DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

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DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby DK37 » Thu Jul 06, 2017 3:33 pm

Hi Everyone,

I wrote up a blog about ASCO 2017. Post it was a bit delayed due to some medical adventures on my end........


https://adventuresinlivingterminallyopt ... asco-2017/

6/4/2012 Dx Stage 3C CRC @ 40 yo. MSS, KRAS-WT, BRAF-WT, p53-mut
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:
2016 Colondar 2.0 Model
DK37 Science Posts List

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Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby Lee » Thu Jul 06, 2017 5:45 pm

Have not read all of it yet, butt I plan to.

Hope your doing okay,

rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

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Location: Ontario, Canada

Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby Steph20021 » Thu Jul 06, 2017 9:13 pm

This is exciting! Great easy to understand blog post DK! Thank you!
DX 1/31/14 @ 33- SPS-T4a(invades visceral peri), N2a(6/106 LN), M1a(ovary) (Stage 4a) MSS; BRAF V600E
2/1/14-subtotal col, lost R ovary, temp ileo
3/14-9/14- folfox; sepsis
11/14-CT/PET: L ovary met, pelvic met, (?)ghost liver met(?)
12/14-folfiri -13 rds kept me stable from 3/15-6/15
09/15- cea 0.9
05/16- recurrence in abdo wall and lymph nodes
01/17- pulmonary embolism
02/17- 1 wk radiation to abdo wall
08/16- on folfiri
11/18- Beacon trial-encorafenib & cetuximab

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Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby LPL » Fri Jul 07, 2017 2:49 am

In his Blog post DK37 wrote:
"Q. Many CRC patients have low CEA measurements in their blood tests, can RO6958688 work in those patients? ...
A. There is not a direct correlation between the amount of CEA expressed by a patient’s tumors and CEA in that patient’s bloodstream (ref. )
– so yes, the drug should be able to work even if a patient has low blood CEA levels. Oftentimes a tumor expresses a lot of CEA – it just isn’t released into the blood allowing it to be measured by the standard CEA blood test!"

Thank You very much DK for info about this Clinical Trial and for explaining this (quoted) about CEA!

Wishing you well !
Kind Regards /LPL
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

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Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby CRguy » Sat Jul 08, 2017 10:36 am

As always buddy ... adding immensely to all our experiences here
by sharing all of your own !

JMO .... BUTT ... I would be good in wishing maybe you didn't need to have so many experiences .... :shock:
if you know what I mean !!!

Cheers and Harmony bro'
Caregiver x 4
Stage IV A rectal cancer/lung met
13 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby jortego128 » Sun Jul 09, 2017 3:43 pm

Very interesting writeup on this new development Tom. I noticed you did the SIRT procedure on June 1. Did you do both lobes at the same time or stagger them? SIRT has a special significance to me as I would have had it done for my mother if we had been aware early enough. I believe in my heart it would have helped her metastatic tumors which were confined solely to her liver.

How was the procedure and recovery? I read it sometimes takes quite a while for results to show on CT scans. Hope you are feeling better. I have read that sometimes SIRT can dramatically improve how you feel if your liver tumors are symptomatic/ causing weakness.

DM 57 yrs old dx 6/8/15 T:4a N:1b M:1
KRAS G12D and TP53 C242fs mutations
Poorly Differentiated, Prominent Signet Ring Component(~50%)
Microsatellite Stable, 3 of (13)lymph nodes positive
15 Liver mets, largest 3.2 cm
Prim. Resection, Right Hemicolectomy 6/21/15
Start Chemo 7/20/15
2 rounds FOLFOX, 1 round FOLFOX +Avastin
CT 8/28/15, met growth, largest 4.5cm
4 rounds FOLFOX+Avastin
CT 11/06/15 mets stable, lungs clear
Begin FOLFIRI+Avastin 11/17/15, Stop chemo 1/26/16
Entered Paradise 3/11/2016

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Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby lpas » Sun Jul 09, 2017 4:00 pm

Definitely a positive development to see this kind of approach having an impact on MSS disease, although I worry a bit about the durability issue. I was so excited to see that JulieYW made it into this trial but it seems (from her blog) that the results were extremely short-lived.

Thanks as always for keeping us updated! So glad to hear the SIRT and the radiation have brought you some relief.
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 & celecoxib
2/19 clean scope
11/19 clean CT
Ongoing cimetidine & other targeted supplements
Mom to a 6 & 8yo

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Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby karaj » Mon Jul 10, 2017 9:49 am

Always so glad to read your updates, both the medical ones and the personal ones. Rooting for more normal days!

If the Lovenox is a big bummer, I was put on Edoxaban a year ago as part of the trial linked below. It cleared up my PE and I haven't had any side effects from the medicine.

Best to you!
36 y/o female, dx at 32
8/14 dx Stage IIIC, 10/30 lymph nodes
8/14-9/14: sigmoidoscopy, fertility preservation, port-a-cath
9/14 - 3/15: FOLFOX (allergic to oxaliplatin, underwent desensitization)
4/15: NED
1/16: dx Stage IV, recurrence in three lymph nodes behind abdomen
8/16: NED
8/17: NED, currently under no treatment, scans every 3 months

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Re: DK37 Blog: ASCO 2017 Best MSS CRC Presentation/Clinical Trial

Postby juliej » Mon Jul 10, 2017 5:04 pm

Thanks for the info, DK! It's always good to get your take on these things because of your expertise! :D

BsMAb's (bispecific monoclonal antibodies) are hot news! There is a Phase 2 trial in France that uses a recombinant anti-CEA BsMAb and a 177Lu-labeled peptide for the treatment of CEA-expressing small cell lung cancers (SCLC) or CEA-expressing Non Small Cell Lung Carcinoma (NSCLC) using radiation (it's called pretargeted radioimmunotherapy). Since more than 50% of lung cancer shows CEA expression, this is good news for SCLC or NSCLC patients. I'm hoping this will eventually apply to CRC patients with lung mets since we all know how difficult they can be to treat.

We need more agents with novel mechanisms of action (like BsMAb's) to tackle MSS CRC!
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

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