Options when folfiri +irinotecan , Erbitux no longer work for stage 4 with carcinomatosis ?

[Delmundoc]

Hi,
My husband was diagnosed with colon cancer stage 3 December 2011, finished 6 cycles of Folfox and Avastin. Recurred May 2014 with carcinomatosis. Placed on Folfiri and irinotecan
Every 2 weeks. NED until January 2019 carcinomatosis with ascites, given Erbitux 8 cycles but developed more ascites. We were told he doesn’t qualify for any trials because of the ascites and if he needs TPN ( which he might need). Please help, our daughter is getting married August 10 of this year. He just wants to walk her to the altar.
What other options do we have that you know?
Thank you so much
Connie

[Pyro70]

Sounds like chemo has actually worked quite well for him, sorry it’s become resistant. You may want to try a third line therapy like regorafenib. It may buy some time if he can handle it.

I’m not sure, but there may also soon be a new agent available for third line (see Asco 2019 abstract below).

ROCKET: A randomized, multicenter phase 2 study of RRx-001 + irinotecan coloreversus regorafenib in 3rd/4th line ctal cancer.
https://meetinglibrary.asco.org/record/171796/abstract

[Pyro70]

I married my wife last month in a simple wedding at home with a friend officiating (you can become an officiant within 5 minutes online). We planned it 2 days in advance because frankly with my health we can’t plan a big event in the future. In hindsight we both really enjoyed a wedding that was just about us and our family with none of the typical drama/stress of a big wedding. If I were your daughter I would consider having 2 ceremonies and plan something for the next week or so. Just a thought...

[Delmundoc]

Hi Pyro 70,
Thank you for your response. Congratulations on your wedding! I will talk to my daughter and see if we can do two weddings as you’d suggested. I will also try to contact the author of the study and see if he can get their experimental drug. Where did you get the HIPEC procedure? Do you think my husband will qualify for this?
Thanks so much.

[Pyro70]

Hi Pyro 70,
Thank you for your response. Congratulations on your wedding! I will talk to my daughter and see if we can do two weddings as you’d suggested. I will also try to contact the author of the study and see if he can get their experimental drug. Where did you get the HIPEC procedure? Do you think my husband will qualify for this?
Thanks so much.

I had the HIPEC at St John Providence in Grosse Point, MI. I don’t know much about your husband’s case, so you’d really need to ask your oncologist, but based on what you’ve said I don’t think a HIPEC/CRS makes any sense. Although some surgeons take on more difficult cases, typically the surgery is limited to patients with good performance status prior to surgery, disease limited to the peritoneum/abdominal cavity that can be removed completely during surgery, and favorable histology. Barring those conditions systemic chemo is a better option than CRS/HIPEC.