Beginning Radiation/Immunotherapy Combination For Lung Mets

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utahgal7
Posts: 63
Joined: Fri Sep 11, 2020 12:04 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby utahgal7 » Wed Nov 17, 2021 11:53 am

prayingforccr:

I was just thinking about you the other day. I had not seen any recent posts from you and I was worried. Sorry to hear about the lung nodules, but it sounds like you have got a good plan of attack in place. I am really sad that the Joe Tippens protocol was ineffective for you. Unfortunately, I have not read about a single rectal cancer patient that has benefited from it.

I do hope you can get back to hiking Camelback Mountain. I didn't know you lived in Phoenix.

Again, I am really sorry to hear about this news. You have been through a lot. You've got this! I will pray and light a candle for you.


Sending you hugs!

Paige
02/20 Rectal Cancer dx - 3 cm mass; located 9 cm from AV
03/20 CEA 2.7; 0.9; 1.4; 0.9; 0.9; 1.2; 1.0
04/20 ST Radiation; 04/20 LAR surgery w/ileostomy
04/20 ypT3N1bM0; MSS; moderately differentiated adenocarcinoma
05/20 CAPEOX
08/20 Ileostomy reversal
09/20 CT scan; suspicious areas in liver; 10/20 MRI liver; dx hemangioma
12/20 CT scan; lung nodules (watch and wait); 03/21 CT scan; stable lung nodules (2)
07/21 & 10/21 CT scan; stable lung nodules

utahgal7
Posts: 63
Joined: Fri Sep 11, 2020 12:04 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby utahgal7 » Wed Nov 17, 2021 12:27 pm

prayingforccr:

One more thing that I forgot to ask....Sorry if this seems like a stupid question...Would FOLFIRI not help shrink the lung nodules? Also, I thought only patients with MSI-H were eligible for Opdivo? I could not find info in your signature about microsatellite status.
02/20 Rectal Cancer dx - 3 cm mass; located 9 cm from AV
03/20 CEA 2.7; 0.9; 1.4; 0.9; 0.9; 1.2; 1.0
04/20 ST Radiation; 04/20 LAR surgery w/ileostomy
04/20 ypT3N1bM0; MSS; moderately differentiated adenocarcinoma
05/20 CAPEOX
08/20 Ileostomy reversal
09/20 CT scan; suspicious areas in liver; 10/20 MRI liver; dx hemangioma
12/20 CT scan; lung nodules (watch and wait); 03/21 CT scan; stable lung nodules (2)
07/21 & 10/21 CT scan; stable lung nodules

roadrunner
Posts: 179
Joined: Sun Jan 12, 2020 8:46 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby roadrunner » Wed Nov 17, 2021 1:15 pm

Paige makes a good point. FOLFIRI has good control numbers too. I think it’s expected to stop progression of pulmonary metastases for 9-12 months. And I know there’s at least one member who cleared multiple nodules with FOLFIRI. Also, 5-FU based chemo did well with your primary, so perhaps it has a better chance of working here? Wouldn’t it potentially be better to take that step first?
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

prayingforccr
Posts: 174
Joined: Sun Jun 28, 2020 4:44 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Wed Nov 17, 2021 4:56 pm

roadrunner wrote:Paige makes a good point. FOLFIRI has good control numbers too. I think it’s expected to stop progression of pulmonary metastases for 9-12 months. And I know there’s at least one member who cleared multiple nodules with FOLFIRI. Also, 5-FU based chemo did well with your primary, so perhaps it has a better chance of working here? Wouldn’t it potentially be better to take that step first?


Why not save that for last?

Also, I would prefer death to chemo until death.

I’ve thought long and hard about this.

No interest in 1970s chemo.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

MadMed
Posts: 54
Joined: Sun May 02, 2021 5:52 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby MadMed » Wed Nov 17, 2021 6:30 pm

prayingforccr wrote:
MadMed wrote:Thank you, i will have to make the surgery decision in a few weeks. Good to know that you got great results locally. I can't imagine going through surgery and then having to deal with chemo post surgery for a recurrence!

As you said, mop up and move on. Sounds like a great plan!


I did a clinical trial at mskcc which involved chemo radiation concurrent with a trial drug (m3814), then 6 cycles of FOLFOX.

It was a brutal year.

Hoping the best for you, MadMed.



Thank you, i'm rooting for a successful treatment for you. It will help everyone to see you better and see a new avenue for treatment.
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
Break before surgery scheduled 1/27/22

Bpaint
Posts: 26
Joined: Sun Oct 11, 2020 8:54 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby Bpaint » Tue Nov 30, 2021 12:45 pm

I'm hoping for the best for you, prayingforccr!

I'm curious, do you know what they will be radiating? Are they going to target only some of the lung spots, or all of them?
My husband (age 41 at dx):
8/20 CRC Stage 4. Mets to lungs, liver, distant lymph nodes (25+)
MSS, KRAS wild
CEA 713 at dx
Folfox (12 rounds)
CEA 113
Liver, colon and lymph node resection 4/21
New lung mets, Vectibix monotherapy started 6/21

prayingforccr
Posts: 174
Joined: Sun Jun 28, 2020 4:44 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Tue Nov 30, 2021 6:58 pm

Bpaint wrote:I'm hoping for the best for you, prayingforccr!

I'm curious, do you know what they will be radiating? Are they going to target only some of the lung spots, or all of them?


I’m going to weill/cornell monday for ir biopsy of 1cm nodule in peri hepatic space.

If that is a met, that is what Dr Formenti will radiate, while another Dr at nyu/langone will administer the immunotherapy.

If it isn’t a met, I’m not sure how she will want to proceed because the two largest are still sub centimeter.

I’m desperate to get to remission, somehow/some way.

In my latest bloodwork, my cea jumped to 3.4 from 2.1 :( , but ca19-9 collapsed from 61 to 19 :D

So, I have no idea what to expect.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

Bpaint
Posts: 26
Joined: Sun Oct 11, 2020 8:54 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby Bpaint » Tue Nov 30, 2021 8:28 pm

Got it. I read the article you linked and a bit more about radiation plus immunotherapy. It’s interesting and I really hope it works for you. I’m going to raise it with my husband’s oncologist at the next visit. I know he is running some clinical trials with opdivo and yervoy for MSS patients, but I don’t think he is also using radiation with them.
My husband (age 41 at dx):
8/20 CRC Stage 4. Mets to lungs, liver, distant lymph nodes (25+)
MSS, KRAS wild
CEA 713 at dx
Folfox (12 rounds)
CEA 113
Liver, colon and lymph node resection 4/21
New lung mets, Vectibix monotherapy started 6/21

prayingforccr
Posts: 174
Joined: Sun Jun 28, 2020 4:44 pm

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Tue Nov 30, 2021 8:54 pm

Bpaint wrote:Got it. I read the article you linked and a bit more about radiation plus immunotherapy. It’s interesting and I really hope it works for you. I’m going to raise it with my husband’s oncologist at the next visit. I know he is running some clinical trials with opdivo and yervoy for MSS patients, but I don’t think he is also using radiation with them.


That is the reason I am cautiously optimistic about it.

That, and the two Doctors helping me.

Dr Formenti is a pioneer/practitioner of the abscopal effect for many years.

I do believe it’s going to work.

Will continue to update.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan


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