Alternate Chemo treatment Serous cell

I'll cut and paste below the list of alternate therapies from the NCCN guidelines. Not all of them are used commonly. The hormonal therapies are not generally first choice after frontline chemo fails, but might be tried in some circumstances or after finishing chemo. It's probably an overwhelming list, but oncology is like that Decisions depend in a lot of factors. Some are even pills.

One thing I would recommend is asking about molecular testing. Some therapies, not listed below, are specific to certain mutations, like trastuzumab for HER-2, pembrolizumanb or nivolumab for mismatch repair-deficient (dMMR), and another one I've never heard of and I guess must be rare (Larotrectinib or entrectinib for NTRK gene fusion-positive tumors). I get the impression not all oncologists check for some of these until asked.

Systemic therapies

• Carboplatin/docetaxel

• Cisplatin/doxorubicin

• Cisplatin/doxorubicin/paclitaxel

• Carboplatin/paclitaxel/bevacizumab

• Cisplatin

• Carboplatin

• Doxorubicin

• Liposomal doxorubicin 

• Paclitaxel

• Albumin-bound paclitaxel

• Topotecan

• Bevacizumab

• Temsirolimus

• Docetaxel (category 2B)

• Ifosfamide (for carcinosarcoma)

• Ifosfamide/paclitaxel (for carcinosarcoma)

• Cisplatin/ifosfamide (for carcinosarcoma

Biomarker-directed systemic  therapy for second-line treatment

• Lenvatinib/pembrolizumab

Hormone therapy

• Medroxyprogesterone acetate/tamoxifen 

(alternating)

• Megestrol acetate/tamoxifen (alternating)

• Progestational agents

Medroxyprogesterone acetate

Megestrol acetate

• Aromatase inhibitors

• Tamoxifen

• Fulvestrant

• Everolimus/letrozole

Hello, David. I had uterine papillary serous cancer, also stage 1, and finished treatment last January -- 6 rounds of taxol/carboplatin and 5 internal radiation (brachytherapy) sessions. I wish I could be helpful, but I didn't even know it was possible to have a recurrence after surgery and one session of chemo. I had a CT scan before surgery, then surgery, then treatment, but there was no scan or CA-125 test done while I was in treatment, so I don't know what might have been going on internally. Three weeks after I completed chemo, my CA-125 was tested, and had dropped from 25 at diagnosis to 7, so the assumption was that the treatment was effective. I continue to have 3-month check ups and will have a scan yearly. 

There are several women who post regularly who also have/had serous, and they are likely much more knowledgeable than I am about alternatives.

Warm best wishes.

Molly

David has she had genomic testing? With it they can see if they can find a target for her cancer and put her on immunotherapy. A close fried has stage four colon cancer. Chemotherapy didn't help her at all but immunotherapy is working unbelievably well. I know, a different cancer but it shows that people respond differently to treatment. Good luck!

Hello David,  I am sorry to hear of your wife's situation.  I was diagnosed with Stage 3C Grade 3 uterine papillary serous cancer in September of 2019.  I did get a second opinion on treatment.  One thing I believe is true is that when you have the full hysterectomy (uterus, fallopian tubes, ovaries and cervix), there is no cervix to be stitched.  So I am confused as to what type of surgery your wife had.  It is important to remove everything and also have a pelvic wash which can help detect any cancer in that area.  I advise you to find out exactly what they did.  You can have the whole medical history including slides sent to a second opinion of your choice.  They can do many things via telehealth without having to physically exam your wife.  For me it brough great piece of mind and treatment suggested between the two was similar tho not exact.  I had the complete history and 6 sessions of carbo/taxol therapy and 25 rounds of pelvic radiation due to a suspicious node.  I hope she responds well to the chemo and does not experience renal failure again.  If you click on my name you can find out the full course of my treatment.  For follow-up I have a pelvic exam and CA125 every three months.  I do not get a routine CT scan as all three doctors who saw me said the research did not support their use.  Unless my CA125 goes over 35 I will not have one.  My best advice is have someone else take a look at things.  It can be very helpful.  I recommend Memorial Sloan Kettering who does this remotely.  They also will do the genomic testing.  My best to you and your wife.

David I admire your activity to get answers regarding your wife's treatment. Not all husbands--in this case--can face it that head on. My Hubble is an example of this latter group. He does not want to discuss the particulars of the cancer and specifics as to how the treatments work. I was diagnose mid-Nov 2020 with stage 3C2 grade 3 endometriosis adenocarcinoma. Radical hysterectomy, lymphectomy, partial vaginectomy were major surgical procedures. Following the surgery the doctors were convinced they'd removed all the cancer. That's all my husband wanted to hear. Pathology came back in 4 days showing cancer in 3/6 para-aortic lymph nodes. So the equation changed a bit. Oh and I had metastasis in the vagina. All that turned my treatments a bit. Husband thought he heard I would do radiation after surgery--heard nothing about chemo. So when the docs rushed to get me started on 6 rounds of taxol/carbo he was confused. Then we threw in in 3 sessions of brachytherapy due to lack of margin in vaginal tissue that was removed. I am now in round 3 recovery time and feeling good.

Don't get me wrong--he is intensely involved in making sure I am managing pain and other side effects of treatment. But all he wants to know about the cancer it's gone. He would not ask any questions beyond that. That's why I admire your involvement and interest. I talk with my sister in great detail but she lives across the country. I wish sometimes he did want to talk more but I have accepted that. We have been married 36 years--our last anniversary was my surgery date--and he's never been a talker so I know that won't change!

Keep researching and advocating for your wife and I wish you all the best.

Deb

David_01 said:

I'm Trying

Thanks Deb. This June will be our 40th aniversery and we are a team. I'm an engineer by trade and studying and problem solving is how I am.

The Test results this week were not good as the Cancer is spreading, but still mostly in the Pelvis area. A couple of tumours are restricting flow between kidneys and bladder so she will be having stents installed next week . We hope this fix he kidney problems. The oncologist is having full genetic testing from the original removed tumour/uterus, so we have an appointment in 2 weeks to lay out the next stage of treatment.

David

So sorry to hear this. I have been very lucky that my diagnosis and treatment follow a very straight line--nothing has happened to disrupt treatment. I was blessed with a robust immune system and never got sick. I chalked that up to the exercise I love to do and even participating in endurance events events such as triathlons.

I pray you and your wife achieve some stability as you fight this together.

Deb