Partial intestinal obstruction and increasing ascites

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Delmundoc
Posts: 4
Joined: Tue Oct 09, 2012 5:34 pm

Partial intestinal obstruction and increasing ascites

Postby Delmundoc » Thu May 16, 2019 10:17 am

Hello all,
My husband was admitted last night at City of Hope for partial intestinal obstruction with increasing ascites. this is his 2nd recurrence after failing folfiri and irenotican. He’s been on erbitux and irenotican since February. looks like he’s not responding to this regimen. What else do you think he can use? Anybody with similar history?
Thank you so much.
Connie

Rock_Robster
Posts: 204
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Partial intestinal obstruction and increasing ascites

Postby Rock_Robster » Thu May 16, 2019 6:46 pm

Hi Connie, sorry it may be a silly question but has he been exposed to oxaliplatin (eg via FOLFOX) before? This is a common first-line, along with FOLFIRI. Depending on some other factors an anti-VEGF drug such as Avastin (bevacizumab) may also often be considered.

Given he has been on Erbitux I presume he doesn’t have a RAS mutation... do you happen to know his MSS status and/or tumour mutation burden (TMB)? This would be important for potential immunotherapy routes (eg Keytruda/Opdivo).

The folk at CoH should be all over this stuff though anyway. Best wishes to you both.

Rob
Male 37; Melbourne, Australia.
10/2018 Dx 3.5 cm RC adenocarcinoma, 12cm from AV
Mod diff (G2), EMVI+, LVI+, PNI-
3 local LN; 4 liver mets, resectable
pT3pN1apM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation w Xeloda; complete metabolic response (TRG 3)
07/19 - ULAR (robotic), temp ileo, 1/27 LN
08/19 - Missed a liver spot; to resect with reversal after adjuvant chemo
08/19 - FOLFOXIRI x 4


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