can you stay in oxaliplatin ?

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Delmundoc
Posts: 7
Joined: Tue Oct 09, 2012 5:34 pm

can you stay in oxaliplatin ?

Postby Delmundoc » Mon Sep 16, 2019 8:07 pm

Hi,
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
Connie

WarriorSpouse
Posts: 215
Joined: Tue Aug 16, 2016 9:02 pm

Re: can you stay in oxaliplatin ?

Postby WarriorSpouse » Mon Sep 16, 2019 10:23 pm

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!
WS
D/H 47 years old, 10/2014, Stage IV M/CRC, nodes 12/15, para-aortic, 5 cm sigmoid resection, positive Virchow. KRAS mut, MSS, Highly Differentiated, Lynch Neg, 5FU/LV and Avastin 1 YR (Oxi for 5 months), Zeloda/Bev since 01/2016. 02/2019 recurrence para-nodes, back to 5FU/LV Oxy/Bev. It is working again. "...Perseverance is not a long race; it is many short races one after the other."-Walter Elliot

NHMike
Posts: 2402
Joined: Fri Jul 21, 2017 3:43 am

Re: can you stay in oxaliplatin ?

Postby NHMike » Tue Sep 17, 2019 8:15 am

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.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
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2/19: Clean CT

Pyro70
Posts: 156
Joined: Mon Jan 21, 2019 4:25 pm

Re: can you stay in oxaliplatin ?

Postby Pyro70 » Tue Sep 17, 2019 1:06 pm

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.
Dx Jan 2017 stage IVB w/ PC age 35
FOLFOX
SEP 17 HIPEC 1, anastamosis leak
XELODA
MAR 18 HIPEC 2
JUN 18, ileo reversal and 2nd anastamosis leak

debsta
Posts: 9
Joined: Sat Mar 30, 2019 11:00 am
Location: Boston MA

Re: can you stay in oxaliplatin ?

Postby debsta » Tue Sep 17, 2019 1:44 pm

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!
Caregiver of DH age 68 at DX w/Stage IVb rectal adenocarcinoma - mets in liver and both lungs
MSS MMRp Kras/Braf/Ras all wild-type TMB 3.04 poorly differentiated CEA 14.7
2/2019 Clinical Trial at Dana Farber - mFolfox6, Avastin, Nivolumab
9/13/2019 CEA 1.0 67% reduction by Recist dropped Oxaliplatin due to neuropathy


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