Large CEA flare on Folfiri?

[Bpaint]

My husband had his third round of Folfiri + Avastin today, and his CEA has more than doubled since he started. It is now 145, from 60. He had a CEA surge when he started Folfox and when he did Vectibix, but not this high. His oncologist has always told us that he doesn't worry too much about CEA increases unless the number doubles, so this one has me worried. Could it still be part of the initial CEA flare from starting a new treatment?

[claudine]

Hi Bpaint,
My husband's CEA went down consistently when he was on Folfiri/Avastin treatment; I cannot answer your question, but I hope the next reading shows a drop - when will that be?

[Bpaint]

He'll get scanned again on March 4, so we'll see what's happening then.

[claudine]

I hope it's good results. I found an article (Strimpakos et al. 2010) that says:

Seventy-eight of 670 (11.6%) patients demonstrated the CEA flare phenomenon. The median baseline CEA value in the flare group was 74 μg/l (range 5–31 480 μg/l) and the median peak CEA value was 115 μg/l, reached in 21 days (range 4–61 days). The median duration of CEA flare (from date of baseline CEA to date of first CEA level below the baseline) was 49 days (range 16–117 days).

So flares can be quite long, and reach high values!

[Bpaint]

Thank you! That is helpful!

My husband's oncologist has always said that his cancer makes a lot of CEA, and his CEA fluctuations have been dramatic.

[stu]

My mum hardly makes any but always doubled on Chemo ,
Scans were always significant shrinkage .
I hope it’s a good scan .
Stu

[Bpaint]

Friday’s scan showed that all of the lung nodules and lymph node spots were were either stable or shrinking, and his CEA has started to drop back down too—it’s 95 now. We are feeling relieved.

[Gravelyguy]

That is great news!

Dave

[Rikimaroo]

NOICE!!

[Bpaint]

Thanks all! We are glad he can stay on Folfiri for awhile—he’s been tolerating it well (better than Folfox) and his oncologist wants him to be on it for at least 4 months so that he can switch back to Vectibix. His oncologist has had success in keeping tumors stable by switching between Vectibix and folfiri with a few patients that have multiple inoperable tumors, with at least a couple who have been doing this for more than 5 years. But for it to work, the patient has to be off Vectibix for at least 4 months, and preferably 6.