Immunotherapy failed

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Joined: Mon Jul 14, 2014 12:13 am

Immunotherapy failed

Postby FindTheBestHelp » Mon Aug 19, 2019 4:21 pm

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.

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Posts: 209
Joined: Sun Oct 08, 2017 3:25 am

Re: Immunotherapy failed

Postby henry123 » Tue Aug 20, 2019 12:31 am

Since you are msi-h , you are a candidate for immunotherapy. But again it works in a certain percentage of MSI High cases only.
Normally 3 months period is considered to be good time to know if it is pseudoprogression or medicine is not working but it can take up to 6 months for the correct results to show . I would wait for another couple of infuisions before reaching the decision .
What is the deal with other parameters such as biomarkers, CEA levels etc.
What is the opinion of your medical oncologist ?

As far as carT therapy is concerned I don't have much experience or knowledge.
46yo M msi-high Lynch +ve
5/16 lap AR 14/21 L nodes +ve
7/16 Capox 9 cyc
9/16 cea 2
1/17 550
PET CT mets in lung & peri
iri+ avast fail
3/17 10577
4/17 regro fail
5/17 cea 28800
5/17 CT inc in size of mes nodes ,onset of multi nodules in liver
6/17 Opdivo start
7/17 26754
8/17 5623
9/17 497
10/17 52
11/17 12
CT all clear exc a nodule in Lung. liver norm
1/18 3.6
4/18 2
Aspirin start
6/18 1.5 CT clear
12/18 1.1 NED
6/19 .9 CT clear
1/20 NED Opdivo stop

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