Stereotactic Body Radiation Therapy and Immunotherapy

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stu
Posts: 1614
Joined: Sat Aug 17, 2013 5:46 pm

Re: Stereotactic Body Radiation Therapy and Immunotherapy

Postby stu » Wed Oct 19, 2022 3:44 am

Looking forward to seeing how this works for you .
All the very best . Sounds extremely positive .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Markdale
Posts: 108
Joined: Wed Dec 02, 2020 4:45 pm

Re: Stereotactic Body Radiation Therapy and Immunotherapy

Postby Markdale » Fri Nov 04, 2022 5:51 am

I’m hoping it works
09/20:Diagnosed colonoscopy
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed
3/24 radiation to acromion bone met + chest lymph nodex2

User avatar
beach sunrise
Posts: 1041
Joined: Thu Mar 05, 2020 7:14 pm

Re: Stereotactic Body Radiation Therapy and Immunotherapy

Postby beach sunrise » Fri Nov 04, 2022 10:43 am

Hey pccr, Thanks for the update. I hope and pray for good results coming your way!
Keep pushing on and its really good plan B is in place for just in case.
I am cheering for you.
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

roadrunner
Posts: 465
Joined: Sun Jan 12, 2020 8:46 pm

Re: Stereotactic Body Radiation Therapy and Immunotherapy

Postby roadrunner » Fri Nov 04, 2022 2:55 pm

I also wish you the best. The way I understand it, success on the immunotherapy front would be icing on the cake, no? And if it isn’t there, you just proceed to the promising experimental therapy you sought through enrolling in this trial. That seems like a reasonably good & hopeful place to be. In any event: Good luck, we are all pulling for you!
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

MadMed
Posts: 216
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Stereotactic Body Radiation Therapy and Immunotherapy

Postby MadMed » Sun Nov 06, 2022 11:11 am

This seems weird to me, spread to adrenals from CRC is rare unless in stage 4 spread everywhere. Seems to me more of a side effect of immunotherapy.
I hope that's the case pccr. The chest scan results are the key now.
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
NED as of 4/06 CT/MRI/sigmoidoscopy
On W&W 04/06/2022

roadrunner
Posts: 465
Joined: Sun Jan 12, 2020 8:46 pm

Re: Stereotactic Body Radiation Therapy and Immunotherapy

Postby roadrunner » Sun Nov 06, 2022 2:40 pm

I think there’s some reason for concern and vigilance here, but also a silver lining, perhaps? First, this would need to be confirmed as a met. The interval growth/appearance is the concern, of course, and though I don’t know the interval, I suspect the growth rate is concerning. Whether immunotherapy or the alternative therapies you pursue could be involved is beyond my knowledge.

The more positive piece here, I think, is that this may well say little about the lungs or other areas in the body. Metastases in the adrenal glands are famously resistant to the effects of immunotherapy. Much research has been done to determine the reason, but I haven’t seen a definitive answer. In any case, that suggests that the therapy might be having positive effects elsewhere, or that your immune system was controlling disease better elsewhere, or both. The lung scans, therefore, may not be bad even if this is a met. The same goes for the overall picture, I believe.

It does raise potential questions for next steps. I have no clue as to whether TIL therapy could affect an adrenal met, and I doubt the folks leading the study will either. Adrenal mets are usually treated via surgery, so the timing of that and how it might interact with TIL therapy (if necessary) and the trial protocol may become important questions. Again, most of the above presumes that this finding does represent disease, which I hope is not the case.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

MadMed
Posts: 216
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Stereotactic Body Radiation Therapy and Immunotherapy

Postby MadMed » Mon Nov 07, 2022 10:37 am

Progression in the lung mets ? Sorry pccr, gut punch.
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
NED as of 4/06 CT/MRI/sigmoidoscopy
On W&W 04/06/2022


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