New to posting not to lurking
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Sandtbad-Welcome and like all sorry you had to find us. I am a CC survivor 2 years cancer free, because of a transplant. My tumor was inoperable and resection was not an option. I am alive because of Dr. William Chapman at Barnes-Jewish Hospital St. Louis, MO. Please read my story at thetelegraph.com under christmas miracle, it is full of HOPE. Please make sure if transplant is not an option, it is ruled out by a doctor who believes it is an option. Transplant is really one of our main means of a cure.
Lots of prayers-CathySandtdad, like the others, welcome to this site. The people here are wonderful as well as helpful. I will keep track of your progress as my cancer is currently unresectable. God bless you.
Pcl1029
Thanks for the clarification
I was just thinking that the medians would still fall in stable disease group
Just more proof how important response rates are to any treatment with this cancerHi,
Just a note.
RR here means response rate. The 33%(14/42)=14 patients had either complete or partial response to the treatment;and 21 additional patients had stable disease(SD);and I think that was the population of patients(total=35patients) the author used to calculate the Median PFS (8.3 month)and OS(9.8 month) .
God bless.Pcl and Eli
Thanks for the information on the studies. There is not much info out there on
these trials
And even the posted results look a little hard to get a handle on
The panitumimab trial seems to have such a low reaction rate
With only 33% getting a reaction and only 8 people having over > a grade 2 rash?
Based on those rates no one having a response is in the median Pfs or os
Hopefully over time more data will become available detailing groups that had responses
ThanksSandtad….I don’t want to make you feel funny, but still would like to welcome you to our discussion board. I am glad that you have found us and have been courageous enough to become a member. You are bring up some interesting points in that some people hesitate from sharing positive developments because of the fear that they may have to retract their optimistic attitude. Or, as you have mentioned, some are hesitant to share their innermost feelings while fearing that it may be too depressing to others. It is all about the feeling of vulnerability.
But, we have learned to be vulnerable on this site. We don’t censure, we don’t control conversations, we don’t judge nor do we critique the expressions of others. We just let it happen. We encourage to share, to understand and to support each person touched by this cancer. We share in the joy of success and we support each other in all phases of this disease.
And, that is why I believe this site has become a major component in the fight against this cancer. We are in this together.
Therefore, please continue to share with us as we learn from each other.
All my best wishes,
MarionHi PCL,
PCL1029 wrote:Also,if you are belonging to the KRAS wild type genotype,your chance of your tumors response will be much better than otherwise.What you wrote has been proven to be true in colon cancer. I’m not sure it has been proven to be true in CC.
See this article:
Time to Move to Targeted Drugs in Biliary Tract
Cancer?
http://content.karger.com/produktedb/produkte.asp?DOI=000271544&typ=pdfOn page 1 they say:
Quote:It is now well demonstrated that efficacy of EGFR antibodies is related to tumoral K-RAS wild-type status and not to EGFR expression in colon cancer [13]. Therefore, EGFR antibodies should be restricted to a sub-population of patients. This may not be the case in other types of tumor, and relationships between EGFR antibodies activity and K-RAS mutational status have to be further explored.(bold font mine)
On page 2 they say:
Quote:Interestingly, neither progression-free
survival nor overall survival were affected by K-RAS status in the GEMOX + cetuximab phase II study [11].Reference 11 points to the Austrian CC trial with 63% response rate.
— Eli
Hi,Sandtdad,
You may have this study about panitumumab alreay,but just in case you don’t,here is the copy.
Marker driven systemic treatment of inoperable cholangiocarcinomas: Panitumumab and combination chemotherapy in KRAS wild-type tumors.
Sub-category:
Hepatobiliary CancerCategory:
Gastrointestinal (Noncolorectal) CancerMeeting:
2011 ASCO Annual MeetingSession Type and Session Title:
General Poster Session, Gastrointestinal (Noncolorectal) CancerAbstract No:
4101Citation:
J Clin Oncol 29: 2011 (suppl; abstr 4101)Author(s):
L. H. Jensen, J. Lindebjerg, J. Ploen, T. Hansen, A. K. M. Jakobsen; Danish Colorectal Cancer Group South, Vejle Hospital and University of Southern Denmark, Vejle, DenmarkAbstract Disclosures
Abstract:
Background: Cholangiocarcinoma is a relatively rare cancer with a severe prognosis. Regimens combining cisplatin and gemcitabine are considered standard chemotherapy in non-resectable cases. In Denmark, a combination of gemcitabine, oxaliplatin and capecitabine has been evaluated in phase I and phase II trials. Based on experience with other gastrointestinal tumors, additional effect may be expected when combining chemotherapy and epidermal growth factor receptor (EGFR) antibodies, but only in KRAS wild-type (wt) tumors. The purpose of this phase II trial was to evaluate the efficacy of chemotherapy and the EGFR-inhibitor panitumumab in KRAS wt cholangiocarcinomas. Methods: Main eligibility criteria were performance status
, age <80 years, evaluable (not necessarily measurable) disease, and KRAS wt. All patients received panitumumab 6 mg/kg, gemcitabine 1,000 mg/m2, and oxaliplatin 60 mg/m2 on day one plus capecitabine 1000 mg/m2 b.i.d. day one to seven on a two weeks cycle. In a two-stage design, the first 18 patients met the criteria for extending inclusion to 46. The primary endpoint was the fraction of progression free survival (PFS) at six months and secondary endpoints were response rate (RR), toxicity, and overall survival (OS). Results: From 10/2008 to 8/2010, 46 patients were included in a single institution. There were 31 women and 15 males. Median age was 66 years (range 37-80). Twenty-five, 16, and 5 patients were in performance status 0, 1, and 2, respectively. The primary endpoint, fraction of PFS at 6 months, was 71.6% (95% CI 56.1%-82.4%, 33 events, intention-to-treat). Forty-two patients had measurable disease and the best response was 1 CR, 13 PR, 21 SD, and 7 patients progressing or dying at or before first assessment after 3 months. Thus, RR was 33% and the disease control rate 83%. Median PFS was 8.3 months (95% CI 6.7-8.7 months) and median OS was 9.8 months (95% CI 7.4-12.5 months). Toxicity was as expected including 8 cases of EGRF related skin adverse events >grade 2. Conclusions: This is the first marker driven phase II trial in inoperable cholangiocarcinoma. The regimen is feasible and will be tested in a randomized trial.
Compare to the GEmox+cetuximab,this study give the overall survival rate and the PFS rate as the other did not have the OS and PFS rate.and that is important.
God bless.Hi,Sandtdad,
It should be included in your report fromMGH. Just ask for the whole copy and see what is included.
Thanks in advance.
With regard to my CC, first resection on 6/2009 with clean margin> 1cm.;on Gemzar For 14 month,decided to stop and see whether I need Gemzar for life.It did return after six month for a2nd resection due to location of the tumor is high up abut to the diaphragm,otherwise RFA with chemoembolization will do the job.(it is only 2.1cm in size).Yes there is periods of normalcy but yes,it has been also intermittent cycle of therapy and recovery.All in all, it is not bad,I can still go to work and help out on this web site and do research for this horrible disease.
This is why we need all the help we can to find a better way for treating this cancer(more effective treatment and less side effects)and soon;not to mention about finding a cure.
Keep reading,keep researching,with God’grace,it can be done. At the least, we know we try our best .
God bless.Pcl1029
I didn’t get a copy of my bio markers report but have a treatment coming up this week and will get a copy. As for an RNA analysis I will have to say you are way ahead of me with most of this stuff ….what is an RNA analysis?
I have noticed that you have been fighting this cancer for awhile with some success…has it been a constant cycle of therapy and recovery or have there been periods of (new) normalcySusie
Thanks so much for welcoming me…although I have been on this site so many times it feels funny to be welcomed.
I will try and keep people up to date on my treatment…although now that I am posting it does feel a little strange….I can see where people would not want to post if things are not going well (depressing)… And if things are going ok….you don’t want to feel/ sound over confident …given the quickness with which this disease can turn on you….Hi Sandtdad. Welcome to the site and sorry you had to join us. Thank you so very much for posting your treatment. I haven’t heard of this combo yet, and I think it is so very helpful to learn what treatments other people are receiving and why that treatment was chosen. Best of luck to you and please keep us posted!!
Susie
Hi,Sandtdad,
Is it possible for you to post your MGH bio markers report on the message board,I would like to see what are the differences especially on the chemo sensitivity and their recommendation. If you also has the RNA ANALYSIS , I like to see it to.it may be 10 to 15 pages long,but since I am working on my bio markers research,it may not be a bad idea to include your data for a better analysis of the outcome of the research.You can email to me thru this web site by clicking the email address under my PCL1029 ID if you cannot copy and paste your result on this message board.
Thanks in advance.
God bless.Hi Sandtdad,
Welcome to the site. Sorry that you had to find us all but I’m glad that you have joined in with us as I know that you will find a ton of support and help here.
It sounds like you have done a lot of research and that is great as the more information you have the better. And that is great also that you have had shrinkage and a response in both the large and small tumours. Long may that continue and I will keep my fingers crossed for the most positive outcome possible. When is your next scan due?
I am glad that you have posted here and I do hope that you will continue to post, and I look forward to hearing more from you. Please let us know how things go for you and know that we are all here for you.
Best wishes,
Gavin
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