Keytruda....Working for MSS....Mutation Burden is the Key

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boxhill
Posts: 789
Joined: Fri Apr 06, 2018 11:40 am

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby boxhill » Fri May 24, 2019 12:26 pm

Pyro, do you think three months is long enough to be certain? I seem to have read that for some people it takes 6 months.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED

natelaugh
Posts: 95
Joined: Wed Apr 03, 2019 11:40 pm

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby natelaugh » Fri May 24, 2019 11:38 pm

Pyro, stay strong and keep hope alive.

Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

Pyro
Posts: 305
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby Pyro » Sat May 25, 2019 8:22 am

Thanks for the words folks, I won’t know anything for sure until Tuesday. I think I’ve done enough chemo for a lifetime, but we will see.
Aug 2015- Stage 4 CC with liver Mets(38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not liver surgery candidate
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery
Mar 2016 -30% of left lobe rem, PVE
May 2016 - 70% of liver rem
Jun 2016-Rad
Jan 2017-perm colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Rad
Mar 2019 - Keytruda fail
Jun 2019 - FOLFURI
Aug 2019 - No more, quality time!

User avatar
LPL
Posts: 651
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby LPL » Sat May 25, 2019 11:42 am

Pyro wrote:Thanks for the words folks, I won’t know anything for sure until Tuesday. I think I’ve done enough chemo for a lifetime, but we will see.

Good Luck on Tuesday Pyro !!
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

Pyro
Posts: 305
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby Pyro » Sat May 25, 2019 12:24 pm

boxhill wrote:Pyro, do you think three months is long enough to be certain? I seem to have read that for some people it takes 6 months.


I like where you heads at on this one, I know my Onc doesn’t think it’s working. Things are happening so fast with immunotherapy, we’re learning as we go. That being said, I’ve read the treatment changes the immune system forever and the actual drug stays in your system for 3 months, so it will keep working, or not working. My Onc has a 0% success record for MSS patients taking Keytruda, winning!
Aug 2015- Stage 4 CC with liver Mets(38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not liver surgery candidate
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery
Mar 2016 -30% of left lobe rem, PVE
May 2016 - 70% of liver rem
Jun 2016-Rad
Jan 2017-perm colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Rad
Mar 2019 - Keytruda fail
Jun 2019 - FOLFURI
Aug 2019 - No more, quality time!

Pyro
Posts: 305
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby Pyro » Wed May 29, 2019 7:27 am

Well, results are in. 4 tumors about 3cm each in the lungs and a newbie in my liver about 2cm. I have a slight wet cough but that could be anything, Cea is now 36. I set up an appointment next Wednesday for FOLFIRI+vectibux with the understanding I might cancel b/c I really don’t want to do it. I’ve told myself for months I’d never do that chemical poison again but with this in my face I’m teetering. I told the Onc if I’m going to die, I don’t want to suffer (chemo) and die. She got a little emotional and told me she saw her dad go through it and colon cancer chemo was one of the hardest for the patients to handle. I’m physically strong enough to do the chemo, I know it, mentally though I’m not sure. I’m heading out to the beach for a few days with family to ponder life and not think about this for a while. I may not check in until I get back, damn this disease.
Aug 2015- Stage 4 CC with liver Mets(38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not liver surgery candidate
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery
Mar 2016 -30% of left lobe rem, PVE
May 2016 - 70% of liver rem
Jun 2016-Rad
Jan 2017-perm colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Rad
Mar 2019 - Keytruda fail
Jun 2019 - FOLFURI
Aug 2019 - No more, quality time!

martd
Posts: 128
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby martd » Wed May 29, 2019 9:03 am

Enjoy your time with family and know whatever decision you make will be a good one
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT Tp53 LOF
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9
04/19 clear scan CEA .9
07/19 clear scan CEA 1.0

natelaugh
Posts: 95
Joined: Wed Apr 03, 2019 11:40 pm

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby natelaugh » Wed May 29, 2019 2:46 pm

A strategy I used to help my dad is use chemo to hold cancer at bay and hope a new med or technology break thru in 1-3yrs. Having hope can help to be mentally strong.

Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

Pyro70
Posts: 156
Joined: Mon Jan 21, 2019 4:25 pm

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby Pyro70 » Wed May 29, 2019 3:37 pm

Pyro wrote: I’m heading out to the beach for a few days with family to ponder life and not think about this for a while. I may not check in until I get back, damn this disease.


I know this beach called scar reef on the island of Sumbawa, Indonesia from when I lived in Indo. Great surf, very chill/cheap BNB right on the beach. It’s hard to get there, so there aren’t a lot of tourists. I’ve certainly thought about making a one way trip a few times...
Dx Jan 2017 stage IVB w/ PC age 35
FOLFOX
SEP 17 HIPEC 1, anastamosis leak
XELODA
MAR 18 HIPEC 2
JUN 18, ileo reversal and 2nd anastamosis leak

User avatar
juliej
Posts: 3114
Joined: Thu Aug 05, 2010 12:59 pm

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby juliej » Wed May 29, 2019 5:52 pm

Pyro wrote:Well, results are in. 4 tumors about 3cm each in the lungs and a newbie in my liver about 2cm. I have a slight wet cough but that could be anything, Cea is now 36. I set up an appointment next Wednesday for FOLFIRI+vectibux with the understanding I might cancel b/c I really don’t want to do it. I’ve told myself for months I’d never do that chemical poison again but with this in my face I’m teetering. I told the Onc if I’m going to die, I don’t want to suffer (chemo) and die. She got a little emotional and told me she saw her dad go through it and colon cancer chemo was one of the hardest for the patients to handle. I’m physically strong enough to do the chemo, I know it, mentally though I’m not sure. I’m heading out to the beach for a few days with family to ponder life and not think about this for a while. I may not check in until I get back, damn this disease.

I really wish I had something witty or clever to say right now, Pyro, but I don’t. This is so f**king unfair. Be you. Be strong, which you are regardless of any choice you make.

You have so many people out here who think about you and love you in their (our) own way, even if we’ve never met. Sending you peace and hugs.

Juliej
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

brokenwings
Posts: 147
Joined: Mon Jan 07, 2019 1:50 am

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby brokenwings » Thu May 30, 2019 10:42 am

Pyro wrote:Well, results are in. 4 tumors about 3cm each in the lungs and a newbie in my liver about 2cm. I have a slight wet cough but that could be anything, Cea is now 36. I set up an appointment next Wednesday for FOLFIRI+vectibux with the understanding I might cancel b/c I really don’t want to do it. I’ve told myself for months I’d never do that chemical poison again but with this in my face I’m teetering. I told the Onc if I’m going to die, I don’t want to suffer (chemo) and die. She got a little emotional and told me she saw her dad go through it and colon cancer chemo was one of the hardest for the patients to handle. I’m physically strong enough to do the chemo, I know it, mentally though I’m not sure. I’m heading out to the beach for a few days with family to ponder life and not think about this for a while. I may not check in until I get back, damn this disease.


Hi Pyro,
I'm really sorry you're in this situation...
Two thoughts:
1. have you ever tried medical cannabis? For some people it's been a miracle therapy against chemo side effects.
2. what about doing a clinical trial?

Hoping for the best...
DX 2019 Adenocarcinoma Sigmoid colon. PC + ovarian met.
Obstruction. Temporary colostomy.
Folfirinox + Avastin: 6 cycles. Scans: partial response.
Surgery (CRS + HIPEC) 04/29: too much disease, surgery cancelled. Right ovary removed.
2nd ptotocol: IP chemo (oxaliplatin) + IV chemo (Folfiri + Avastin). 8 cycles
10/31/2019: 11 hour-long Hipec + 6 weeks in hospital
12/30/2019: liver met
02/05/2020: reversal surgery. New peri mets discovered
March 2020: 5fu+Avastin
May 2020: fistula
Back to 1957: 5fu.

Pyro
Posts: 305
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby Pyro » Mon Jun 03, 2019 11:16 am

natelaugh wrote:A strategy I used to help my dad is use chemo to hold cancer at bay and hope a new med or technology break thru in 1-3yrs. Having hope can help to be mentally strong.

Nate.


Thanks to all who responded, I’m still mulling it over. I’ve been dealing with this for damn near 4 years, thinking of doing chemo for another 1-3 years is a bridge too far for me, I’ve already done 80+ rounds. I have been “officially” doing medical cannabis for a year, it makes a big difference, wish I would have started 4 years ago but I was still in the military. We stayed at the Catamaran resort in San Diego, I didn’t want to leave. If I could figure out how to post a picture I would. I’ll keep you all updated, need to go smoke something.
Aug 2015- Stage 4 CC with liver Mets(38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not liver surgery candidate
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery
Mar 2016 -30% of left lobe rem, PVE
May 2016 - 70% of liver rem
Jun 2016-Rad
Jan 2017-perm colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Rad
Mar 2019 - Keytruda fail
Jun 2019 - FOLFURI
Aug 2019 - No more, quality time!

stu
Posts: 1614
Joined: Sat Aug 17, 2013 5:46 pm

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby stu » Mon Jun 03, 2019 1:48 pm

Pryo ,
I am feeling for you and hope you come to a decision that feels right within you .

If you try Tinypics it’s really easy to upload a photo . You just select “ Message Board” and copy onto the thread . I am dreadful with all this but managed it well . It would be lovely to see your photo .

Take care ,

Court
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Pyro
Posts: 305
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby Pyro » Wed Jun 05, 2019 8:26 pm

Had to delete, most family doesn’t know yet. Added Facebook profile, I’m the wet pilot second from left. Sorry, I won’t friend you if we’ve never met.
Last edited by Pyro on Thu Jun 06, 2019 8:36 am, edited 1 time in total.
Aug 2015- Stage 4 CC with liver Mets(38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not liver surgery candidate
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery
Mar 2016 -30% of left lobe rem, PVE
May 2016 - 70% of liver rem
Jun 2016-Rad
Jan 2017-perm colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Rad
Mar 2019 - Keytruda fail
Jun 2019 - FOLFURI
Aug 2019 - No more, quality time!

natelaugh
Posts: 95
Joined: Wed Apr 03, 2019 11:40 pm

Re: Keytruda....Working for MSS....Mutation Burden is the Key

Postby natelaugh » Wed Jun 05, 2019 10:57 pm

Pyro,

5FU is a walk in the park for you. After 2-3 days disconnecting chemo, and it is ON. My dad would eat and gain his strength.

Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone


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