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can you stay in oxaliplatin ?

Posted: Mon Sep 16, 2019 8:07 pm
by Delmundoc
My husband had his second recurrence of colon cancer with carcinomatosis January 2019. He was placed on Erbutux and after 2 cycles developed massive ascites. He was re challenged on folfox and avastin. He responded and Ascites resolved. He had 8 cycles of this regimen and his oncologist discontinued the oxaliplatin . Will monitor if ascites recurs, will reintroduce oxaliplatin.
Does this sound right?
Thanks so much

Re: can you stay in oxaliplatin ?

Posted: Mon Sep 16, 2019 10:23 pm
by WarriorSpouse
I am sorry to read what you guys are going through. Many here have used Oxaliplatin on various occasions beyond their initial treatment. I believe the side effects are strong concerning neuropathy with Oxaliplatin, and breaks are part of the normal treatment approach. It is definitely not considered a maintenance drugs like Zeloda and Avastin are used.

Follow the recommendations of your Oncologist and seek a second opinion from your local major cancer center for your next plan of treatment, if needed again.

All the best going forward!

Re: can you stay in oxaliplatin ?

Posted: Tue Sep 17, 2019 8:15 am
by NHMike
I had cuts in Oxaliplatin but did the full eight rounds. I could not see being on it long term - as in years. The platinum stays in your system for a very long time - a study I saw said that the percentage is still high after seven years. And I would think that the amount of platinum in your bloodstream would be cumulative.

Re: can you stay in oxaliplatin ?

Posted: Tue Sep 17, 2019 1:06 pm
by Pyro70
Oxaliplatin causes permanent neuropathy as the cumulative dose increases. Neuropathy usually starts after cycle 8. If he currently has no neuropathy it’s okay to continue, but I would likely stop if neuropathy (that lasts throughout the cycle) shows up. When you stop FOLFOX you can switch to FOLFIRI. Patients typically only do ~12 rounds of FOLFOX (I would stop sooner if there are neuropathy concerns). FOLFIRI doesn’t really cause cumulative issues so you can do it for a long time (basically until it stops working).

Ps I did 11 rounds of Oxi. I had neuropathy in hands and feet. Fortunately it resolved in my hands, but it’s permanent in my feet. It’s annoying in my feet but doesn’t cause issues. I would be pissed if I had neuropathy still in my hands. My oncologist likely should have stopped sooner.

Re: can you stay in oxaliplatin ?

Posted: Tue Sep 17, 2019 1:44 pm
by debsta
My husband did 12 rounds of Folfox with the full dose of Oxaliplatin and then two more rounds of Folfox with a 50% reduction in Oxaliplatin before dropping the Oxaliplatin altogether.

He hated to drop it because he was seeing very good results with his Folfox/Avastin/Nivolumab regime but his neuropathy was increasing at too rapid a rate and his Onc wanted him to quit while the neuropathy was still manageable.

Onc says he can revisit the Oxaliplatin if needed at some point in the future but wants Carl to take at minimum a year break from the Oxaliplatin.

Really hoping the other drugs pick up the slack!