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Has anything been found to be effective for liver mets?

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Posted 6/19/2017 10:26 PM (GMT 0)
Dan just finished 6 cycles of Etoposide/Carboplatin and his numbers have risen since the fourth treatment. New scans showed an increase in number and size of liver mets. Has anyone had any success at this stage? Thanks.
Mary
Posted 6/19/2017 10:46 PM (GMT 0)
Mary-

There have been a couple discussions on HW of hepatic artery embolization with drug eluting microspheres.
Posted 6/19/2017 11:33 PM (GMT 0)
Hi Mary

I know it is not the same but i had mets on my lungs and they where gone by my last scan after six chemo treatment. I had docetaxel for chemo. I hope this gives you hope.

I am not aware of Etoposide/Carboplatin.
Posted 6/20/2017 1:12 AM (GMT 0)
TA - Thanks for the recommendation. I've done some reading on the microspheres; do you know whether it is approved for prostate cancer liver mets?

Everton - Dan failed on taxotere after three treatments. I've seen that someone went back to it after other treatments failed and had some success though, so we may have to try that again. Hope your great results continue.

Mary
Posted 6/20/2017 4:18 AM (GMT 0)
I know that a couple of guys on here have tried it or radioembolization with Y90 microspheres. Try searching for them. It is FDA approved for liver mets secondary to colon cancer but Medicare/insurance will approve off-label use under certain circumstances, such as a registry or clinical trial, such as this one at Northwestern (I forgot where you are and you didn't enter your city in your profile)

/clinicaltrials.gov/ct2/show/NCT00532740
Posted 6/20/2017 5:16 AM (GMT 0)
TA - We are in St. Louis. I saw the trial at Northwestern but thought it was for liver cancer rather than mets from other cancer in the liver. I 'll definitely call them tomorrow. I also have a couple Keytruda trials that I plan on contacting, and I'm waiting on a return call from MSKCC on the 1311-MIP1095 trial. They mentioned travel restrictions because of the radiation, so I'm not sure if that would work or not. I don't know what our MO will have to offer tomorrow or what the bone scan will show. It would be nice to find something that would treat visceral and bone mets at the same time. Your advice is always appreciated.
Mary
Posted 6/20/2017 5:35 AM (GMT 0)
Hi Mary,
What about the LU177 trial in Houston? They are recruiting, but it costs a lot. I thought the initial results from the trial in Europe was quite positive.
Gary had a pretty decent run on mitoxantrone after liver mets and omental mets were detected.
Might not be applicable to Dan if the cancer is mostly neuroendocrine.
Beth
Posted 6/20/2017 5:37 AM (GMT 0)
It says "metastatic to the liver" so I think Dan might qualify. I hope he can qualify for the trial at MSK and/or a Keytruda trial. Did they do an analysis of his tumor type? It's a longshot, but he might qualify for the new indication. The Lu-177-PSMA-617 trial in Houston is very expensive. I'm hoping Scott Tagawa will announce a new trial soon.
Posted 6/20/2017 6:35 AM (GMT 0)
Beth - I did contact Houston about the LU177 trial, but the cost was prohibitive. I contacted Dr. Tagawa in May, and he was filling the second group for his LU177 Phase I trial, with a third group planned for July and a fourth later this summer. He also anticipated two more PSMA trials this summer, so that's something to look forward to also. Dan was in the midst of chemo in May thus excluded at that time. I'll be checking back with him also. I've been following your posts and my heart breaks for you. Hope you and Gary can be at peace with the decisions you have to make.
TA - They did a 50-Gene Somatic Mutation Analysis Panel at MD Anderson, but they found no mutations. The biopsy report stated "By immunohistochemistry, tumor cells positive for cytokeratin, CK7 and focally weakly staining for CK20, with no unequivocal staining for androgen receptor, PSA, PSAP, prostein, NKX3.1, TTF-1, napsin chromogranin and synaptophysin. This immunostain pattern in not specific." I'm sure this means more to you than me. It was assumed at the time that the PC could be in transition to small cell. This was done at the end of January so we may be due for another biopsy.
Posted 6/20/2017 6:42 AM (GMT 0)
TA - Do you know of any connection between melanoma and prostate cancer? Dan had a malignant melanoma removed about 4 years ago, and his brother who was diagnosed with a brain tumor almost 15 years ago also had one removed. I noticed the Keytruda is used to treat melanoma and head and neck cancers and now possibly prostate cancer. Maybe it's just coincidence.
Posted 6/20/2017 4:58 PM (GMT 0)
Yes, an association has been noticed. My friend, HW member "Nomar Lupron," survived prostate cancer only to succumb to what I suspect was melanoma.

Personal History of Prostate Cancer and Increased Risk of Incident Melanoma in the United States

Keytruda is an immunotherapy active against a few cancers that express a protein called PD-L1
Posted 6/20/2017 8:46 PM (GMT 0)
https://www.youtube.com/watch?v=1N39Z0ODeME
please check this out, you can contact them.
Posted 6/22/2017 5:27 PM (GMT 0)
You mentioned that Dan's liver mets were biopsied - were they looking for MSI-H? It wasn't clear from the gene testing info.

It's a long shot, but if Dan turns up MSI-H that qualifies him for Keytruda right away. Email me if you want more info.
Posted 6/22/2017 6:24 PM (GMT 0)
Dan had liver mets biopsied in January at MD Anderson, but they didn't test for MSI-H at the time. Testing is being done now, so we have our fingers crossed for that. Congratulations on starting Keytruda! Hope you get the great results other have. I'll be watching.
Mary
Posted 6/22/2017 7:12 PM (GMT 0)
Thanks Mary, and good luck to you too. Seems odd to be wishing for Dan's gene testing to turn up extra mutated (the doc told us that's basically what MSI-H means), but that's what I'm doing.
-- Carolyn
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