Folfiri after Folfox fails

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hopefulandstrong
Posts: 11
Joined: Fri Apr 19, 2019 7:11 pm

Folfiri after Folfox fails

Postby hopefulandstrong » Wed May 01, 2019 1:12 pm

Wondering if any of you have stories about folfiri as a second line treatment when folfox fails. Just learned that five rounds did not work. Additional nodes in liver and possibly in abdominal cavity and spleen. Looking for hopeful stories hee.

Thanks!
54, female
1/8/19 DS Stage 4 with Liver Mets
1/11/19 Successful Colon Resect -- 12 inches of transverse colon removed
2/9/19 PET scan with disease confined to liver
2/18/19 Started Folfox -- CEA 70
2/25/19 -- Scans to determine next steps -- HIA, Liver resect
5/1/19 -- Scans show progression -Switch to Folfiri
5/8/19 - BRAF mutation -- switch again to Triplet Therapy: Encorafenib, Binimetinib, Cetximab

Claudine
Posts: 21
Joined: Tue Mar 12, 2019 2:41 pm
Facebook Username: Claudine Tobalske

Re: Folfiri after Folfox fails

Postby Claudine » Wed May 01, 2019 4:22 pm

Hi there Hopefulandstrong,

My husband didn't have Folfox but Xelox as adjuvant chemo last Fall (following radiation for a lumbar met); it didn't work and a PET scan found a new tumor in his adrenal gland in January. He started Folfiri (with Avastin) mid-March and so far his CEA levels have been steadily dropping - 58, then 17, then 10. He'll probably get an MRI farily soon to see how much the tumor has shrunk (it was 5.3cm in March). But it's a good sign! Hopefully the same for you! Also, the side effects of Folfiri are a lot less intense than those of Xelox - a little tiredness, some heart burn (easily controlled with medication); hair loss, but that's temporary...
Good luck XXX
Wife of Dx 04/18 (51 yrs old then)
No primary found, lytic tumor L4 vertebrae, CEA 10
Radiation 04/18
Resection small intestine 05/18 (activity on PET scan, but no cancer found)
Xelox * 6, 05/17 to 10/18
5.3 cm hypermetabolic left adrenal mass 01/19
SBRT L4 02/19
Folfiri + Avastin
CEA 58 03/15
CEA 17 03/29
CEA 10 04/12
CEA 6.4 04/26
CEA 5 05/10

hopefulandstrong
Posts: 11
Joined: Fri Apr 19, 2019 7:11 pm

Re: Folfiri after Folfox fails

Postby hopefulandstrong » Wed May 01, 2019 6:17 pm

Thank you!

That is so helpful. My onc at MSK tried to be hopeful today, but she is also realistic. We still don't have the genetics -- though we know I'm negative for Lynch. That there are suspicious lesions in the peritoneal cavity was what most concerning to her. How quickly did you start to see CEA's drop?
54, female
1/8/19 DS Stage 4 with Liver Mets
1/11/19 Successful Colon Resect -- 12 inches of transverse colon removed
2/9/19 PET scan with disease confined to liver
2/18/19 Started Folfox -- CEA 70
2/25/19 -- Scans to determine next steps -- HIA, Liver resect
5/1/19 -- Scans show progression -Switch to Folfiri
5/8/19 - BRAF mutation -- switch again to Triplet Therapy: Encorafenib, Binimetinib, Cetximab

CrossfitChick1980
Posts: 47
Joined: Wed Nov 25, 2015 9:40 pm

Re: Folfiri after Folfox fails

Postby CrossfitChick1980 » Thu May 02, 2019 6:32 am

My husband had shrinkage in the tumor in his liver with FOLFOX but after a scan, the oncologist realized that while the liver was responding, two lymph nodes in his chest had actually grown. He was switched to FOLFIRI and his liver tumors disappeared. His lymph nodes no longer lit up on scan and so he was moved to maintenance chemo.
Caregiver to DH dx with Adenocarcinoma of Small Intestine
Mar14- Small Bowel Resection (dx @31)
May14-Oct14: Folfox
Apr15- Liver mets
Jun15- Xeloda/Oxalyplatin
Oct15- Folfiri/Avastin
Dec15- Liver Mets, lymph nodes shrinking.
Apr16- Liver mets gone! lymph nodes stable
Jun16- Avastin/Xeloda (MSS, KRAS)
Jul16- Maintenance Chemo
Jun18- Cancer is back in liver
Sep18- Lonsurf
Oct18- Therasphere txment (failed)
Dec18- Folfiri/Avastin
Dec 22 2018- He is no longer suffering- My Love is sleeping in Peace

hopefulandstrong
Posts: 11
Joined: Fri Apr 19, 2019 7:11 pm

Re: Folfiri after Folfox fails

Postby hopefulandstrong » Thu May 02, 2019 8:21 am

Thank you so much for this information. I see your husband passed late last year. So sorry. And, it also looks like the treatment gave him more time with you. You are so kind to remain on this forum.
54, female
1/8/19 DS Stage 4 with Liver Mets
1/11/19 Successful Colon Resect -- 12 inches of transverse colon removed
2/9/19 PET scan with disease confined to liver
2/18/19 Started Folfox -- CEA 70
2/25/19 -- Scans to determine next steps -- HIA, Liver resect
5/1/19 -- Scans show progression -Switch to Folfiri
5/8/19 - BRAF mutation -- switch again to Triplet Therapy: Encorafenib, Binimetinib, Cetximab

Claudine
Posts: 21
Joined: Tue Mar 12, 2019 2:41 pm
Facebook Username: Claudine Tobalske

Re: Folfiri after Folfox fails

Postby Claudine » Thu May 02, 2019 10:14 am

hopefulandstrong wrote:Thank you!

That is so helpful. My onc at MSK tried to be hopeful today, but she is also realistic. We still don't have the genetics -- though we know I'm negative for Lynch. That there are suspicious lesions in the peritoneal cavity was what most concerning to her. How quickly did you start to see CEA's drop?


When we went in for his second infusion (he gets them every two weeks), his onc told us not to panic if levels didn't drop for a while, or even kept going up (they were at 58 at first chemo). Then he came back all smiles with the blood test results because they'd already dropped to 17 after only one treatment! Since then the decline has been more gradual, 10 at 3rd chemo, and 6.4 last Friday. But decline nonetheless. They had to reduce the Irinotecan by 20% at 3rd chemo because his neutrophils were dipping low; they were back to decent levels last Friday.
Wife of Dx 04/18 (51 yrs old then)
No primary found, lytic tumor L4 vertebrae, CEA 10
Radiation 04/18
Resection small intestine 05/18 (activity on PET scan, but no cancer found)
Xelox * 6, 05/17 to 10/18
5.3 cm hypermetabolic left adrenal mass 01/19
SBRT L4 02/19
Folfiri + Avastin
CEA 58 03/15
CEA 17 03/29
CEA 10 04/12
CEA 6.4 04/26
CEA 5 05/10

User avatar
Jack&KatiesMommy
Posts: 579
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: Folfiri after Folfox fails

Postby Jack&KatiesMommy » Thu May 02, 2019 10:31 am

I was on Irinotecan first (for over a year) (with Xeloda) and then was switched to Oxi w/ Xeloda to try to knock out some lung mets that were stable but not shrinking. The Oxi never worked...I went back on Fofiri and we used rfa procedures to knock down the lung mets. Irinotecan was much more effective for me.
Cynthia
Mommy to Jack (8) now (16) and Katie (4) now (12)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection
8/13-12/15 (10) RFAs lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new mets lymph nodes lung:
05/18: Keytruda (MSS w/Intermediate TMB): CEA: 66.4, 39.2, 23.8, 13, 3.5 1.8, 1.0, 2.8 3.9, 5.0, 5.6, 1.5, .8, .8, 1.1, 1.1, .7
7/18; 9/18; 11/18; 2/19 Clear CT scans

teacher2017
Posts: 231
Joined: Sat Sep 09, 2017 1:18 pm
Facebook Username: Lydia Clark

Re: Folfiri after Folfox fails

Postby teacher2017 » Fri May 10, 2019 7:41 pm

hopefulandstrong wrote:Thank you!

That is so helpful. My onc at MSK tried to be hopeful today, but she is also realistic. We still don't have the genetics -- though we know I'm negative for Lynch. That there are suspicious lesions in the peritoneal cavity was what most concerning to her. How quickly did you start to see CEA's drop?



Hi my onc is at MSK too. Who is she? Dr. Z?
48 year old female- mom of 2 (12,15)
DX stage 3c - 12/17 LN. T3
8" sigmoid resection Sept 22 2017
6.1cm tumor size
chemo -folfox 11/8/17-4/18
CEA level- 1.4 11/8/17
Colonoscopy- 5/30/18 - CLEAR!
Cea level- 1.8 6/1/18
Cea level- 2.1. 8/4/18
Sh$t has hit the fan- 8/10/18 Stage 4
1cm met in seg.8 liver
Liver resection- 9/12/18
Cea level- 1.5 10/1/18
Cea level- 1.2 12/1/18
Clear scan- 12/5/18
Cea level- 1.1 3/2/19

hopefulandstrong
Posts: 11
Joined: Fri Apr 19, 2019 7:11 pm

Re: Folfiri after Folfox fails

Postby hopefulandstrong » Sat May 11, 2019 6:46 am

My doc is Dr. Cercek. I also recently learned that I am positive for the BRAF mutation, which is now calling for a different treatment... I shall report in as that develops.
54, female
1/8/19 DS Stage 4 with Liver Mets
1/11/19 Successful Colon Resect -- 12 inches of transverse colon removed
2/9/19 PET scan with disease confined to liver
2/18/19 Started Folfox -- CEA 70
2/25/19 -- Scans to determine next steps -- HIA, Liver resect
5/1/19 -- Scans show progression -Switch to Folfiri
5/8/19 - BRAF mutation -- switch again to Triplet Therapy: Encorafenib, Binimetinib, Cetximab


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