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New treatment strategy

snommintj's picture
snommintj
Posts: 602
Joined: Mar 2009

I wasn't able to get any copies of my study today. I'm going to get one on Wed when I get my avastin. Here is what I found out and my new strategy. I have two significant protein overexpressions.
I have the maximum overexpression of SPARC: secreted protein acidic and rich in cysteine. It is calcium binding macroprotein. Cells use it for wound repair. Tumor cells use it for angiogenesis. It collects and stores albumin. Clinical studies show that nab-paclitaxel (Abraxane) is very effective in tumors that overexpress SPARC. Abraxane is a 2nd line breast cancer therapy. Abraxane is a derivative of camptothesen, which is a naturally occuring microtubular agent. Microtubular agents limit cell division that often results in the cells death. Abraxane is delivered and transported into the cell via albumin. Which is probably why SPARC overexpression responds well to Abraxane.
I also have a maximum overexpression of PDGFR: platelet-derived growth factor. These growth factors bind to the protein tyrosine kinase which leads to changes in gene expression. The drug Imatinib inhibits PDGFR activation.
They are going to recheck me for BCRP overexpression: Breast Cancer Resistance Protein. They think I might also have the maximum overexpression of BCRP. If so, recent studies suggest that overepressions of both BCRP and SPARC result in very favorable responses to mytomycin-c. This drug was researched heavily a decade ago but was found to have very little benefit, though there were reports of a small number of significant positive responses. I may be one of those.

I will do two more cycles of Xeloda and avastin. After that I will be doing four cycles of Abraxane and avastin. I will then be scanned a hopefully the chemo along with the embolization will have worked well enough for me to have surgery to remove what ever may be left.

CarisDx Molecular Profiling Institute is the lab that did the work. They have many sites but their new lab is in Phoenix AZ. To learn more they have a website. CarisDx.com,

Last month I was told I would be on xeloda until it didn't work any more and that would be the end of my treatment. Today, I was given, three very good alternatives, all with 6-9 month progression free survival times. That along with a 6-9 month prognosis pushes my possible time to beyond two years. That's plenty of time for something new to come along. Hope is a powerful thing.

Fight for my love
Posts: 1346
Joined: Jun 2009

Hi John,it sounds pretty good,especially the insurance company is going to give you more alternatives.Good luck with the treatment.Hope is powerful!

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

John,

This is exciting news- thanks for sharing it with us! I'm printing out what you wrote and taking into my oncologist's appt. I just made an appt w/ him for this Wed. I'm going to discuss my plans of going to see Dr. Cantrell in Nashville, but also want to have other info with me, as well. I'm sure you'll let us know how things go for you- it's so great to gain hope with new treatment possibilities!

Lisa

fighting for mom's picture
fighting for mom
Posts: 96
Joined: Jan 2009

I have been keeping up with you on your journey. Your new info gives so many out there a new window of hope and encouragment. I find it unbelievable the amount of info you gained from your last test. And how different the cell types were and different treatments to complete for better outcomes.

I look forward to more info as your journey continues.

Susan

Annabelle41415's picture
Annabelle41415
Posts: 4411
Joined: Feb 2009

Sounds like you have a future of hope. It is amazing what they can test for now.

Kim

tootsie1's picture
tootsie1
Posts: 5016
Joined: Feb 2008

That's exciting! I love hope!

*hugs*
Gail

lizzydavis's picture
lizzydavis
Posts: 893
Joined: May 2009

What a good feeling to hear the news!

robinvan's picture
robinvan
Posts: 1014
Joined: May 2007

What a turn-around! What an incredible stroke of good fortune that you had this connection to get the study done! And your Onc seems to be right on top of it. Within less than a week you have a radically new program and new hope.

Thank you for sharing your journey with us. You are a "hope bearer" bringing us all a sense of what is now possible.

Hope is indeed a powerful thing!

Rob; in Vancouver

"We have only begun
to imagine the fullness of life.
How could we tire of hope?
So much is in the bud."
Denise Levertov

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

....you are the shizzle.......Im glad for ya John......Buzzard

coloCan
Posts: 1873
Joined: Oct 2009

researching the exact nature of your condition to be better informed as to what needs to be done. Hope your treatment is a success-never give up......Steve

thready's picture
thready
Posts: 475
Joined: Sep 2009

John,
It is great that you can get specifics like this. But I was wondering when this (these) tests might come to us, or where can be get them done if need be. Seems more specific treatments are in order for so many because the general stuff does not always do the job.
Just wondering.

Jan

snommintj's picture
snommintj
Posts: 602
Joined: Mar 2009

I'm pretty sure anyone can have these tests done right now. Go to the Caris Dx website and see what they can do

KathiM's picture
KathiM
Posts: 7948
Joined: Aug 2005

One question....does breast cancer run in your family?

There is one school of thought that says the two cancers are related...wondered when you shared about the BCRP...

I, as you may remember, have experienced both...and my mom is a BC survivor.

Hugs, Kathi

jscho
Posts: 62
Joined: Jun 2009

Wow. That is great information. I had never even heard about SPARC before. I look forward to seeing the full report. I am curious as to what protein expression levels and gene mutations were analyzed. For the Imatinib, I hope they are sure about your K-ras status, as that is downstream from the receptor of PDGF.

Did you get a more complete analysis than what CarisDx typically offers?

Exciting stuff.
Jeremy

Kathryn_in_MN's picture
Kathryn_in_MN
Posts: 1258
Joined: Sep 2009

How wonderful to get all this information and have new options! I am excited for you!

sfmarie's picture
sfmarie
Posts: 605
Joined: Aug 2009

I am soo very happy for you! This sounds awesome, to have two options. And with such a detailed analysis, sounds like either one of those is going to work wonders! Thank you for sharing the information. I read your post and it gave me hope and pure joy for you. I know how you have battled this disease and I pray for NED for you very soon. Marie

positivenergy
Posts: 6
Joined: Oct 2009

My mother is 65, and was diagnosed in May 2008 with UPSC: uterine papillary serous carcinoma, stage 1C. In June 2009, we discovered it spread to her liver and she has multiple tumors. So far she had a total hysterecrtomy in May 2008, June-Oct 2008 6 treatments of Chemo Carboplatin 1hr & Paclitaxel 3hrs and then a second round of chemo June-Oct 2009, Carboplatin 50mg & Doxorubicin 10mg. A few weeks ago, just before the 6th treatment of chemo, an mri showed that the cancer had become immune to the chemo and that the tumors were growing again. We were sent to a top liver specialist at mt sinai the next week who could not offer surgery but suggested RadioEmbolization SIR Spheres (selected internal radiation). She will have a mock procedure done next week on November 17, 2009. If successful, they will do procedure just after thanksgiving. Her oncologist is also thinking about giving her weekly injections of Tobotokin. Has anyone had success with RadioEmbolization? Tobotikan? Avistan (which we may consider if weget approval)? I also had a friend who is a top pancreatic doctor in NY who recommended Carisdx.com but when I discussed with our oncologist they were not quick to agree. They said we would need to arrange shipment of cancer tissue. Has anyone done this? How do I arrange shipment? I am thinking we might request that they take some new cancer tissue during cat scan when they do the radioembolization. Thank you in advance for any advise on how to arrange shipment and if you suggest it is worth trying caris.

My mother's history: After abnormal bleeding in May 2008, my mother, who is 65 and very healthy, was diagnosed with UPSC: Uterine Papillary Serous Carcinoma, Stage 1C. Although is was a very rare endometrial cancer, the pathological test was clean and the cancer had not broken the line of uterus. She immediately had a total Hysterectomy by lyposcopic surgery and began chemotherapy from late June 2008-October 2008 Carboplatin 1hr, Paclitaxel 3 hrs, every 3 weeks for 6 treatments. In Nov 2008 her PT scan looked clean. The doctor told us there was a 5% chance the cancer would come back. 6 months later in early June 2009, she started to have pain and on June 24, 2009 her PT Scan confirmed multiple hypermetabolic lesions throughout the liver, increased activity within the left iliac bone, suspicious for bone metastic lesion.

She immediately began a second round of chemo from June 29-October 2, 2009 of Carboplatin 50mg & Doxorubicin 10mg. In early October 2009, just before her 4th treatment, her blood level, which had steadily been falling, shot up from 800 to 2000. She began to also have pains on the side but her doctor still gave her the 5th treatment. Just before her 6th treatment, on October 20, 2009, her blood level was still high so her doctor did an MRI that showed the cancer was growing again and had become immune to chemo. He postponed her 6th treatment that was scheduled for October 23, 2009 and we were sent to a liver specialist the next week who did not see surgery as an option but suggested RadioEmbolization Sir Spheres (Selected Internal Radiation) with Nuclear Medicine. The insurance just approved it and she will have the mock procedure done on Tuesday, November 17, 2009. If it is a scucess, she will have the procedure done jsut after thanksgiving. Her oncologist is also trying to get approval for Avistan but may start giving her weekly Tobotikan. Has anyone had success with Radioembolization for liver cancer? Tobotikan? Caris?

Kathryn_in_MN's picture
Kathryn_in_MN
Posts: 1258
Joined: Sep 2009

PositiveEnergy - you may want to post this in the gynecological cancer section for uterine cancer. This is the colon cancer section so some of the drugs, questions and procedures you mention are very foreign to most here.

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