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Need opinion on chemo combo the doc is proposing. John Help!


Guest Phyllis

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Guest Phyllis

The doctor in MS I saw and really like has suggested the following plan:

1. I take a two to three month chemo break unless I start to have problems. Two months sounds long enough to me. I can't imagine my cancer staying stable.

2. Then do Xeloda (I had great success with this drug), gemzar and navelbine for shrinkage, and this drug I can't remember but it keeps the cancer cells from mutating, which mine always do after the first two rounds. I think he said it was like C225 or something.

I would like to do chemo sensitivity testing but I am sure my doc in Chicago will probably feel that it doesn't do anything. I have also asked about stem cell transplant. They just freaked at this and keep insisting no one does that on Head and Neck cancer or lung. I said I know they do for lung. Any advice will be appreciated.

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C225 is Erbitux and also called Cetuximab. It is like Iressa except it works on the outside of the cell instead of the inside. It is a monoclonal antibody.

Some Drs wont try another EGFR targeted drug if one failed, but I think just because one fails doesn't necessarily mean the others will. The have the same target but use different molecules for the drug and like I said Erbitux works by blocking EGFR on the receptors on the outside of the cells, Iressa and Tarceva interfere with signals on the inside of the cells

http://www.cancerconsultants.com/syndic ... ypeID=News

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Phylis

Good to hear from you and that you made it home safely.

I have no advice on the treatment.

Are your lung tumors mets or are do you have a different primary in addition to the head and neck that you originally were dxed with? I am not sure if that makes a difference in treatment or not.

Have you looked into any of the vaccine trials? There is a new one. Information on it is in the new treatments section here.

Keeping you in my thoughts.

elaine

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One thing that is interesting is that you responded so well to Xeloda. Xeloda I believe is like 5FU which is used in colorectal cancer.

UFT was posted by someone on here a while ago. It also acts like 5FU. It is not approved in the US.

http://www.docguide.com/news/content.ns ... B2006B6505

Erbitux was also successful with colorectal, so maybe the docs are thinking that this will work for the type of lung cancer you have since you responded to drugs that work well for colorectal

I don't really know too much about the combo they are giving you but maybe some of this information will help with discussions with you doctors

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Guest Phyllis

Thank you all once again. My cancer is originally head and neck with mets to the lung. Very difficult to do anything for once that happens and I guess I have managed to live longer and healthier than the majority of head and neck. They use the same treatments for the most part for my kind of cancer as they do lung cancer. I asked about the vaccine. Unfortunately my Chicago doctor does not believe in the vaccine and says there are no trials for head and neck.

My doc in MS seems to think I could do that one drug you mentioned John for the mutating. Maybe because it does work on the outside and not inside. They had wanted to put me on the Tarceva trials but wouldn't due to my failure with Iressa. To me Xeloda is a drug that works well with women. The men had a terrible time with it, but myself and the other woman did great. Unfortunately, my Chicago doc feels that it was the PTK that worked and not the Xeloda and the drug companies will not be happy to here elsewise. If I can significantly shrink the tumors I can be reconsidered for the rfa. I know this is paranoid but I am afraid they just want me to take a 3 month break figuring that is all the time I have left and right now with low blood counts and anemia I feel like they are right. That is why I am forcing myself to eat this stale, tough piece of pizza.

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Guest Phyllis

Thank you. I would never be able to figure out these things without you. I am about ready to agree with you Frank. I just want something in the wings all of the time. I just can't seem to give up.

My doctors I think are close to giving up. That vaccine trial looked good but they only want Stage III head and neck. Hopefully, a Stage IV trial will open up for the vaccine. I want stem cell now. That will be a tough sale.

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Phyllis - I hope your oncs aren't really ready to give up.

My mom is on hold for stem cell because of poor pulmonary function. She's going to see a pulmonologist.

Stem cell only works when the cancer is very responsive to chemo. Stem cell rescue simply means you get poisoned within a half-inch of your life with chemo drugs (and up to 5% of patients do actually die) and then have your stem cells which were previously harvested pumped back in.

My parents said they met a woman at the hospital who had stem cell about 6 months ago for an aggessive form of breast cancer. She came in with a cane, looking like death warmed over, and the office staff gushed about how terrific she looked :shock: . It's a very tough procedure, takes about a year to recover from. It's only feasible if the cancer can killed - not just controlled - by chemo.

I wish it were an option for you, but it won't work for all kinds of cancer. The right chemo has to be found first. SCLC is not commonly treated with stem cell rescue - the only reason my mom's dr. brought it up was because she had an incredibly fast, complete remission, meaning her specific cancer is quite sensitive to chemo.

Hope this makes things a bit more clear for you. And I'll keep you in my prayers - may your dr. find a truly effective treatment for you.

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Guest Phyllis

Thank you all for your help. I feel so good it would be hard for me to give up. I feel fixable. Plus, I just can't do that to my daughter. She thinks I am superwoman and will be ok.

Jonathan, thanks, the drugs the Dr. in MS has suggested are: gemzar, taxotere, capeciatabine (Xeloda?), cetuximab, su-11248, bevacizumab, and ifosfamide. I wish I could go down there for a while and let him treat me. By Sept. 1 I should have my daughter off to school and maybe I could figure out a way to be gone for a while if social security comes through. The docs at the Univ. of Chicago have hinted at maybe a clinical trial. The doc in Chicago is discouraged because standard chemo is not what he does.

I wish the stem cell was an option. I did see on the news last night at one hospital in Chicago, Northwestern, they are doing a radiation treatment called transferon? or something. They inject radioactive pellets into the blood vessel surrounding the tumors. They are only doing it on the liver I guess.

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They do brachytherapy (internal radiation) for lung cancer also.

Results from a large phase III trial show that adding ErbituxTM (cetuximab) to radiation therapy can nearly double survival in patients with head and neck cancer that has not spread.

“The use of cetuximab and radiation therapy may become an excellent choice of therapy for this group of patients,” said James A. Bonner, MD, chairman and professor of radiation oncology at the University of Alabama at Birmingham. “Future studies should be performed the examine combinations of chemotherapy, radiation therapy and cetuximab.”

Researchers compared survival between 211 patients with locally advanced squamous cell cancer of the head and neck who received high-dose radiation therapy plus Erbitux and 213 patients who received radiation alone. Median survival nearly doubled in the Erbitux group: 54 months versus 28 months. More of the Erbitux-treated patients were alive at two years (63 percent versus 55 percent) and three years (57 percent versus 44 percent) compared to the radiation-only group.

For more about Erbitux, go to www.erbitux.com.

Until next time,

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