The oncologist offered either opdivo, keytruda, or opdivo+yervoy and after a difficult decision and concern about added toxicity of the latter, keytruda was settled on. About 7 infusions were given and recently CT scan results showed progression, some nodules are growing or some new one or two have formed near the pelvic region, while some other masses have stayed stable for about a year. I have asked the oncologist and await a reply about:
1. how to be sure it's not a pseudo progression
2. whether it could be worth trying, and possible to try, opdivo+yervoy since it works thru a different pathway and may be more aggressive.
3. is CAR-T therapy a viable option worth trying for colorectal cancer patients
4. what chemo options would be on the table and would be best given that folfox was given for 6 months after initial CRC diagnosis and surgery. (seemed to work for a while with CEA dropping down to 1.x but after about a year was ticking upwards again), leading to a 2nd abdominal mass forming and a 2nd surgery.
Could those of you with experience, personal or otherwise, be so kind as to provide input on those questions as well as some guidance on what may be best to do next? The oncologist appointment is in 4 days.
age 71, female
originally diagnosed with CRC at age 66.
total colectomy and large mass removed from abdominal region/colon area
6 months folfox
2nd surgery about a year ago to remove new mass in abdominal region
subsequent scan showed metastasis to pelvic region (nodules)
immunotherapy was recommended, keytruda chosen
7 keytruda infusions given (3 weeks apart)
CT scan returned showing some new growth and some stabilization
Cancer is so relentless.
Thank you in advance.