Is it the new liposomal irinotecan (Onivyde)? Will that be done in conjunction with the at-home 5FU pump? I've had two oncologists propose it, but don't want to do the pump again.

I guess when you run out of options, keep looking for more options! Hope this treatment serves as a bridge that holds you over until another trial opens up.

There might be more options overseas if you're able to travel. I've heard Germany is a lot more open to combining treatments that aren't approved for use together in the USA, but I also read that they had many changes scheduled to take effect 1/1/2025, so I'm not really sure what's available there.

I did get a quote for a "personal peptide protocol" treatment (in Germany) derived from my own tumor tissue (or NGS results if tissue is not available). It was in the range of $80K. I haven't seen any peer-reviewed papers supporting it, so I can't tell if it's just snake oil, but it has the markings of it. Being stage-4 myself, I'm open to a lot of unproven options (on top of my SoC chemo), but I'm too cheap to drop $80K on anything without a clear history of benefit.