Beginning Radiation/Immunotherapy Combination For Lung Mets

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

Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Mon Nov 15, 2021 7:19 pm

I will be receiving radiation and immunotherapy at weill/cornell under the care of Dr Silvia Formenti.

I have at least 18 sub centimeter lung nodules which are metastasis from a resolved rectal primary.

Dr Formenti is a pioneer/proponent of the abscopal effect which holds that by treating a tumor in one part of the body, the immune system is then inspired to go after cancer throughout the body, even in untreated areas.

I believe the immunotherapy will be a combination of opdivo and yervoy, though I am at the moment uncertain.

Treatment will last 10 weeks in new york

I believe this is my only, best chance at remission, and am so grateful for the treatment.

I will update if the thread generates interest.
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

catstaff
Posts: 177
Joined: Wed Mar 03, 2021 11:37 am

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby catstaff » Mon Nov 15, 2021 8:03 pm

Good luck, keep us informed.
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-

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

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Mon Nov 15, 2021 8:28 pm

catstaff wrote:Good luck, keep us informed.


Thank you, catstaff.

I really think this can work.
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

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

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby roadrunner » Mon Nov 15, 2021 9:00 pm

Good luck, indeed! I hope you have success with this approach.
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 » Mon Nov 15, 2021 9:15 pm

roadrunner wrote:Good luck, indeed! I hope you have success with this approach.


Thank you, rr.

I have a surgeon ready going forward who has agreed to ablation should any be needed.

I’ll update this thread as I go through this.

I have no idea what to expect.

This is a little info on the abscopal effect: https://www.cancer.gov/news-events/canc ... unotherapy
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

Sunnycd
Posts: 69
Joined: Fri Feb 26, 2021 10:36 am

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby Sunnycd » Mon Nov 15, 2021 11:12 pm

Good luck, and hopefully you will find a few fun things to do in NY. Broadway shows are back and I think it is much easier to get tix too. Keep us posted. We are all rooting for you!
DX Feb. ‘21 CC IIB @ 51
Jan. ‘21 ER surgery, temp. colostomy
Sigmoid, adernocarcinoma
T4aN0MX, G2
0/24 lymph nodes
LVI: indefinite
PNI: not identified
Margins: clear
March ‘21 started 4 rounds of CAPOX
06/17/21 last day of CAPOX
06/25/21 CT scan clear
CEA: @ dx 4, post surgery 1.9, post chemo: 2.9; 09/21: 1.5
07/14/21 colostomy reversal
09/24/21 CT clear
10/12/21 colonoscopy; 1 polyp
MSS, RAS/RAF wild, PIK3CA mutant

Rock_Robster
Posts: 608
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby Rock_Robster » Mon Nov 15, 2021 11:30 pm

Good luck, and great to hear. Is this as part of a trial, or off-label for the I/O drugs?
39M Australia
2018 Dx RC, 12cm high
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a Stage IVa. MSS NRAS G13R
CEA: Nov-18= 14; then 2.0 - 3.1. Nov-21: 5.4
11/18 FOLFOX x6
3/19 Liver resection
5/19 25x pelvic radiation
07/19 ULAR w ileo, 1/27 LN+
08/19 Liver spot
08/19 FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19 Liver resection
02/20 Ileo reversed
03/20 NED (since Dec-19)
11/21 New liver lesion (celiac node?), 4 v. small (<2mm) indeterminate lung things

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

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby MadMed » Tue Nov 16, 2021 8:29 am

prayingforccr wrote:
I will update if the thread generates interest.


great to hear from you prayingforccr, Good luck, i really hope this works. I’m curious, the primary is completely gone and you never had surgery ? That means you don’t have to deal with post surgical complications right ?
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

Claudine
Posts: 569
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby Claudine » Tue Nov 16, 2021 9:31 am

That is fantastic news :D :D :D
Kudos for being so proactive and finding someone ready to go after the multiple mets. I’ll be looking for updates as the treatment progresses, hoping for a complete cure for you!
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 81.1, low 3.2, now 66.1
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 09/17/2021: stable

boxhill
Posts: 756
Joined: Fri Apr 06, 2018 11:40 am

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby boxhill » Tue Nov 16, 2021 1:54 pm

This is fascinating. I hope this approach works for you. (And others. I had vaguely heard of efforts to sensitize non-MSI tumors to immunotherapy using radiation.)

Please, do, keep us informed. Keeping all appendages crossed for you!
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
6/20 Stop Key
All MRIs NED

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

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Tue Nov 16, 2021 6:01 pm

Claudine wrote:That is fantastic news :D :D :D
Kudos for being so proactive and finding someone ready to go after the multiple mets. I’ll be looking for updates as the treatment progresses, hoping for a complete cure for you!


Thank you, Claudine!

Thank you for your optimism/encouragement throughout all this.
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

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

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Tue Nov 16, 2021 6:03 pm

boxhill wrote:This is fascinating. I hope this approach works for you. (And others. I had vaguely heard of efforts to sensitize non-MSI tumors to immunotherapy using radiation.)

Please, do, keep us informed. Keeping all appendages crossed for you!


I really think this will work, boxhill.

It is my only, best shot.
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

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

Re: Beginning Radiation/Immunotherapy Combination For Lung Mets

Postby prayingforccr » Tue Nov 16, 2021 10:04 pm

MadMed wrote:
prayingforccr wrote:
I will update if the thread generates interest.


great to hear from you prayingforccr, Good luck, i really hope this works. I’m curious, the primary is completely gone and you never had surgery ? That means you don’t have to deal with post surgical complications right ?


The primary, as far as we can know, is dead/resolved.

I never had surgery, as I would never agree to a procedure that would leave me with a colostomy.

My ass is still plenty messed up, but I deal with it and think I know how to ameliorate the problem.

Let’s mop up the rest of the cancer with this treatment and get back to the top of Camelback Mountain this year.
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 9:47 am

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!
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

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 11:26 am

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.
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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