CarrieN~Specific links re chemo drugs in possible clinical trial treatments MDA mentioned

LorettaMarshall
LorettaMarshall Member Posts: 662 Member
in Esophageal Cancer #1

Hello again Carrie ~

 In response to your last post - https://csn.cancer.org/comment/1593203#comment-1593203 You wrote: “Thank you - Thank you both for your support.  I will stay positive and push my way through this. I don't have a choice!!  MDA has recommended a clinical study that will have me in 1 of 3 groups. One group will be on a combination of nivolumab plus ipilimumab (types of immunotherapy), - group 2 will be on nivolumab and standard chemo (either XELOX or FOLFOX), and group 3 will be on just standard chemo.

They said that these immunotherapy drugs have been FDA approved for other cancers, but not esophageal cancer. We didn't even discuss my prognosis.” 

______________________________________________________________________

So I am putting information here about the possible treatments that MDA mentioned in your particular case.   There are good links that others may find useful as to your different types of chemo drugs and the clinical trial requirements that they suggested here.   So here are the links.

My heart goes out to you.  We’re “big girls” now, and we know we’re in for a wild ride, but God goes with us.  That makes a big difference in our ability to cope.  I’ve also sent you some detailed information on getting a SECOND opinion from Houston Methodist in Houston, TX.  I’m impressed with Dr. Edward Y. Chan, whose specialties are Esophageal Cancer and Lung cancer.  I’m impressed with his credentials and the publications and research work that is directly related to these cancers.  It pays to be informed about what your doctors are recommending.  Naturally, my husband and I, are praying for you to be able to make the very best decisions.

Love & prayers,

Loretta Marshall (Wife of William Marshall, EC III (T3N1M0) - Ivor Lewis Minimally Invasive Esophagectomy (MIE) @ University of Pittsburgh Medical Center, (UPMC) performed by Dr. James D. Luketich on May 17, 2003.  So far William (aka Bill or Billy) is testing free of cancer these many years later)

_____________________________________________________________

1. https://www.cancer.gov/about-cancer/treatment/drugs/XELOX

XELOX - listen - This page contains brief information about the drug combination called XELOX. The drugs in the combination are listed, and links to individual drug summaries are included.

Drugs in the XELOX combination:

XEL

= Capecitabine (Xeloda)

OX

= Oxaliplatin

Chemotherapy is often given as a combination of drugs. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.

Each of the drugs in this combination is approved by the Food and Drug Administration (FDA) to treat cancer or conditions related to cancer.

Use in Cancer - XELOX is used to treat:  Colorectal cancer that is advanced.

This combination may also be used with other drugs or treatments or to treat other types of cancer.   More About XELOX - Definition from the NCI Drug Dictionary - Detailed scientific definition and other names for this drug.

Important: The drug information on this page is meant to be educational. It is not a substitute for medical advice. The information may not cover all possible uses, actions, interactions, or side effects of this drug, or precautions to be taken while using it. Please see your health care professional for more information about your specific medical condition and the use of this drug.”

  • Posted: January 6, 2012
    • Updated: July 31, 2014
    • _______________________________________________________
 

2.      https://www.cancer.gov/publications/dictionaries/cancer-drug?CdrID=657267

NCI Drug Dictionary

The NCI Drug Dictionary contains technical definitions and synonyms for drugs/agents used to treat patients with cancer or conditions related to cancer. Each drug entry includes links to check for clinical trials listed in NCI's List of Cancer Clinical Trials.

XELOX regimen

 A chemotherapy regimen consisting of capecitabine (Xeloda) and oxaliplatin used for the treatment of advanced-stage colorectal cancer. This regimen differs from a similar regimen, CAPOX, with regards to the dosing schedule for oxaliplatin. (NCI Thesaurus)

Synonym:

capecitabine-oxaliplatin regimen
Xeloda-oxaliplatin regimen
XELOX

 _______________________________________________________________

3.      http://www.chemocare.com/chemotherapy/acronyms/xelox.aspx

Acronym: XELOX

Most often associated with treatment of Colorectal Cancer

Capecitabine - (Xeloda) - Used for metastatic colon, rectal and breast cancer.

Capecitabine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Capecitabine is classified as an "antimetabolite."

Learn More - Oxaliplatin

(Eloxatin)

Oxaliplatin is used to treat colon or rectal cancer that has spread (metastasized), it is often given in combination with other anticancer drugs (fluorouracil and leucovorin).

Learn More …”

_____________________________________________________

4.      http://www.chemocare.com/chemotherapy/drug-info/oxaliplatin.aspx

________________________________________________________

5.      http://www.chemocare.com/chemotherapy/drug-info/capecitabine.aspx

 

Capecitabine -  (ka pe SITE a been) - Brand Name: Xeloda®

Capecitabine is the generic name for the trade name drug Xeloda. In some cases, health care professionals may use the trade name Xeloda when referring to the generic drug name capecitabine…

What Capecitabine Is Used For:  Colon or rectal cancer - Metastatic breast cancer

  • Esophageal, gastric, hepatobiliary, neuroendocrine, pancreatic, ovarian, fallopian tube, peritoneal or unknown primary cancers (off-label use)

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Capecitabine Is Given:

  • Taken as a pill by mouth.
  • Take after food (within 30 minutes of a meal) with water. (Usually taken in a divided dose 12 hours apart).
  • Tablets come in 2 sizes; 150mg and 500mg.
  • Do not crush, chew or dissolve tablets.
  • If you miss a dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses.

The amount of capecitabine that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule…”

 

__________________________________________________________________

6.      http://www.chemocare.com/chemotherapy/drug-info/oxaliplatin.aspx

Oxaliplatin - Trade Name: Eloxatin TM …

What Oxaliplatin Is Used For:

  • Oxaliplatin is used to treat colon or rectal cancer that has spread (metastasized), it is often given in combination with other anticancer drugs (fluorouracil and leucovorin).

Note:  If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Oxaliplatin Is Given:

    • It is given by infusion into the vein (intravenous, IV).
    • There is no pill form of Oxaliplatin.
  • The amount of Oxaliplatin you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have.  Your doctor will determine your dosage and schedule…”

_______________________________________________________________

7.      https://www.navigatingcare.com/chemotherapy_treatments/folfox-colorectal

Regimen Information  - For FOLFOX, including Side Effects

FOLFOX

Drugs in this Regimen:

For the treatment of Colon Cancer

How FOLFOX chemotherapy is given and possible side effects.

FOLFOX for the treatment of Colon Cancer

FOLFOX is the acronym for a chemotherapy regimen used in the treatment of colon cancer.

 

DRUGS IN THE FOLFOX COMBINATION:

FOL

= Leucovorin Calcium (Folinic Acid)

F

= Fluorouracil

OX

= Oxaliplatin

Chemotherapy is often given as a combination of drugs. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.

MOST COMMON SIDE EFFECTS OF FOLFOX

  • Risk of Infection - Diarrhea - Mouth Sores - Hand Foot Syndrome …”

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8. https://www.navigatingcare.com/explore/esophageal

“Esophageal Cancer Resources - Navigating Care Library Resources

The Navigating Care Library includes articles about cancer, chemotherapy regimens and drugs from the National Cancer Institute and other experts.

Esophageal Cancer Articles

Helpful Esophageal Cancer Links

9. https://www.navigatingcare.com/library/esophageal/learn/treatment-options-for-recurrent-esophageal-cancer

Treatment Options for Recurrent Esophageal Cancer

Treatment of recurrent esophageal cancer may include the following:

  • Use of any standard treatments as palliative therapy to relieve symptoms and improve quality of life.
  • Clinical trials.

Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent esophageal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

This information is not intended to replace the advice of a doctor. Navigating Care disclaims any liability for the decisions you make based on this information. This information was sourced and adapted from Adapted from the National Cancer Institute's Physician Data Query (PDQ®) Cancer Information Summaries on www.cancer.gov.

This information updated August 1, 2017.

Learn more:

 

10.  https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/results?protocolsearchid=6197279&vers=1

Clinical Trials Search Results…

Show Search Criteria

Cancer Type/Condition:  Esophageal cancer
Stage/Subtype:  recurrent esophageal cancer
Trial Type:  Treatment…”

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11.  https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=789057&version=HealthProfessional&protocolsearchid=6197279

A Study to Evaluate Efficacy in Subjects With Esophageal Cancer Treated With Nivolumab and Ipilimumab or Nivolumab Combined With Fluorouracil Plus Cisplatin Versus Fluorouracil Plus Cisplatin

ON THIS PAGE

o    Summary

o    Eligibility Criteria

 

Basic Trial Information

Phase

Type

Status

Age

Trial IDs

Phase III

Treatment

Active

18 and over

CA209-648
NCI-2017-00937, 2016-001514-20, NCT03143153

Trial Description

Summary

The main purpose of this study is to compare how long subjects with esophageal cancer live

overall or live without disease progression after receiving nivolumab and ipilimumab or

nivolumab combined with fluorouracil plus cisplatin versus fluorouracil plus cisplatin

Eligibility Criteria

Inclusion Criteria:

1.      Must have histologically confirmed squamous cell carcinoma or adenosquamous cell carcinoma of esophagus

2.      Male or Female at least 18 years of age

3.      Must have esophageal cancer that cannot be operated on, or treated with definitive chemoradiation with curative intent, that is advanced, reoccurring or has spread out

4.       Must have full activity or, if limited, must be able to walk and carry out light activities such as light house work or office work

5.      Must agree to provide tumor tissue sample, either from a previous surgery or biopsy within 6 months or fresh, prior to the start of treatment in this study

Exclusion Criteria:

1.       Presence of tumor cells in the brain or spinal cord which are symptomatic or require treatment

2.       Active known or suspected autoimmune disease

3.       Any serious or uncontrolled medical disorder or active infection

4.       Known history of positive test for human immunodeficiency virus (HIV) or known

5.       acquired immunodeficiency syndrome (AIDS)

6.       Any positive test result for hepatitis B or C indicating acute or chronic infection and/or detectable virus

Trial Contact Information

Trial Lead Organizations / Sponsors / Collaborators

Bristol-Myers Squibb

  • Ono Pharmaceutical Company Limited

Link to the current ClinicalTrials.gov record.
NLM Identifier NCT03143153

Note: Information about participating sites on pharmaceutical industry trials may be incomplete. Please visit the ClinicalTrials.gov record via the link above for more information about participating sites…”

__________________End of references___________________

 

 

 

Comments

  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    #2
    CarrieN~See my "personal letter" on a separate line :)

     

    Hello again Carrie -

    I first put a second letter to you here underneath this "more technical" response.  However, I've decided to put the more personal one on a separate line all its own. 

    See: https://csn.cancer.org/node/311584

    I've had you on my mind almost constantly since your letter of August 19th, and have been "on the hunt" ever since to find things to help.  My prayers go with you. 

    Wishing you every success in finding the very best second and third opinions,

    Loretta (& William)

  • CarrieN
    CarrieN Member Posts: 11
    edited August 2017 #3
    Thank you

    Thank you Loretta. I very much appreciate your support and advice. I am so glad I found this site. I'll keep you posted. 

    Thank you so much,

    Carrie

  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    #4
    CarrieN said:

    Thank you

    Thank you Loretta. I very much appreciate your support and advice. I am so glad I found this site. I'll keep you posted. 

    Thank you so much,

    Carrie

    Carrie~another reference for a 2nd Opinion at Houston Methodist!

    Hello again Carrie ~

    Previously I had told you that I was waiting on another call from Houston Methodist.   At the time I wrote you the letter above, I had not heard back.  Well I now have the name of a second surgeon whom I think is well qualified as well.  His name is Dr. Min Peter Kim.  So I would be happy to have either one of them see me for a SECOND opinion.  I've sent you some references via private e-mail. 

    May you manage to stay safe there in the Houston area.  Hurricane Harvey seems to be "very angry!"  I'm sorry to be listening to the weather reports for your area.  But you know what--it's not as devastating as having Stage IV Cancer I say.  Hope you can weather the storm without personal damage.  "Things can be fixed--people not as much!"

    Stay safe if you can.

    Loretta

  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    #5
    LorettaMarshall said:

    Carrie~another reference for a 2nd Opinion at Houston Methodist!

    Hello again Carrie ~

    Previously I had told you that I was waiting on another call from Houston Methodist.   At the time I wrote you the letter above, I had not heard back.  Well I now have the name of a second surgeon whom I think is well qualified as well.  His name is Dr. Min Peter Kim.  So I would be happy to have either one of them see me for a SECOND opinion.  I've sent you some references via private e-mail. 

    May you manage to stay safe there in the Houston area.  Hurricane Harvey seems to be "very angry!"  I'm sorry to be listening to the weather reports for your area.  But you know what--it's not as devastating as having Stage IV Cancer I say.  Hope you can weather the storm without personal damage.  "Things can be fixed--people not as much!"

    Stay safe if you can.

    Loretta

    Carrie~Can U update me re Hurricane Harvey from where U live?

    Dear Carrie ~ We all are devastated to see on TV the fury of Harvey.  I'm surprised that it was a "male" instead of a "female" since "normally" only a woman could wreak this much havoc! Surprised Is your head "above water?"  Are you dry?  I assume you live in the vicinity of Houston since your treatments so far have been at MDAnderson there in Houston.  This is a storm of "biblical proportions".  Our recent Matthew storm dumped 4 to 5 inches in our garage because it was on the ground floor, but thankfully the rest of our house is on a crawl space.  We lost a lot of "stuff" but our lives were not in danger.  We have thought of you in particular since this catastrophic storm began.  Needless to say, for once America may be in agreement about one thing--we are praying for all the folks affected and for the rescue teams doing their best to help. 

    Love & prayers,

    Loretta & William

  • CarrieN
    CarrieN Member Posts: 11
    edited August 2017 #6
    I'm okay!

    Hi Loretta, we are okay. We just made it to my mother in laws, which is only a few miles away, but a lot better option for us right now. We live next to a lake which has risen several feet since this morning. We literally had no water in our cul-de-sac at 8:00 this a.m., and then by 10:00 a.m. the lake had overflowed into our culdesac, and into our neighbors house. It is supposed to rise several more feet overnight. Our house is up higher than our neighbor's, so hopefully we will be okay, but we couldn't risk staying there with an 8 year old. I have lived in Houston area my entire life and I have never seen it this bad. We are very thankful for all of the volunteers that have come from so many places to help out. They are truly a blessing from God.

    Thank you so much for thinking of us,

    Carrie

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