myrta wrote:I am not a doctor, but I have heard that chemo is effective against quickly dividing cells, not against dormant or quiescent cells....what if quiescent colon cancer stem cells are left?
Myrta, chemo is to some extent effective against the more slowly dividing dormant/quiescent cells. It's important to remember that even within that category, some cells are more dormant (or more actively dividing) than others.
This article might help explain the multi-activity level of various types of cells:http://www3.interscience.wiley.com/jour ... 1&SRETRY=0
jdepp wrote:I know a lot of us are on adjuvant chemo. I'm curious about your regimens & how you came to choose them, especially if they involve biologicals where long-term PFS and OS data is obviously not yet available.
Actually, none of my adjuvant (post-surgery) chemos have involved biologics. My oncologists are holding them in reserve, bigger guns to save in case I present active tumors again. The last biologic I had was part of my neo-adjuvant (pre-surgery) chemo, FOLFOX+Avastin, my very first chemo regimen. The last adjuvant chemo, the one I just ended, was plain-vanilla 5FU+Leucovorin. The adjuvant chemos in between were all some variation (in succeedingly lowered doses) of Folfiri. Dr. Personality prefers Folfiri, which is why after surgery I was switched to that regimen (I'd also reached max tolerated dose or MTD of oxaliplatin after 16 cycles.)
My onc seemed perfectly willing to consider switching my biological from Erbitux to Avastin. Erbitux attacks the EGFR pathway and Avastin goes after the VEGF, and switching would give my cancer a new look. We decided against doing that, however, mainly because it seemed like I was still responding to Erbitux before surgery. Sir Onc wants to maximize the benefit from that regimen & I guess I do, too (though on some level it feels, ahem, like a rash decision).
Well, 'rash' decision or not
it's usually considered a good plan by my oncologists (both of them) to get all of the mileage out of a given drug that I can tolerate. So, for instance, since I tolerated folfiri really well for a looong time, I got it for 13 months (26 systemic treatments) before the liver resection, and then 3 months (6 systemic treatments) after the liver resection. And then Dr. P optimistically tried it after my surgery last April, and after one month (only two systemic treatments), my local onc removed the irinotecan and took me down to 5FU+Leucovorin for the balance of treamtnets (5 more months, 10 more treatments.) Dr. P agreed; I've finally developed immunohistamine sensitivity to irinotecan, so that's now off the table for me.