Reuse Folfox?

[meatie]

Has any one , after using folfox first-line and then using folfiri, reused folfox? The web seems to have some anecdotes of this possibility.

[midlifemom]

That is what I'm currently doing. When i did folfox as first round it seemed to be ok, but after finishing i had liver mets in just three months. After the liver was resected and HAI used, i did 1.5 years folfiri. That kept thing moving slowly, but lung mets showed up. Avastin was added, things kept stable.
When i couldn't handle the irinotecan anymore, i stopped that and everything grew.
I will have a ct in sept to see if things are still growing or if the folfox (@ reduced dose), is keeping things stable.
Good luck to mom.

[meatie]

@midlifemom

Did your onc say that folfox is more effective than folfiri? Some articles on the web seem to say so.

[wwroam]

Reading your signature it appears that you have done 12 cycles of Folfox but switched to Folfiri after recurrence.
Oxaliplatin has a useful life of 20-24 cycles according to our oncologist. I think many oncologists drop it after 12 cycles fearing progressive side effects which aren't necessarily the case.
The problem is from what I have seen with my partner, the big gains are made up to the 6th cycle , taper off and become progressively less effective.
We're still waiting on the Folfiri results but they are good so far, not too dissimilar to the Folfox results.
I have seen on this board trials of Oxi and Irinotecan taken together to good effect. That my be a good trial to go for.

[midlifemom]

I have heard that dr Kemeny at MSKCC prefers folfox. When i last saw her, she indicated my choices were really folfox or folfiri.

However, the way my local oncologist described his reasoning for selecting folfox -
(Too scientific, i will mess this up)
Cancer is clonal in how it grows. So, there are new cancer cells in me that have never been exposed to the folfox. Perhaps we can kill or control those cells with folfox at this point. Also, i have been on folfiri too long.
My onc doesn't seem enthusiastic about stivarga or lonsurf and I'm not either. So we're not left with many choices.

[meatie]

@midlifemom

My mom had folfox for 8 rounds. Then for round 9 to 12, oxaliplatin was dropped, as she had an allergic reaction on round 9. It has been over a year since her last treatment with the full folfox. So, maybe the toxicity from oxaliplatin has cleared up enough that my mom could withstand another 12 round of full folfox?

[midlifemom]

That's a question for the oncologist. Sorry i know nothing about that.