MCRC with peritoneal Mets. Is Immunotherapy an option?

@tgoz, that's tough news to hear from your oncologist. You could phone Mayo Clinic clinical trials to see if there is a match for which you are eligible.

Mayo Clinic Clinical Trials
http://www.mayo.edu/research/clinical-trials
Cancer-related clinical studies questions
Phone: 855-776-0015 (toll-free). This number is answered from 7 a.m. to 6 p.m. CST, Monday through Friday.

Your current treatment of encorafenib and panitumumab which reduced your CEA from 178 to 5 sounds like the combination is working well for you. Are you continuing with this treatment? How are you doing?

Colleen,
Recently, I've started to become resistant to the current combo, a recent CT scan now shows measurable cancer. I have checked on clinical trials and have been cleared for one that is located about an hour from me. It is a PIPAC trial at Northwell in NY. This trial did not require measurable scans because the actually look at the tumors during the treatment. I also apparently qualify for a trial with Dr Van Morris at MD Anderson that adds immunotherapy to my current combo. I will keep updating my treatments so others may benefit from my experience.
I would also be grateful to hear from anyone that has gone through these trials
Tim

Hi - Panitumumab is immunotherapy.... It is an antibody that has been shown to be effective with BRAS CRC, however for MSS cancers, immunotherapy typically has been found not to be that effective and is not indicated. For this reason I suggest you change oncologists, and try to go to Memorial Sloan Kettering, MD Anderson or Mayo for a consult. You mentioned two rounds of chemo, what was the chemo regimen exactly how many courses did you have?

Hello
Panitumumab is actually a monoclonal antibody and I am taking it with BRAFTOVI (Encorafenib) which is specific to the BRAF v600e mutation. They worked really well but I am becoming resistant to it. My mets in the peritoneum was not scannable (V small tumors) but (un)fortunately is now big enough to be seen. I am already being treated at MSK and have received CAPOX then Folfiri, avastin so far but will start the PIPAC trial at Northwell soon.
I have contacted Dr Morris at MD Anderson regarding his Clinical trial which I believe could be a game changer for MSS cancers like mine.
I'll post updates of my treatment so others with similar disease can maybe benefit from my experience.
Tim

You're certainly at one of the finest institutions. Suggest you ask for tumor informed CTDNA test results to monitor therapy going forward. Don't pay attention to CEA. Ask your oncologist to review with you.....March 2024 Abstract re BRAF MSS....JCR Abstract 5056: Molecular characterization of microsatellite stable (MSS) colorectal cancer (CRC) patients with a BRAF V600E mutation

BRAFV600E MSS CRC exhibited immune activation characteristics that were not observed in the BAF WT group, including greater CMS1 status, PD-L1 expression, and CD8-T cell infiltration. As such you may need a cocktail of antibodies that address each of these characteristics. The one you were on is only addressing EGFR

You're certainly at one of the finest institutions. Suggest you ask for tumor informed CTDNA test results to monitor therapy going forward. Don't pay attention to CEA. Ask your oncologist to review with you.....March 2024 Abstract re BRAF MSS....JCR Abstract 5056: Molecular characterization of microsatellite stable (MSS) colorectal cancer (CRC) patients with a BRAF V600E mutation. More...Recent studies have found that the multi‐pathway regimens combined with PD‐1/PD‐L1 inhibitors can enhance the efficacy of anti‐PD‐1/PD‐L1 in MSS CRC by increasing the number of CD8+ T cells, upregulating PD‐L1 expression and improving the tumour microenvironment. This paper reviews the research progress of PD‐1/PD‐L1 inhibitors in combination with cytotoxic T‐lymphocyte–associated antigen 4 (CTLA‐4) inhibitors, oncolytic virus, intestinal flora, antiangiogenic agents, chemotherapy, radiotherapy and epigenetic drugs for the treatment of pMMR‐MSI‐L/MSS CRC.

Thanks for the info, I forgot to mention that 3 separate CtDNA tests and 3 CT/PET scans were negative so the only indicator of active disease was CEA. Dr Van Morris seems to be a leader in this area of immunotherapy in MSS CRC and I have been in contact with him but for now I believe the PIPAC trial is my best course. I will stay on top of the immunotherapy trials.

btw Dr Whelan is currently enrolling in the PIPAC trial sponsored by City of Hope, however there is a waiting list. If you haven't already you may want to call. Sounds like you may qualify. Good luck

Trial is PIPAC for the Treatment of Peritoneal Carcinomatosis in Patients With Ovarian, Uterine, Appendiceal, Colorectal, or Gastric Cancer. Besides Northwell the other locations for this trial are Mayo Clinic in Jacksonville and City of Hope, Duarte. Greenlawn, New York, United States, 11740

Recruiting

Northwell Health Cancer Institute at Huntington

Contact:
Richard L. Whelan
212-434-4860 rwhelan1@northwell.edu
Principal Investigator:
Richard L. Whelan