Folfiri Sessions

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Sonofafighter
Posts: 16
Joined: Sun Nov 17, 2019 1:19 am

Folfiri Sessions

Postby Sonofafighter » Sun Aug 15, 2021 5:16 am

How many sessions of Folfiri are recommended in a go ? Dad has had 14 so far, with Avastin, and the most current CT shows 2 nodules in the lungs stable from the prior CT (which showed considerable decrease in them).

All the literature i can find recommends 12 at most.

He is asymptomatic, no sign of cancer other than the lung nodules and other than fatigue and tummy trouble following CHEMO, he seems to be doing alright. The doctor wants to continue the same protocol, and i cant find much online about such extended use.

worriedson714
Posts: 37
Joined: Mon May 03, 2021 4:27 pm
Facebook Username: jasonbeck

Re: Folfiri Sessions

Postby worriedson714 » Sun Aug 15, 2021 12:59 pm

Hello sorry your dad is going threw this but I am glad he seems to be handling it well . My dad also just started folfiri and his oncologist says we will go for as long as it works . But I think alot of factors go into how much chemo has your dad had surgery ? Is surgery a option for him at all ? I assume he is stage 4 ? I don't know of any one size fits all for chemo seems to kind of depend on the patient from my experience with my dad .
My Dad was DX - 3/19 stage 3 rectal cancer
Folfox - 6/ 2019 threw 10/2019
Rad - 4/ 2019 threw 5/2019
12/ 19 - Abdominal Perineal Resection - Cancer left and permanent colostomy
watching and waiting
9/21- Surgery to remove prostate and bladder- Permanent Urostomy still cancer left
Watching and waiting
5/28/21 - Positive Biopsy Mostly necrotic tumor
6/14/21 - Sepsis with obstructive uropathy needed nephrostomy tube
7/19/21 Kidney infection
7/28/21-Started folfiri
8/3/21 - Blood Clots in lungs and leg

Nor Cal
Posts: 36
Joined: Sun Dec 06, 2020 8:18 pm

Re: Folfiri Sessions

Postby Nor Cal » Sun Aug 15, 2021 2:01 pm

My oncologist says FOLFIRI and avastin for as long as it works.
Dx June 2020, stage IV, w liver mets in both lobes. M, age 50. Right-sided colon tumor. BRAF mutation. CEA 120
July 2020 - September 2021 20 cycles chemo (FOLFOXIRI x9, FOLFIRI x9, 5-FU x2) + Avastin
December 2020 - February 2021 Radioembolization, Chemoembolization x2

catstaff
Posts: 138
Joined: Wed Mar 03, 2021 11:37 am

Re: Folfiri Sessions

Postby catstaff » Sun Aug 15, 2021 8:08 pm

Often they will do breaks after every 12 cycles or so, depending on how things are going.

Going with DH for #10 tomorrow. Confirmed partial response, we'll see how far we can drive it down. But the onc has mentioned the possibility of breaks.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

Sonofafighter
Posts: 16
Joined: Sun Nov 17, 2019 1:19 am

Re: Folfiri Sessions

Postby Sonofafighter » Mon Aug 16, 2021 1:43 am

Thank you all for your replies. After my post (from the centre) I got some details from the nurse.

The doctor was not available yesterday because of another emergency, hopefully talk to him next time.

He had 12 cycles of 5FU + Leukovorin + Irin + Avastin. Given his CT after 6 cycles showed major partial response (more than 40% reduction), and after 12 was stable (2mm reduction in significant nodules), he is now on 5 FU + L + Avastin. They dont give Iri more than 12 cycles in 1 go due to risk of side effects I am told.

Has anyone been on this regimen for maintenance ? Can't seem to find much medical papers on this.

Sonofafighter
Posts: 16
Joined: Sun Nov 17, 2019 1:19 am

Re: Folfiri Sessions

Postby Sonofafighter » Mon Aug 16, 2021 1:49 am

worriedson714 wrote:Hello sorry your dad is going threw this but I am glad he seems to be handling it well . My dad also just started folfiri and his oncologist says we will go for as long as it works . But I think alot of factors go into how much chemo has your dad had surgery ? Is surgery a option for him at all ? I assume he is stage 4 ? I don't know of any one size fits all for chemo seems to kind of depend on the patient from my experience with my dad .


Hello, I hope your dad handles his treatments well - Its so difficult watching parents in their older age when they should be enjoying their retirements.

Yes, he was DX Stage 3, and had a temp ileostomy and reversal between 2019 and 2020. Prior to that was Chemo + Rad for 5 weeks.

The Lung nodules showed up midway through his post surgical chemo. Our guess is that he had a torrid time with XELOX and was forced to take a 2.5 month break during which their were hospital admissions for Toxicity and surgery to remove skin that was a result of a nasty cellulitis infection. This was the weakest he had been during his initial battle. During that time, the nodules probably settled ?

zephyr
Posts: 323
Joined: Thu Aug 18, 2016 7:31 am

Re: Folfiri Sessions

Postby zephyr » Tue Aug 17, 2021 5:37 pm

I hesitate to post this because I am so not an expert or anything close so please understand that this is based solely on my own experience. I think the bigger question might be whether after 4-6 months, the nodules are metabolically active. Maybe the next step would be to do a PET scan to make that determination. That said, if the nodules are too small, a PET won't give you the kind of information you need. Again, I'm speaking only from my own experience ... but it might be a question worth asking.
Nov-2009 Early stage CRC found during routine colonoscopy
2010, 2011, 2014 F/U colonoscopies, all clear
Jun-2016 CRC during followup colonoscopy, surgery, Stage 4, KRAS, MSS, inoperable lung mets
Aug-2016-May-2018 Folfox, 5FU & Avastin, 5FU, Folfiri & Cyramza
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Dec-2020 Progression, considering all options
Mar-2021 Forfiri/Avastin

catstaff
Posts: 138
Joined: Wed Mar 03, 2021 11:37 am

Re: Folfiri Sessions

Postby catstaff » Wed Aug 18, 2021 7:50 am

DH's CEA is still dropping, but slowly now, and his side effects are manageable still, so looks like his oncologist has scheduled him for at least 14 cycles of folriri+bev. Of course he can always cancel later. CT in four weeks so we'll see what the onc decides after that. But it suggests that going a few cycles beyond 12 is reasonably common as long as side effects aren't bad.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-


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