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Hi Diane,
My husband had Mek162 as a single agent without Gem/cis as he had this regimen as adjuvant therapy after the surgery in 2010. Side effects he had was vision change and an elevated enzyme related to heart (forgot the name). Hope the combination works for you. Good luck!!
Lee
Thanks KrisV and Gavin!
The PleurX was placed and he has lots of pain on top of what is already going on with his biliary catheter/stent. The pain has been mostly managed by pain meds, but his bilirubin came down initially and now went back up. He has been hospitalized since last Wednesday and is so frustrated about the drainage/stent. He is scheduled for another ERCP. tomorrow I really hope IT WILL WORK THIS TIME!! I PRAY…
Lee
Hi Diane,
My husband was treated with Mek162 as a single agent. It worked for a short time, but he has been treated with other agents targeting the EGFR-MAPK-ERK pathway so he may have developed resistance to Mek162. Overall Mek162 has demonstrated promising efficacy in cholangiocarcinoma as a single agent. Combining with cytotoxic agents may have even more anti-tumor effects. Best of luck!!
Lee
I am very sorry to hear about this. My husband used irinotican and it did not work for him either. Have you been treated with erlotinib and avastin? Both drugs are targeted agents and approved for other indications. clinical trial data (UpToDate Oncology) showed promising results in patients with cholangiocarcinoma. This is the BEST regimen my husband has ever responded and very well tolerated.. You may want to talk to your onc and ask for off-label use. Below is published data in UpToDate Oncology. Best of luck!!
Lee
Erlotinib plus bevacizumab — Vascular endothelial growth factor (VEGF) is overexpressed in biliary tract cancers and has been proposed as a therapeutic target [57]. The efficacy of bevacizumab, a monoclonal antibody targeting VEGF, in combination with erlotinib was addressed in a multinational phase II study [58]. Fifty-three patients with advanced cholangiocarcinoma (n = 43) or gallbladder cancer (n = 10) received bevacizumab (5 mg/kg every two weeks) plus erlotinib (150 mg once daily). Nine patients achieved a PR, which was sustained beyond four weeks in six (12 percent), with a median response duration of 8.4 months. Stable disease was documented in 51 percent. In the entire group, the median time to disease progression was 4.4 months, and median overall survival 9.9 months. Four patients (8 percent) developed grade 4 toxicity (cerebral ischemia or thrombosis), and the most frequent grade 3 toxicity was skin rash (three patients), although in all, 40 patients developed a rash of any grade during therapy.
Hi KrisV,
Thank you so much for the detail information regarding your husband. I know exactly what you and your husband have gone through and am very sorry for your loss (I read your posts previously and was hoping your husband would pass the 2-year mark and remain cancer free….).
My husband is scheduled for pleurX today and I hope it will help relieve some of his symptoms (shortness of breath, rapid heart beat). We are hoping to go home tomorrow.
Lee
Thank you Marion and KrisV! His chest CT showed suspicious nodules (bilateral) although small less than 1cm. The plural effusion is bilateral with significant more on the right side. CT did not mention about abnormal plural and the onc did not say where is the effusion could be resulted from.
KrisV – was your husband’s effusion bilateral or one side?
Lee
Thank you all! The results of cytology showed malignant effusion (found adenocarcinoma cells). Now they are trying to decide if they should do a chest tube or Pleurodesis. His albumin is low (2.4) and he had edema. Other liver enzymes are improving. He has lots of pain in abdomen. His onc talked to us yesterday about pain control and palliative care.
Lee
Thanks to all for your positive comments. Unfortunately my husband developed fever again early next morning. He had fast heart rate and shortness of breath. We rushed to the ER. Chest X-ray showed plural effusion on the right side that covered 2/3 of his right lung. ER doc drew about 2L of fluid, and he was admitted to the hospital. He has been on iv antibiotics and started to feel better today. I pray he continues to improve.
Lee
My husband had biliary catheter placed today. Lots of drainage came out so far, and he started to feel better. My fingers are crossed for continued improvement. Thank you all very much for your prayers and positive thoughts.
Lee
Thank you Gavin and Sharon! My husband is scheduled for tomorrow morning and we pray the procedure goes well to get the bilirubin down!!
Lee
Thanks so much, KrisV!! This is very helpful. I pray the procedure will go well and get his bilirubin down.
Lee
Hi Valerie,
Thanks for sharing your story! I am so glad that you are responding to the clinical trial drug and hope you continue to respond.
My husband was diagnosed with CC in 2010 and has been treated at the James that Dr. Goldberg is his oncologist and is wonderful!! If I can answer any of your questions, please feel free to email me at lee4532@gmail.com.
Best wishes,
LeeHi Christine,
This neoadjuvant chemotherapy is to help shrink the tumor to reduce the extent of the surgery. This method has been used in other cancers as well and shown clinical benefit. I know MSKCC is a leading cancer center in this field. Chemotherapy after the surgery is to eliminate the residual cancer cells, sometimes microscopic to prevent cancer from coming back.
Best wishes,
LeeHi Christine,
I am so sorry to learn about your diagnosis. My husband was diagnosed in November 2010, had surgery at OSU James Cancer Hospital. His disease recurred in September 2011. He has been on numerous chemo regimens. We went to MSKCC a couple of times and saw Dr. Fong (I think now he is at the City of Hope in LA), who did his second surgery in October 2013. He stayed in the hospital for 2 weeks due to complications. MSKCC has a great team in liver/biliary disease and we had good experience in general. I hope you visit to MSKCC is meaning to you!!
Best wishes,
LeeHello,
I can relate your experience and share your concern. My husband was diagnosed with ICC in November 2010. He had two surgeries and numerous of chemo regimens. Recently he has developed jaundice and CT found a stricture in his bile duct. A stent (plastic) was put in early April and a week later was replaced with 2 stents as the doc thought the first one was not working. He was on oral antibiotics for 5 days after the ERCP. A week after he finished the antibiotics, he had fever and ended up in the ER and was admitted to the hospital subsequently. He was discharged 3 days later with oral antibiotics, and again a week after he finished the antibiotics, he had chills, fever and admitted to the hospital again. They found one of his stents was occluded and both stents moved from where they were placed. He was discharged last Tuesday and is now on oral antibiotics. These plastic stent needs changed between 6 – 10 weeks depending on the length of the stents. But stents get blocked off sometime that will require to be changed. Our GI doc told us it usually requires the stent to be changed sooner when it is initially placed. So I am hopeful that my husband’s and your stent will last longer after the initial placement. I am very alert about his temperatures and measure several times a day. You do need to pay close attention to these symptoms, such as dark urine than usual, chill, fever of course, and should seek medical care immediately. Hope this is helpful, but hang in there!
Lee
