What options have you uncovered for Stage 4 mets to lung and liver?

Posted by maxmom @maxmom, Jun 24 1:16pm

We began this journey in Dec. 2023 - stage 3 borderline resectable. Did 7 rounds of 5FU - scans found no change but no further spread - YAY! Switched to Gem/Abraz - 6 rounds - new scans showed spread to liver and lung - hello Stage 4 🙁 All we've heard is biopsy to see if any mutations and hopefully trials. No mention of other chemo options, immunotherapy, radiation - nothing. So what's a person to do, just sit and pray there is a trial? Did research Nanoknife but no doc, other than Donoway in Fla, does Nano on Stage 4. Any thoughts? Help? Suggestions? Greatly appreciated.

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markymarkfl | @markymarkfl | Jun 24 4:52pm

If the original tumor(s) are still in the pancreas AND now elsewhere (liver and lungs), AND 5FU did little while Gem+Abrax did less, surgery to resect meaningful amounts of cancer seems like risky and futile endeavor, unless there's a palliative need to remove intestinal blockages or something immediately painful and/or serious.

Clinical trials do sound like your best option at this point. Please be aware that not all of them require a specific mutation (or mutations of any sort) -- this can definitely increase your number of feasible trials. But don't let that stop you from getting as much biopsy tissue as possible, analyzed in as much depth as possible, as soon as possible.

Out-of-the-box therapies I've heard of include brachytherapy (internal radiation pellets, Civa Sheet, etc) and hepatic arterial infusion pump (HAIP) chemotherapy https://www.mayoclinic.org/biographies/poruk-katherine-m-d/bio-20545266 but these all seem to work in isolation on one organ at a time.

Have you asked your current docs about referrals to any specific/appropriate trials?

maxmom | @maxmom | Jun 27 10:39am

We are meeting with a Mayo oncologist today and waiting for biopsy results but those will take a few weeks. It seems like the only trials really worth pursuing are Stage 3 or 2 (maybe) but not sure how many of those there are.

gamaryanne | @gamaryanne | Jun 28 12:28pm

Do not rule out any trials; they will be ruled out for you as each has very specific eligibility requirements. As you review them, carefully read their purpose and also interim papers that have been published, if available, showing data collected thus far. If a trial is recommended, the doctor should be able to provide this.
If you are willing and able to travel, be sure to make this clear. All trials are not offered at all Centers of Excellence. In fact, most are not. I know someone that has been on hold for a trial at MSK for a long time being told there are no slots. Further investigation shows there ARE slots elsewhere just not at MSK. Best of luck on your next steps. It is a frightening crossroad but know there are still options and drug combos you have not done.💜