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; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 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; complete met. response, TRG 3
07/19 - ULAR (robot), temp ileo, 1/27 LN+
08/19 - Missed liver spot
08/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 2
10/19 - Planned liver resection #2 & ileo reversal