Stage IV patient with increasing CEA: wait-and-see?

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Mercy110
Posts: 114
Joined: Wed Aug 16, 2017 12:13 am

Stage IV patient with increasing CEA: wait-and-see?

Postby Mercy110 » Wed May 08, 2019 9:26 am

Hello. Some background of my mum. My mum is a stage IV patient who had tried both Folfox and Folfiri with Avastin for chemo. She showed good response to the former while poor response to the later that her CEA is now increasing from 9 to 100.
CT scan was done two weeks before and showed more nodules in lungs. However, she suspected a swollen and harden mass near her anus as a new site of spread that no surgeon or onco would do anything about it because they told us the only solution is to go on chemo. (We are from HK, btw, that most doctors are quite conservative towards stage IV cancer)
Now the onco announced there are no more new drugs in public hospital that could treat my mum, and they don't think Folfiri is doing the right job, so they suggested my mum to take a 3-month chemo break even though her CEA kept raising.

We are now trying to figure out other options. New drugs from private onco are expensive and this has been regarded as the last resort of ours. We are now waiting for chances to get mum into some drug trials. Also, onco told us there are oral drugs (not xelox) for patients like her, but the effectiveness of the drug is questionable that 95% of patient is not responding well to the oral meds.

At the same time, I received some information that high dose of vitamin C could possibly improve the situation of stage IV patients? I am not sure about the effects but I guess having some supplement right now would not be that bad?

Any opinions and experiences could be shared? Thanks so much!
My Mum (age 56), NRAS-mutate Q61R
2017-05: Surgery with stoma. T4N1M0. Stage3C. Xeloda Only. Increasing CEA. CT: Multiple lung nodules. Stage4.
2017-09: 85% FOLFOX + Avastin, stable CT
2018-03 to 05: Folfox Allergy, Folfiri (with Avastin since Oct)
2019: CEA:178, started Irinotecan+Zaltrip+TS-1, 25 times radio with xeloda
2020: CEA: 217.3, pending treatment


WISH ALL MIGHTY GOD HEALS MUM WITH HIS MIRACLE

boxhill
Posts: 607
Joined: Fri Apr 06, 2018 11:40 am

Re: Stage IV patient with increasing CEA: wait-and-see?

Postby boxhill » Wed May 08, 2019 5:21 pm

Is she a candidate for immunotherapy?
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
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 lymph nodes 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
5/19 MRI stable/NED
Stop Key
8/20 MRI NED

Mercy110
Posts: 114
Joined: Wed Aug 16, 2017 12:13 am

Re: Stage IV patient with increasing CEA: wait-and-see?

Postby Mercy110 » Wed May 08, 2019 9:50 pm

Thanks for asking. I guess the drug trials may involve immunotherapy coz the Onco told us it is related to PD-1. As for Keytruda, it is a drug that could only be founded in private oncology clinics so that would be one of our last resorts.
My Mum (age 56), NRAS-mutate Q61R
2017-05: Surgery with stoma. T4N1M0. Stage3C. Xeloda Only. Increasing CEA. CT: Multiple lung nodules. Stage4.
2017-09: 85% FOLFOX + Avastin, stable CT
2018-03 to 05: Folfox Allergy, Folfiri (with Avastin since Oct)
2019: CEA:178, started Irinotecan+Zaltrip+TS-1, 25 times radio with xeloda
2020: CEA: 217.3, pending treatment


WISH ALL MIGHTY GOD HEALS MUM WITH HIS MIRACLE

User avatar
GrouseMan
Posts: 837
Joined: Mon Aug 12, 2013 12:30 pm
Location: SE Michigan USA

Re: Stage IV patient with increasing CEA: wait-and-see?

Postby GrouseMan » Wed May 08, 2019 10:46 pm

Your mom might respond to a MEK inhibitor such as CI-1040, AZD6244 or Binimetinib as the NRAS mutation is more commonly found in Melanoma patients, and MEK inhibitors have found some success in those.

See: https://www.mycancergenome.org/content/ ... r/nras/77/

and: https://ckb.jax.org/geneVariant/show?geneVariantId=3220

Good Luck

GrouseMan
DW 53 dx Jun 2013
CT mets Liver Spleen lung. IVb CEA~110
Jul 2013 Sig Resct
8/13 FolFox,Avastin 12Tx mild sfx, Ongoing 5-FU Avastin every 3 wks.
CEA: good marker
7/7/14 CT Can't see the spleen Mets.
8/16/15 CEA Up, CT new abdominal mets. Iri, 5-FU, Avastin every 2 wks.
1/16 Iri, Erbitux and likely Avastin (Trial) CEA going >.
1/17 CEA up again dropped from Trial, Mets growth 4-6 mm in abdomen
5/2/17 Failed second trial, Hospitalized 15 days 5/11. Home Hospice 5/26, at peace 6/4/2017


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