Dear all,
One month after finishing radio/ chemo of my father, we had done an MRI that shows both bigger tumor and lots of edema.( We increase dexa to 8 mg and I stop boswellia and curcomin because of " foci of hemorrhage", which I deeply regret doing that. Then around 16 days ago he found a ptosis in his left eye and pupiledema in the other eye. We add dexa to 16 for 3 days and acetozolamid (2*250). Left eye still has lots of problem and my father is sleeping most of the time. I start the supplements again.
Now in our meeting with our NO he said that we should take avastin 10 mg/ kg and temodal (second cycle) still 150 mg/ kg.
I was very interested in avastin before I have a more serious look of previous discussions here.
1) I really need to know whether it is not too much avastin to take with temodal? 5mg or 2.5 would not be more wiser?
2) if it be a pseudo-progrresion should we stop right after control of edema? and if the egfr is amplified would it harm to take few dose even fore controlling edema?
I have to decide in two days about dosage and I really appreciate any suggestion. (P.s. today I painfully found that there are few labs doing mutation tests here and I wasnot aware! I will do the mgmt, egfr amp. and cmv tomorrow. Could not convince the NO to write more test!)
Thanks in advance
One month after finishing radio/ chemo of my father, we had done an MRI that shows both bigger tumor and lots of edema.( We increase dexa to 8 mg and I stop boswellia and curcomin because of " foci of hemorrhage", which I deeply regret doing that. Then around 16 days ago he found a ptosis in his left eye and pupiledema in the other eye. We add dexa to 16 for 3 days and acetozolamid (2*250). Left eye still has lots of problem and my father is sleeping most of the time. I start the supplements again.
Now in our meeting with our NO he said that we should take avastin 10 mg/ kg and temodal (second cycle) still 150 mg/ kg.
I was very interested in avastin before I have a more serious look of previous discussions here.
1) I really need to know whether it is not too much avastin to take with temodal? 5mg or 2.5 would not be more wiser?
2) if it be a pseudo-progrresion should we stop right after control of edema? and if the egfr is amplified would it harm to take few dose even fore controlling edema?
I have to decide in two days about dosage and I really appreciate any suggestion. (P.s. today I painfully found that there are few labs doing mutation tests here and I wasnot aware! I will do the mgmt, egfr amp. and cmv tomorrow. Could not convince the NO to write more test!)
Thanks in advance
The main problem with the retrospective studies showing efficacy of lower dose Avastin, is that patients weren't randomized to standard dose or low-dose, so there may have been selection bias influencing the outcomes. Did patients with more aggressive tumors get standard dose and patients with less aggressive tumors get lower dose in those studies?
ReplyDeleteI would probably start off with standard dose Avastin until the tumor progression and edema is brought under control, then you could perhaps lower the dose later.
2) I don't think there is harm in taking Avastin if EGFR is amplified, there is just an association with less chance of being effective, but it would still be worth trying.