Liver Mets: what can we do different 2nd round?

KattyC

Hey all, I'm back on the board after 7 years.  Found out last Friday that I have mets to the liver.  I'm wondering this time around what can be done differently in treatment in hopes for a better outcome.  Original dx is DCIS, <2cm, ER/PR+, lumpectomy, 4 rounds of AC, radiation, tamoxifen, zoladex injections to suppress ovaries.

I'm disappointed that not much seems to have changed in standard protocol, surgery, chemo, radiation, hormonal treament.  I'm searching for new ideas and developments in molecular pathways, biomarkers, more targeted therapies, etc.  My questions pertain to a couple of areas:

1.  Has anyone had tumor tissue from surgery sent off for targeted chemo or other treatment testing?  If yes, what tests were performed (i.e. chemo, biological, etc.)?  What has been your progress?

2.  If you have or had mets, what different treatment options were explored or used other than chemo or hormonal treatments? 

 Thanks to everyone in advance for your answers and support.

Gitane

I do not have mets.  However, I want to share with you that chemosensitivity testing was done on my tumor to see which chemos would or would not work.  I felt it was a very useful thing to do.  My testing was done by Rational Therapeutics.  A tumor sample must be sent to them directly after surgical removal.

 Rational Therapeutics, 750 East 29th Street , Long Beach, CA (1 562 989-6455), www.rationaltherapeutics.com 

KattyC

Thanks Gitane, I knew there was something like this out there, just didn't know the company that provides the testing.  Have you also heard of any other testing for molecular pathways/biomarkers from a biological or hormonal treatment perspective vs. a chemo perspective? 

Also if I might ask, how did your Onc. monitor your progress with your chemo treatment selection?  I hear there is a 'CTC' simple blood test that measures the number of cancer cells ciculating in a given sample.  This can be performed at the Onc.'s office during scheduled visits.  Does anyone have any experience with this or any other non-traditional methods (i.e. not the usual scans, mammo, chest x-rays, etc.) .

Thanks again, I meet with the surgeon this morning to discuss recommendation for resection in about an hour.  I'll post with any new information I gain from the meeting. 

Gitane

I don't know of any other special biomarkers or tests. Sorry.  I wish I could help more.  Was the surgeon helpful?

My oncologist did pre/post treatment MRIs to monitor the tumor shrinkage.  Since I had neoadjuvant chemo, he did the chemosensitivity testing on tumor taken from the post treatment mastectomy to see if my tumor would respond to any more treatment.  It still was responding to AC, so I got 2 more rounds of that.  He's doing 15-3 tumor markers to follow me now.   

gpawelski

KattyC

Currently approved diagnostic modalities for following tumor response "after" drug agents are introduced to the patient are x-rays, blood tests, CTs, MRIs, Pet imaging, history, physical exam, etc.

Results of using the CellSearch technique to monitor circulating tumor cells (CTC's) can contibute to the understanding of tumor-blood interactions and may provide a valuable tool for therapy monitoring in solid tumors like breast, colorectal or prostate cancer. With cells being alive in circulation, it may mean that a patient would need additional treatment.

The outcome for metabolic responders and non-responders with imaging and the CellSearch technique is basically what is going on with cell-based functional profiling assays (Rational Therapeutics), showing what patients are benefiting from what drug agents "before" introducing them into the patient.

The CellSearch System could be utilized for confirmation after being administered empiric treatment or the assay-directed most beneficial therapeutic agents or empiric treatment. You still need to measure the net result of all cellular processes, including interactions, occurring in real time when cancer cells actually are exposed to specific cancer drugs.

TenderIsOurMight

Member gpawelski has spoken in the past of an ex vivo (i.e., laboratory or outside the body) cancer cell chemotherapy assay using fresh tissue. Tonight I took a look at Rational Therapeutics website and encourage you all to also if you are interested.  Please read the Shannon Watson's comments (under testimonials) as she has an interesting report. As always, trying to keep an open mind. T.

Here is the website: http://www.rationaltherapeutics.com/patients/aboutus.aspx