Hey Alex, great that you heard back from MSK! Indeed under the circumstances I think these results are both good and probably largely unsurprising.
When I got my opinion from them they were also very hesitant to say any on the HAI pump without seeing me in person, and also assessing my response to 4 cycles of FOLFOX. My doc here also wouldn’t talk about much else until I’d done 4 x FOLFOX. It seems FOLFOX is pretty standard first line in both the US and Australia, whereas FOLFIRI is more common in Europe.
I guess then the only things I’d say would be:
1. It makes sense to me to not see MSK right now, given they’d just tell him to go do FOLFOX and come back in 8 weeks for scans. However I agree with other views that you would want to get the MSK appointment booked beforehand, as you wouldn’t won’t to be off treatment too long for travel, scans, waiting for appts, etc.
2. I guess it’s just worth being aware that this is changing his treatment plan in order to get a consult with MSK. I don’t see any huge downside with this - FOLFOX is on average at least as effective as FOLFIRI, and given he hasn’t progressed on FOLFIRI there shouldn’t be anything preventing him going back to it if he maxes out on FOLFOX. My question would be the Vectibix - would this continue? FOLFOX/FOLFIRI + an EGFR inhibitor is basically gold-standard first line for a RAS-wild patient and he seems to have done well on it so far. I guess this is something your onc in Denmark would have an opinion on.
Best wishes again!
Rob