Hallo, For 31 months I’m now treated for OC (IIIc). Cancer recurred 14 wks after Carbopl./Taxol and Doxil was given for the next 9 months before it lost effect. No bulky disease was found in PET/CT, but ascites required several paracentesis. I was put on Tamoxifen and had pneumonia. Then I developed bowel obstruction, that resolved upon chemo with Carbopl+Gemzar. CA125 only responded marginally (from 180 to 130) and chemo had to be stopped after 3 cycl. due to extreme liver enzyme rise and haematological problems. Topotecan/docetaxel weekly reduced CA125 level within 6 weeks to 40, but it increased thereafter and treatment was stopped because of alveolitis and CA125 had reached 70 again. Next chemo was taxol weekly with avastin biweekly, which led to a fast drop of CA125 (after 3 weeks down to 20!). But as with the former chemos, the effect was only of short duration. CA125 rose again and that time PET/CT showed active metastases: two small foci in the pelvis and one lymph node in the groin. Carbopl. 6AUC was tried, but 3 cyc. showed no effect on CA125 (meanwhile at 500!). The newest PET shows regression of the two pelvic foci, ascites and peritoneal carcinomatosis, but now there are 5 18FDG-active lymph nodes. For the moment Doxil biweekly has been started and we hope to see an effect…
Now my questions:
a) Under which preconditions is a secondary surgery a good option? I feel ok, only one of these lumps in the goin starts to disturb. My oncologist is reluctant for surgery in the absence of a good adjuvant chemo.
b) What about radiation or regional hyperthermia, to increase chemo effect?
c) I believe the cancer is heterogeneous by now, what about alternating a platinum(cis or oxi?) (maybe combined with avastin) with doxil and gemzar?
d) Is there any other drug (also experimental) that might show an effect (permetrexed, endoxan….??)
I know Im lucky to still feel rather well!
Thank you for your opinion and ideas about how to continue my treatment!