MRI shows 6 new liver Mets 2 weeks after clean CT scan? CEA normal.

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mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: MRI shows 6 new liver Mets 2 weeks after clean CT scan? CEA normal.

Postby mpbser » Tue Sep 18, 2018 7:18 am

Hope all went well yesterday.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

Cmac1275
Posts: 55
Joined: Mon Aug 06, 2018 4:21 pm

Re: MRI shows 6 new liver Mets 2 weeks after clean CT scan? CEA normal.

Postby Cmac1275 » Tue Sep 18, 2018 8:24 am

Thank you. Biopsy was a breeze. Hoping for good news when results come back.
42 yr, male, husband and father of 3
DX Stage IV Colon Cancer Jan 2018
Multiple liver mets
KRAS G13D / MSS

Jan 2018 Partial colon resection
Mar 2018 FOLFOX + Avastin | CEA 60.1
July 2018 Partial liver resection | CEA 4.7
Sep 2018 Recurrence in liver | CEA 2.9
Oct 2018 FOLFOX + Avastin
Nov 2018 Stopping FOLFOX. New mets | CEA 4.3
Dec 2018 Beginning AbbVie ABT-165 Trial

plastikos
Posts: 351
Joined: Wed Jan 14, 2015 6:09 am

Re: MRI shows 6 new liver Mets 2 weeks after clean CT scan? CEA normal.

Postby plastikos » Wed Sep 19, 2018 9:44 am

Been following this. Hoping the results turn out to be favorable. By the way, have you been tested for MSI status?
St. IV Colon CA @ 37, male, Kras wild, MSI-high (2014)
11/2014 Right Hemicolectomy + Liver Resection
12/2014 - 6/2015 FOLFOX + Cetuximab
10/2015 - Recurrence liver
Liver resection 10/2015
FOLFIRI 11/2015 - 5/2016
Recurrence liver, nodes 11/2016
Pembrolizumab started 12/2016 -> pseudoprogression(?) -> biliary obstruction -> biliary stenting
Chemo 4x: most mets inactive and smaller on PET-CT
March 2017 - Back on Pembrolizumab again
Sept 2017 - SIRT - > NED
2019 NED

Cmac1275
Posts: 55
Joined: Mon Aug 06, 2018 4:21 pm

Re: MRI shows 6 new liver Mets 2 weeks after clean CT scan? CEA normal.

Postby Cmac1275 » Wed Sep 19, 2018 8:28 pm

plastikos wrote:Been following this. Hoping the results turn out to be favorable. By the way, have you been tested for MSI status?



Thanks, Plastikos. Meeting with my new oncologist tomorrow. Will be asking to get more detail on exactly what they’ve tested for. If I’m being honest, when I was Dx’ed in January, I just plowed ahead with whatever the docs said to do. I suppose, in a way, that was a mechanism to avoid getting sucked into the inevitable phase of digging into every corner of the internet to find answers. Now that I’ve had this possible recurrence, that phase has officially arrived.
42 yr, male, husband and father of 3
DX Stage IV Colon Cancer Jan 2018
Multiple liver mets
KRAS G13D / MSS

Jan 2018 Partial colon resection
Mar 2018 FOLFOX + Avastin | CEA 60.1
July 2018 Partial liver resection | CEA 4.7
Sep 2018 Recurrence in liver | CEA 2.9
Oct 2018 FOLFOX + Avastin
Nov 2018 Stopping FOLFOX. New mets | CEA 4.3
Dec 2018 Beginning AbbVie ABT-165 Trial

cartech78
Posts: 78
Joined: Thu Oct 25, 2018 6:22 pm

Re: MRI shows 6 new liver Mets 2 weeks after clean CT scan? CEA normal.

Postby cartech78 » Fri Oct 26, 2018 1:38 am

Hey Cemac, I am new here as of today. I just thought i would chime in because in reading this post it seems we have a lot of similarities. I am 40 and was dx on 10/5/18. I am stage 4 with 6 or 7 mets to liver. Had a colon resection on 10/6. Like you my CT scan of liver showed clear originally but the MRI told the truth unfortunately. I also noticed you mentioned an Abbvie trial. My Wife works for Abbvie here in IL. I found out about their trial through her and we are currently trying to find out if i would qualify for it. I am starting Chemo on Monday and am going on I believe oxy and xeloda then Avastin at some point after i heal from colon resection. In 2 months i have an appointment at the Mayo clinic for a second opinion as my current doctors say my liver is not operable. Mayo wants the 2 months of treatment before i come to see them! I was curious if you know anything more about the trial as even my wife who works there cant seem to find much info on it. Anyways good luck and may god bless you on your road to recovery.
40 Y/o male
Dx 10/5/18 stage lV CRC
Sg colon
23 inoperable liver mets largest 4.5 cm
Colon resection 10/6/18 clean margins
Starting FolFox on 11/18
2nd opinion at MSK on 12/18
HAI pump installed on 3/6/2019 also found 20 more small tumors on liver scans missed
7/2/2019 MRI and CT show only 2 liver tumors visible and they are shrunk by 3/4
11/25/19- Liver resection at MSK- got out all cancer and am NED. More scans and mop up chemo to follow.
1 month Scan clear! Jun/20 scans still clear. Off chemo since 3/20

Cmac1275
Posts: 55
Joined: Mon Aug 06, 2018 4:21 pm

Re: MRI shows 6 new liver Mets 2 weeks after clean CT scan? CEA normal.

Postby Cmac1275 » Thu Nov 01, 2018 9:21 am

cartech78 wrote:Hey Cemac, I am new here as of today. I just thought i would chime in because in reading this post it seems we have a lot of similarities. I am 40 and was dx on 10/5/18. I am stage 4 with 6 or 7 mets to liver. Had a colon resection on 10/6. Like you my CT scan of liver showed clear originally but the MRI told the truth unfortunately. I also noticed you mentioned an Abbvie trial. My Wife works for Abbvie here in IL. I found out about their trial through her and we are currently trying to find out if i would qualify for it. I am starting Chemo on Monday and am going on I believe oxy and xeloda then Avastin at some point after i heal from colon resection. In 2 months i have an appointment at the Mayo clinic for a second opinion as my current doctors say my liver is not operable. Mayo wants the 2 months of treatment before i come to see them! I was curious if you know anything more about the trial as even my wife who works there cant seem to find much info on it. Anyways good luck and may god bless you on your road to recovery.


Hi Cartech, nice to meet you. Wish it was under different circumstances. But this has turned out to be a great place to get information and support.

I actually ended up not doing the trial. At least not yet. To qualify for the trial you have to show progression after taking FOLFOX/AVASTIN. You will not be accepted into the trial unless that was the specific chemo cocktail you were on. The trial is not blind, but it is random. So, you’ll either end up in the control group receiving FOLFIRI/Avastin or you’ll be in the experimental drug group taking FOLFIRI + the Abbvie drug (ABT-165).

Now, while I was indeed on the FOLFOX/Avastin cocktail, my oncologist isn’t convinced I’ve shown true progression. Yes, they found previously unidentified spots. However, they can’t rule out microdisease that was already there and grew in the absence of any chemo/treatment while prepping and recovering from liver surgery.

As such, my oncologist did not want to burn the FOLFOX/Avastin match just yet. There are only so many matches in the box when it comes to chemo. Since it worked so well to shrink my tumors the first time, we decided to go back to it. If or when FOLFOX/Avastin stops working (or I can’t tolerate the Oxiliplatin in FOLFOX anymore), then we’ll decide on trial.

That said, there’s been an interesting new development here at Duke Cancer Center. My oncologist is currently part of a board in talks with Memorial Sloan Kettering in NYC. It looks imminent that Duke will beging working with MSK specialists to offer HAI pump treatment. They already do maintenance for several patients who’ve had the pump installed at MSK in New York City. Dr. Kemeny, who pioneered this technique, has had good success. So, this could potentiall become another viable option. Frankly, my wife and I were prepared to visit MSK anyway. But it’s a blessing we may not have to incur the travel and cost burden of out of state treatment.

Happy to keep you posted as I learn more. Reach out any time. We’re all here for each other, after all.
42 yr, male, husband and father of 3
DX Stage IV Colon Cancer Jan 2018
Multiple liver mets
KRAS G13D / MSS

Jan 2018 Partial colon resection
Mar 2018 FOLFOX + Avastin | CEA 60.1
July 2018 Partial liver resection | CEA 4.7
Sep 2018 Recurrence in liver | CEA 2.9
Oct 2018 FOLFOX + Avastin
Nov 2018 Stopping FOLFOX. New mets | CEA 4.3
Dec 2018 Beginning AbbVie ABT-165 Trial


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