFR2 target is Nintedanib (BIBF 1120). Its a Pan Tyrosine Kinase inhibitor that inhibits most of the VEGFr/PDGFr/FGFr isoforms. Think of this as being a super Avastin sort of small molecule rather than an Antibody. Unfortunately side effects from a drug like this one often can be pretty hard to take I believe. For a discussion in Wikipeda see :https://en.wikipedia.org/wiki/Nintedanib
Good Luck.
GrouseMan
DW 53 dx Jun 2013
CT mets Liver Spleen lung. IVb CEA~110
Jul 2013 Sig Resct
8/13 FolFox,Avastin 12Tx mild sfx, Ongoing 5-FU Avastin every 3 wks.
CEA: good marker
7/7/14 CT Can't see the spleen Mets.
8/16/15 CEA Up, CT new abdominal mets. Iri, 5-FU, Avastin every 2 wks.
1/16 Iri, Erbitux and likely Avastin (Trial) CEA going >.
1/17 CEA up again dropped from Trial, Mets growth 4-6 mm in abdomen
5/2/17 Failed second trial, Hospitalized 15 days 5/11. Home Hospice 5/26, at peace 6/4/2017