Unfortunately, I had disease progression in my liver with two new tumors following 5 cycles of FOLFIRI, so I am now trying something novel, off-label use of vinorelbine. I had my first infusion today of vinorelbine, an FDA approved drug to treat lung cancer. This was brought up with the article " A Vulnerability of a Subset of Colon Cancers with Potential Clinical Utility". This Cell magazine article talks about the the specific defect of V600E BRAF cells in microtube formation unveiled a potential vulnerability of such tumors to microtube disrupting agents like vinorelbine. The pre-clinical analysis in mouse and in-vitro studies conclude that BRAF cells are more sensitive to vinorelbine and that the toxicity is due to mitotic arrest followed by apoptosis. More over, the data suggest the liver metastises of BRAF colon cancer respond to vinorelbine therapy. There is a current clinical trial with European investigational sites. The dosing schedule is 3 weeks on (1 infusion per week), 1 week off. I am appealing the use with my insurance company, but I am not optimistic they will approve. The self pay option may not be too out of reach, as the cost of generic vinorelbine is modest at about $50 / dose.
So treatment options for BRAF CRC patients include FOLFOXIRI, triplet targeted chemotherapy (Vectibex, Tafinlar, Mekinist), vinorelbine, and the new MD Anderson protocol of Vemurafinab (melanoma BRAF inhibitor) combined with CRC-approved irinotecan + Erbitux.
I have also completed four cycles of ten-pass auto major hemotherapy (Ozone therapy) and don't have any radiographic results about the therapeutic effect. I plan on doing another four cycles of ozone therapy, then evaluating the results from a CT scan.