KRAS Mutant Stage IV colorectal Cancer

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milan2000
Posts: 2
Joined: Sun Aug 07, 2022 1:18 pm

KRAS Mutant Stage IV colorectal Cancer

Postby milan2000 » Sun Aug 07, 2022 2:23 pm

Dear All,

Back on December 31st. My mom was diagnosed with Stage IV colorectal cancer in the UK. After her diagnosis, the doctor said she was not a candidate for surgery since she has 7 Mets in different parts of the liver. So they started her chemotherapy process to try to reduce the tumors to the point where she will be able to have surgery. Her first line of treatment was FOLFOX, she was tolerating the chemo very well until she became fully constipated. The doctors had to operate and they placed a stomach bag. Since this was an indication that the first line of treatment was not working they moved her into FOLFIRI. For this treatment, she had 6 rounds of chemo, with the main side effect being fatigue. Some days she wanted to stay in bed all day. After the sixth round of chemo, she went for her MRI. While we were waiting for her results to come back, this past Sunday she developed pain in her abdomen close to where her uterus is. We brought her to the hospital, and they performed some tests and observed she had an infection. They also observed some progression. This is what the report says

" There has been a significant increase in the necrotic metastatic lesion within the mesentery located between the caecal pole and the distal sigmoid colon and measuring at least 56mm x 51mm" their conclusion was as follows: Significant progression of an intraperitoneal metastatic lesion extending by continuity from the rectum and located mostly between the caecal pole and the distal sigmoid colon. Associated peritoneal inflammatory changes, lymphadenopathy, and diffuse fatty stranding within the mesorectum and mesentery"

Her livers Mets are stable and the lung base is clear.

Even though we still have not had the entire scan results back, the Doctor seems very pessimistic and said it is very common this response due to her KRAS mutation. I was very upset since it seems that they are only following standard procedures and hoping for the best. I don't know what to do. I have set up an appointment with a different oncologist to have a second opinion. I live in the US and it seems the approach is more aggressive here than in the UK. I have read different posts and it seems that the surgical removal of primary cancer is the first approach for most cases here in the US. Should we look into a surgeon that is capable of doing this procedure?

Also, does anyone has experience using a high Dose of Vitamin C? Does help with the side effects? How about the cancer progression?

The last question that I have is, My sibling and I are looking to at AVASTIN for my mom's treatment. It is not covered by the NHS, but we are willing to pay for it. Does anyone have experience with AVASTIN?

Thank you in advance for any information anyone can provide me.

Luna18
Posts: 30
Joined: Mon Aug 01, 2022 12:22 pm
Facebook Username: piglesias

Re: KRAS Mutant Stage IV colorectal Cancer

Postby Luna18 » Mon Aug 08, 2022 12:35 pm

I am sorry for your mom is going through. This is a very tough journey and it is important that your mom and your family keep the hope. My sister was diagnosed with Colon Cancer 5 years ago. She had some recurrences, but her last treatment worked very well. She had FOLFORI+AVASTIN and got complete clinical response after 3 months (6 cycles). She is also taking VITAMIN C. She lives in Spain and the treatment (including AVASTIN) was covered by the SS (public health insurance). Sending you love and positive energy.
Best wishes,
Sister DX July 2017 age 44
T4N2M1 G2/G3
MSS
July 2017- Colostomy and primary tumor resection
Aug 2017 Chemo started - Folfox
Nov 2017- Liver resection, and colostomy reversal
March 2017- Chemo ended
November 2018- Recurrence in liver- Liver resection- No chemo
Aug 2019- Recurrence in liver and lungs
Sep 2019- Chemo started- Folfiri +Avastin
Dec 2019 PET showed no activity- fully response to chemo
March 2020 PET showed no activity
2021 NED
2022 May NED

Nor Cal
Posts: 89
Joined: Sun Dec 06, 2020 8:18 pm

Re: KRAS Mutant Stage IV colorectal Cancer

Postby Nor Cal » Mon Aug 08, 2022 3:22 pm

Thoughts go out for your mom.

I had avastin through about 15 cycles and we've seen great results. What to attribute to the avastin? Who knows? For side effects, I'd have regular nose bleeds but very minor, and three or four superficial blood clots that could have been the avastin or the chemo. We've discontinued it as I have some non-cirrhotic scar tissue in my liver from a remarkably heavy tumor burden that has been treated. Not much help, I know, but the data shows generally positive results on fluororacil based treatments plus avastin.
Dx June 2020, stage IV, w liver mets in both lobes. M, age 50. Right-sided colon tumor. CEA 120.
BRAF+ TMB 5% MSS TDL1-1%
July 2020 - Present: 55 cycles chemo (All the various 5-FU regimens)
December 2020 - February 2021 Y90 Radioembolization, Chemoembolization x2

User avatar
beach sunrise
Posts: 1033
Joined: Thu Mar 05, 2020 7:14 pm

Re: KRAS Mutant Stage IV colorectal Cancer

Postby beach sunrise » Mon Aug 08, 2022 9:07 pm

https://www.lewrockwell.com/2022/08/jos ... treatment/
Latest I have read on IVC. Also, I take high dose melatonin along with other things to combat cancer pathways, tP53 and Kras.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

User avatar
JJH
Posts: 408
Joined: Mon Apr 24, 2017 7:26 am

Re: KRAS Mutant Stage IV colorectal Cancer

Postby JJH » Tue Aug 09, 2022 10:54 am

milan2000 wrote:...
The last question that I have is, My sibling and I are looking to at AVASTIN for my mom's treatment. It is not covered by the NHS, but we are willing to pay for it. Does anyone have experience with AVASTIN?

Thank you in advance for any information anyone can provide me.

I'm sorry to hear about your mom's diagnosis and the situation with NHS's refusal to cover Avastin treatment there in the U.K.

It looks like the NHS is using cost-benefit analysis to try to keep their costs under control:
.
https://www.dailymail.co.uk/health/article-1305582/Avastin-cancer-drug-banned-NHS.html

Nevertheless, in a number of other countries Avastin has been found to be useful in selected Stage IV CRC cases where the main objective was to stabilize or downsize the tumor burden enough so as to allow surgery to take place and provide the patient with additional months of quality living. So, in my opinion it would indeed be worthwhile for your mom to try to find a local oncologist willing to prescribe Avastin outside of the the NHS system of reimbursement.

There is even a remote chance that some of the costs of Avastin treatment might be covered by one of the independent foundations that have been set up to help qualified patients pay for their treatments.

The manufacturer of Avastin has a website that provides information on some of these independent foundations and what their qualifying conditions are. It might be worth your while to go through the various web pages below to see if you can find a foundation that would support needy patients in the U.K.

In the Gastrointestinal Oncology area of the Independent Co-pay Assistance Foundations referral page there are 6 independent foundations listed.  You could check to see if any of them might cover overseas situations like your mom's predicament with NHS's refusal to reimburse Avastin costs. There is even a toll-free telephone number you could call to talk to someone in the Avastin Access Solutions department who knows how these independent foundations operate.

Referrals to Independent Co-pay Assistance Foundations

https://www.genentech-access.com/patient/brands/avastin/how-we-help-you.html

===========

Note: Avastin is approved only when it is used in combination with a fluorouracil-based drug, so the available CRC regimens for Avastin are usually limited to: FOLFOX+Avastin, or FOLFIRI+Avastin, or FOLFOXIRI+Avastin. Avastin cannot be used by itself as a single-agent regimen.

Here are the drugs & drug combinations approved by the FDA for CRC use in the U.S. at this time. In order to determine a patient's eligibility for any of the drugs on the list, the patient's KRAS/NRAS/BRAF mutation status (e.g., KRAS mutant vs. KRAS-wild-type), as well as the patient's MSI-status (e.g., MSI-high vs. MSI-low/MSS) must be determined.

Also, it would help to know exactly where the primary tumor is located.

Drugs and drug-combinations approved for colorectal cancer 2021
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=65284&p=507610#p507610

https://www.empr.com/wp-content/uploads/sites/7/2020/08/FDA-Approved-Colorectal-Cancer-Treatments-0820.pdf

===============
NHS guidance on Avastin (2010)

Bevacizumab in combination with oxaliplatin and either fluorouracil plus folinic acid or capecitabine for the treatment of metastatic colorectal cancer

Technology appraisal guidance [TA212]Published:15 December 2010

https://www.nice.org.uk/guidance/ta212

================

IV Vitamin C - (IVC)
http://orthomolecular.org/resources/omns/v15n11.shtml
Last edited by JJH on Thu Aug 11, 2022 1:57 am, edited 1 time in total.

milan2000
Posts: 2
Joined: Sun Aug 07, 2022 1:18 pm

Re: KRAS Mutant Stage IV colorectal Cancer

Postby milan2000 » Wed Aug 10, 2022 6:12 pm

Thank you so much everyone for your information and encouragement.

We have decided we are going to start my mother with Avastin as well as a high dose of vitamin C. The latest paper I have read seems to have some promising results when combined with chemotherapy. It will be worthy to try and see if we can get some shrinkage of her tumors

User avatar
beach sunrise
Posts: 1033
Joined: Thu Mar 05, 2020 7:14 pm

Re: KRAS Mutant Stage IV colorectal Cancer

Postby beach sunrise » Thu Aug 11, 2022 3:42 pm

I believe you are on the right track. I really think chemo plus naturals are both very important.
I also take celebrex and other anti inflammatories as part of my ADAPT+++ protocol.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test


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