Thanks mbpser, I now understand.
My understanding is that when 5-FU monotherapy is used in an adjuvant setting (ie post curative surgery) it is typically for one of a few reasons, including:
- tumours with relatively low risk of recurrence (eg stage II without high-risk features)
- diminished patient performance score (eg elderly, frail or comorbidities)
- Inability to tolerate oxaliplatin (eg allergy, or dose-limiting side effects reached)
There is also some practice to use 5-FU (or Xeloda) as a ‘maintenance’ therapy to either sustain or prevent recurrence, either as a cyclical therapy at full dosage, or at a lower dose continuously (aka metronomic chemo). I don’t think the latter is especially common, esp. outside Europe, and esp. in a metastatic setting (ie stage IV).
There may be other reasons or rationales - others can no doubt add.
Given everything your husband as been through, I presume you’re looking for a ‘lighter’ chemo alternative? (Given it doesn’t seem that he failed either FOLFOX or FOLFIRI).
Male 37 years; Melbourne, Australia
10/2018 Dx: 3.5 cm rectal adenocarcinoma, 10 cm from verge. Well/mod diff (G1-2), T3bN1bM1a.
3 enlarged local lymph nodes and 4 liver lesions.
MSS, MMR-proficient, mutated in NRAS (G13R).
CEA: Oct-18 = 12; Nov-18 = 14, Mar-19 = 2.4
11/18 - 6 cycles neoadjuvant FOLFOX
12/18 - DVT, started clexane
3/19 - Liver resection, R0
4-5/19 - Long-course pelvic chemoradiation (45 Gy w/ Xeloda)
07/19 - Planned restaging scans and ULAR w temp ileo