results: Tumor resistant to folfox & folfiri

What a beautiful smile on
What a beautiful smile on the little guy! Thanks for posting; please keep us updated.

sfmarie said:

Treatment Plan
Sounds great! I like that you are treating him uniquely. Please keep us posted. I wish all oncologists treated this disease specifically and not just follow some protocol.

Oncotyping is the future
I had my tumors oncotyped in sept. I still can't figure out how to get them paid for. Is your insurance going to cover it? If you learn of any programs that will lesson the expense, I would greatly appreciate any info you have. There are several drugs that my tumors show a strong response to, they all cost over 10k per treatment and insurance won't cover them, since they aren't an approved treatment.

linandtom said:

Oncotyping
Can you tell me how this is done? Also, what drugs did your tumors show a strong response to? My husband is not doing well. He's been on Folfox, Folfiri, and now 3 different clinical trials. Many mets to his liver, and in his abdominal wall area. Not sure what next....another clinical trial - go back to Folfiri that did work at one time. His tumors are not responding to anything right now....dr said to keep trying clinical trials. Not sure if this is going to be best for us right now. I'll see what I can find out about Oncotyping. Maybe you can help by telling us more?

caris dx
You can have your Dr send a tumor sample. There are several labs around the country, but make sure they're doing the latest and greatest. I had mine in sept at their new labs in phoenix, I think. By December their was already a new test out that my previous test didn't cover.
Basically they test for any and all protein over expressions or under expressions and other known tumor specific abnormalities. Once they get your specific genetic profile they cross reference it to all known literature. Take my cancer for example:

I have stage 4 colon cancer with mets to liver and lungs. But genetically, my colon cancer is much closer to kidney cancer than colon cancer. My cancer over expresses the genes most typically associated with genetic over expressions in other people who have kidney cancer. But, my cancer is also closely related to breast cancer. As far as colon cancer goes. My cancer doesn't share any distinct known colon cancer over expression. I have a highly over expressed protein called SPARC, in fact I have the maximum over expression. Studies have shown that people who are even mildly SPARC over expressed respond extremely well to Abraxane with Mytomycin C. That cocktail runs about 20k a month so I've been holding out with conventional therapy. If things change for the worst I'll definitely get some but not until conventional treatment stops.
Just as important as showing what works, the report also publishes things unlikely to work. Several things were excluded from working in my study including camptosar and oxaliplatin. What else is nice is that they give percentages of response rates. For me Camptosar had an ineffective rating of over 90% while oxaliplatin was only 60%. The abraxane mytomicin regimen has over a 90% positive response. Now certainly that doesn't mean it's going to cure me, it just means that I have a 90% chance of it slowing or killing it for a time. Caris Dx has a website, check them out

snommintj said:

caris dx
You can have your Dr send a tumor sample. There are several labs around the country, but make sure they're doing the latest and greatest. I had mine in sept at their new labs in phoenix, I think. By December their was already a new test out that my previous test didn't cover.
Basically they test for any and all protein over expressions or under expressions and other known tumor specific abnormalities. Once they get your specific genetic profile they cross reference it to all known literature. Take my cancer for example:

I have stage 4 colon cancer with mets to liver and lungs. But genetically, my colon cancer is much closer to kidney cancer than colon cancer. My cancer over expresses the genes most typically associated with genetic over expressions in other people who have kidney cancer. But, my cancer is also closely related to breast cancer. As far as colon cancer goes. My cancer doesn't share any distinct known colon cancer over expression. I have a highly over expressed protein called SPARC, in fact I have the maximum over expression. Studies have shown that people who are even mildly SPARC over expressed respond extremely well to Abraxane with Mytomycin C. That cocktail runs about 20k a month so I've been holding out with conventional therapy. If things change for the worst I'll definitely get some but not until conventional treatment stops.
Just as important as showing what works, the report also publishes things unlikely to work. Several things were excluded from working in my study including camptosar and oxaliplatin. What else is nice is that they give percentages of response rates. For me Camptosar had an ineffective rating of over 90% while oxaliplatin was only 60%. The abraxane mytomicin regimen has over a 90% positive response. Now certainly that doesn't mean it's going to cure me, it just means that I have a 90% chance of it slowing or killing it for a time. Caris Dx has a website, check them out

caris dx
Thanks for sharing this info. Will discuss with our dr next week. Hope you are doing well today.

snommintj said:

caris dx
You can have your Dr send a tumor sample. There are several labs around the country, but make sure they're doing the latest and greatest. I had mine in sept at their new labs in phoenix, I think. By December their was already a new test out that my previous test didn't cover.
Basically they test for any and all protein over expressions or under expressions and other known tumor specific abnormalities. Once they get your specific genetic profile they cross reference it to all known literature. Take my cancer for example:

I have stage 4 colon cancer with mets to liver and lungs. But genetically, my colon cancer is much closer to kidney cancer than colon cancer. My cancer over expresses the genes most typically associated with genetic over expressions in other people who have kidney cancer. But, my cancer is also closely related to breast cancer. As far as colon cancer goes. My cancer doesn't share any distinct known colon cancer over expression. I have a highly over expressed protein called SPARC, in fact I have the maximum over expression. Studies have shown that people who are even mildly SPARC over expressed respond extremely well to Abraxane with Mytomycin C. That cocktail runs about 20k a month so I've been holding out with conventional therapy. If things change for the worst I'll definitely get some but not until conventional treatment stops.
Just as important as showing what works, the report also publishes things unlikely to work. Several things were excluded from working in my study including camptosar and oxaliplatin. What else is nice is that they give percentages of response rates. For me Camptosar had an ineffective rating of over 90% while oxaliplatin was only 60%. The abraxane mytomicin regimen has over a 90% positive response. Now certainly that doesn't mean it's going to cure me, it just means that I have a 90% chance of it slowing or killing it for a time. Caris Dx has a website, check them out

Molecular vs Cellular Profiling
A clinical trial of the Caris Diagnostics (Caris Dx) in Phoenix.

http://cancerfocus.org/forum/showthread.php?t=3167

Molecular vs Cellular Profiling

Targeted drugs are specifically designed to block one or more critical pathways involved in cancer-cell growth and metastases. The development of these therapies stem from advances in molecular biology that have permitted the identification of qualitative and quantitative differences in gene expression between cancer cells and normal cells.

The new agents range from antibodies to small molecules. The interaction of the antibody or drug with its target inhibits pathways that are essential for cell proliferation or metastasis or activates pathways that culminate in cell death (apoptosis). Since these targets are usually specific for or overexpressed in cancer cells, the new agents generally have fewer side effects than most conventional chemotherapeutic agents.

Testing for these pathways (molecular profiling), those which identify DNA, or RNA sequences or expression of individual genes or proteins often examine only one component of a much larger, interactive process. It doesn't matter if there is a target molecule in the cell that the targeted drug is going after. If the drug either won't "get in" in the first place or if it gets pumped out/extruded or if it gets immediately metabolized inside the cell, drug resistance is multifactorial.

For example, the EGFR (epidermal growth factor receptor) is a protein on the surface of a cell. EGFR inhibiting drugs certainly do target specific genes, but even knowing what genes the drugs target doesn't tell you the whole story. All the EGFR mutation studies can tell us is whether or not the cells are potentially susceptible to this pathway of attack.

It doesn't tell you if one EGFR inhibiting drug is better or worse than another which may target this pathway. There are diffferences. The drugs have to get inside the cells iin order to target anything. In different tumors, either one EGFR inhibiting drug might get in better or worse than another. And the drugs may also be inactivated at different rates, also contributing to sensitivity versus resistance.

You can though take the advantage of profiling the entire cell to measure the interaction of the entire genome (not just one pathway or a couple of pathways). There are many pathways to altered cellular (forest) function (hence all the different "trees" which correlate in different situations).Functional profiling the whole cell measures what happens at the end (the effects on the forest), rather than the status of the individual trees.

Cancer is a complex disease and needs to be attacked on many fronts. Improving cancer patient treatment through proper drug selection will enable oncologists to prescribe treatment more in keeping with the heterogeneity of the disease. The biologies are very different from patient to patient and the response to given drugs is very different.

You might have to test for the 15 or 20 gene mutations that may be involved in determining sensitivity/resistance to a given drug (that's 15 to 20 tests). Because if you miss just one, that might be the one which continues cancer growth.

tootsie1 said:

Cute baby!
Your baby is precious! Such a great smile.

I do hope they will find exactly the medication your husband needs to do the trick.

*hugs*
Gail

Thanks for the information.
Thanks for the information. It gives me another idea to present to my ONC. The baby is beautiful !! Brenda