TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

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LMighty
Posts: 81
Joined: Sun Aug 28, 2016 6:16 am
Location: Hong Kong

TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby LMighty » Tue Jul 11, 2017 3:36 am

HI everyone,

With the help and support from members on this board (particularly Maia -- the info you shared is crucial!) and our VERY accommodating, supportive oncologist, treatment with TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for my mom (stage IV, KRAS wild-type, MSS; failed Xelox + Avastin & Irinotecan + Erbitux in less than a year) finally starts today. The regimen is based on the initial data of the well-known pivotal clinical trial (http://oncologypro.esmo.org/Meeting-Resources/ESMO-2016/Efficacy-and-safety-of-cobimetinib-cobi-and-atezolizumab-atezo-in-an-expanded-phase-1b-study-of-microsatellite-stable-MSS-metastatic-colorectal-cancer-mCRC).

I am creating this thread as a record of the efficacy of this daring regimen as I am sure caregivers and fellow patients (especially with MSS) on this board would be interested. I will post updates regularly.
Supporter to my mom (64 yr); KRAS wild type; MSS

2012: DX Stage I, rectal cancer; resection and colostomy, no chemo
5/16: DX Stage III, mets found; right groin lymph node and soft tissue nodules
5-6/16: Radiation + Xeloda
7/16: DX Stage IV, pleural effusion; cancer cells found in fluid
7-12/16: Xelox + Avastin X 6
1/17: Clean PET scan, NED
2/17: Pleural effusion; recurrence
4/17: Iri + Erb X 3
5/17: Ascites; Chemo failed
6/17: Keytruda X 1
7/17: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib)

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Maia
Posts: 2365
Joined: Fri Aug 24, 2012 8:00 am

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby Maia » Tue Jul 11, 2017 9:07 am

Ohhh, our messages crossed paths --I just posted in your previous thread.
Sending my best thoughts for a good response. But more important: how is your mom feeling? Does she feel like pursing this treatment, how is her spirit, and physical condition?

LMighty
Posts: 81
Joined: Sun Aug 28, 2016 6:16 am
Location: Hong Kong

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby LMighty » Tue Jul 11, 2017 9:43 am

Hey Maia,

Thanks for your concern! My mom is still in hospital for pleural fluid and ascites drainage and it has been a month. We are leaving the drains in so we can remove the fluid at home.

X-rays from a few days ago showed a bit more shadow especially in the left lung. Our onc's interpretation is that the cancer seems to have spread to the trachea, and her left lung has only about 30% of function left. He thinks there is no immediate danger for now but things can go south unexpectedly at an alarming rate, and if the immune system friendly fires the lungs after treatment (although not too likely), it would be life threatening. She has been on small dose of steroids to boost lung function until taking the new drugs today.

My mom in general feels tired everyday due to all the breathing and sleeping problems but she is accepting the treatment. She and I think the first infusion of Keytruda may have worked a bit as the amount of pleural fluid and ascites seem to be decreasing at a slow rate recently, so we are both hopeful that the new regimen will work even better. We are taking one step at a time -- first goal is to go home ASAP! Her lungs performance in the coming days will determine when she is going home and it seems to be slowly improving.

Keeping fingers crossed!
Supporter to my mom (64 yr); KRAS wild type; MSS

2012: DX Stage I, rectal cancer; resection and colostomy, no chemo
5/16: DX Stage III, mets found; right groin lymph node and soft tissue nodules
5-6/16: Radiation + Xeloda
7/16: DX Stage IV, pleural effusion; cancer cells found in fluid
7-12/16: Xelox + Avastin X 6
1/17: Clean PET scan, NED
2/17: Pleural effusion; recurrence
4/17: Iri + Erb X 3
5/17: Ascites; Chemo failed
6/17: Keytruda X 1
7/17: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib)

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Maia
Posts: 2365
Joined: Fri Aug 24, 2012 8:00 am

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby Maia » Tue Jul 11, 2017 11:38 am

Oh, glad to hear about the slight decrease in pleural fluids and ascites!! I'm sending my best thoughts so she can be at the comfort of her home ASAP!

Lee
Posts: 4920
Joined: Sun Apr 16, 2006 4:09 pm

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby Lee » Tue Jul 11, 2017 12:46 pm

Just wanted to wish your Mom good luck, hope this puts her in NEDville,

Lee
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!

[Ana & Alex]
Posts: 60
Joined: Tue Feb 14, 2017 5:14 pm
Location: Austria

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby [Ana & Alex] » Tue Jul 11, 2017 10:50 pm

Dear LMighty,

I've been silently accompanying your journey with your mom. I hope the treatment works for her, I really do.

Just wanted to wish very good luck!
Thinking of you and sending out positive vibes..

All the best,
Ana
29 yo. Mum (21 Mo) & Wife

12/2016: Dx Rectum AdenoCa G2 4 cm ab ano. CEA 4.3. RAS Wildtyp. MSS. IIIB.
01 - 03/2017: 28 RTx + CHT 2500 mg/d Capecitabine
03 - 06/2017: Suplemments and Cimetidine.
05/2017: TME/TAMIS + permanent Colostomy CEA 0.5
05/2017: ypT2N2aM0 (4/15), very good cRP, limited pCR
06 - 11/2017: 2 full x CapOx w/ 230mg + 3500 mg/d. 1x Oxi reduced to 80% (167mg) (4 to go)

LMighty
Posts: 81
Joined: Sun Aug 28, 2016 6:16 am
Location: Hong Kong

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby LMighty » Fri Jul 14, 2017 3:49 am

Hi everyone,

Thank you so much for your kind words!

I have an encouraging update. Since Wednesday the ascites reduced from 300-500ml daily to virtually zero. Not even detectable by ultrasound. Our onc said it's good news but it's too early to tell if it represents response. We will see if it stays this way in the coming days. Other vitals are also improving.

We can really use some good news after a month of scares!
Supporter to my mom (64 yr); KRAS wild type; MSS

2012: DX Stage I, rectal cancer; resection and colostomy, no chemo
5/16: DX Stage III, mets found; right groin lymph node and soft tissue nodules
5-6/16: Radiation + Xeloda
7/16: DX Stage IV, pleural effusion; cancer cells found in fluid
7-12/16: Xelox + Avastin X 6
1/17: Clean PET scan, NED
2/17: Pleural effusion; recurrence
4/17: Iri + Erb X 3
5/17: Ascites; Chemo failed
6/17: Keytruda X 1
7/17: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib)

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LPL
Posts: 267
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby LPL » Fri Jul 14, 2017 5:11 am

LMighty,
Like [Ana & Axel] I have been following your posts and I am So Happy for you that things are looking better :)
Kind Regards /L
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage 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 for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets

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Maia
Posts: 2365
Joined: Fri Aug 24, 2012 8:00 am

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby Maia » Fri Jul 14, 2017 8:10 am

LMighty, so happy to hear! An actual step in the right direction!
Is your mom feeling more comfortable now? Not needing the drainage is itself such a relief.

LMighty
Posts: 81
Joined: Sun Aug 28, 2016 6:16 am
Location: Hong Kong

Re: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib) for Stage IV, starting 11/7/2017

Postby LMighty » Sat Jul 15, 2017 8:40 am

Maia wrote:LMighty, so happy to hear! An actual step in the right direction!
Is your mom feeling more comfortable now? Not needing the drainage is itself such a relief.

Yes she is. Her energy level is slowly recovering with the help of low dose of supplementary oxygen. She has intestinal cramps and mild diahhrea that have lasted for a few days and the cause is unknown. Our onc suggests wait & see and does not want to make any assumption. It seems to lessen little by little over time. We hope it has nothing to do with the cancer!
Supporter to my mom (64 yr); KRAS wild type; MSS

2012: DX Stage I, rectal cancer; resection and colostomy, no chemo
5/16: DX Stage III, mets found; right groin lymph node and soft tissue nodules
5-6/16: Radiation + Xeloda
7/16: DX Stage IV, pleural effusion; cancer cells found in fluid
7-12/16: Xelox + Avastin X 6
1/17: Clean PET scan, NED
2/17: Pleural effusion; recurrence
4/17: Iri + Erb X 3
5/17: Ascites; Chemo failed
6/17: Keytruda X 1
7/17: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib)


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