A brief modified FOLFIRI-Bev update for Gilbert’s

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Location: Brisbane, Australia

A brief modified FOLFIRI-Bev update for Gilbert’s

Postby Rock_Robster » Wed Jan 24, 2024 7:53 pm

Hi all, a few folk suggested I update when I had some info on how my new somewhat personalised protocol was going. Essentially I’m doing FOLFIRI+Bev, but modified as below:

W1: 35% irinotecan, bolus fluorouracil, leucovorin, 100% bevacivzumab

W2 35% irinotecan, bolus fluorouracil, leucovorin

W3: Off

Having now done 2 cycles of this, my CEA has halved (140 to 70), and similar on CA19.9 (400 to 200ish). LDH is down from 600 to 400, though onc reckons that will also be elevated due to my regular Neulasta use.

Am going to get a CAP CT tonight to confirm the inside matches the bloods, but overall feeling positive/hopeful. Not least because this a much more tolerable (if perhaps more inconvenient) regimen for me when compared to protocol FOLFIRI-Bev, given I also have Gilbert’s Syndrome.

Of course I still also want to qualify for trials, so now my best outcome would be that everything has shrunk, but I also need an eagle-eyed radiologist to spot one “something” new somewhere non-concerning but that meets the size criteria, so we can technically argue progression and start trial screening again…

Thanks all,
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial

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