Eli
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Hi Rima,
Welcome to the forum. Sorry that you had to find us.
Chemosat system is fairly new. It’s going through clinical trials. My understanding is that FDA has not approved it yet.
Chemosat is approved in the European Union for some types of cancer that metastasize to the liver. Not sure if EU approval includes CC.
As far as I know, only a handful of CC patients received this treatment through clinical trials. I haven’t seen any first-hand testimonies posted in our forum.
Here are a few previous discussions that mention Chemosat or Delcath, the company that develops Chemosat.
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=9165
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=6742
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=2415
Eli
Hi Bruce,
Your sample includes 25 patients. Italian sample was 72 patients. These are small samples. The profile of the two samples — demographics, staging, treatment protocols, performance status — can be very different. That would explain the discrepancy between your result and Italian result.
When I researched the survival statistics for my wife’s case, I saw a *wide* range of numbers. From very grim to quite encouraging. Most papers I looked at were single hospital studies with small samples. If I recall correctly, Japanese reports had the best results.
Eli
Pam,
I’m absolutely thrilled to hear the news. So happy for Lauren, you and your entire family. Sending my best wishes that everything goes exactly as Dr. Sonnenday has planned.
I know you must be scared… hang in there.
Hugs,
EliVery interesting. Thanks for posting!
A quote from the trial page:
Quote:CPI-613 is a novel anti-cancer agent (Zachar et al. 2011). CPI-613 selectively targets the altered form of mitochondrial energy metabolism in tumor cells, causing changes in mitochondrial enzyme activities and redox status which leads to apoptosis, necrosis and autophagy of tumor cells (Zachar et al. 2011). The activities of CPI-613 involve the catalytic and regulatory functions of the altered form of the pyruvate dehydrogenase complex (PDC)To me this sounds similar to how DCA is supposed to work. The general idea seems to be the same. I’m not an expect, so I can be wrong.
We discussed DCA here:
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=7284Hi TripleBlessed,
Welcome to the board but sorry that you had to find us. Thank you so much for sharing your story. The Oncologist article about your case is very interesting.
Dr. Jennifer Knox is a well-known expert in the world of CC. Her opinion comes across as very conservative. No solid evidence = no treatment. I understand her reasoning but I can’t agree with it (but then I’m not a doctor).
BTW, I live in the same Canadian province as Dr. Knox. I had a tentative plan to set up a consultation with her, to discuss maintenance chemo for my wife. Now that I read the article, I’m not sure it would be worthwhile. Maintenance chemo lacks solid evidence, even more so than adjuvant chemo. Dr. Knox is highly unlikely to recommend it, given how conservative she sounds in the article.
My best wishes to you.
Eli
Hi Pam,
5-FU infusion can run longer than 48 hours. My wife was connected to the pump 5 weeks in a row when she did chemo-radiation. They changed her bottle once a week. She only got a few short breaks between the bottles.
I don’t know what works better: a daily pill of Xeloda, or non-stop infusion of 5-FU. I haven’t seen any data one way or the other.
Xeloda is much easier to administer than 5-FU. That might be the reason why Dr.Z prefers Xeloda. Definitely ask him why he thinks it’s a better fit. He owes you a good explanation.
Eli
Lainy, glad to hear that you enjoyed the restaurant and the company of your grandson. Sending lots of virtual hugs.
Hi Bruce,
I’m not sure what’s going on here. It’s not just Figure 4 that looks odd. Look at the bottom chart in Figure 2. The last column (AJCC 7th ed) shows data splits for Stages I, II, III and IV. These stages are clearly at variance with NCCN Guidelines.
My best guess: AFC-IHCC-2009 Study Group wrote this paper before AJCC 7th Edition was finalized and published. Maybe they worked with a draft 7th edition which was subsequently modified? Just a guess.
I double-checked the stages in two other sources:
Source 1:
Quote from Page 10:
Quote:Stage IV includes all patients with metastasis, whether nodal or distant, separated into IVA and B to permit identification of each subgroup.
• Stage IVA now includes node-positive disease (N1).
• Stage IVB now includes distant metastasis (M1).Source 2:
Page 11 shows the same stage groupings as NCCN Guidelines.
