3d Line Chemo Followup

Dr Goodman.  Thank you for your responses on my prior posts.  An update on  my mom's 2d Recurrance chemotherapy.

3d line(3 Cycles) Gem: 1gm/m2  (total dose 1600mg on D1 and D8) Avastin 400mg q15 days Oxaliplatin 130mg / m2 ( 200mg D1) .  

CA Came down from 185 to 29 and PET CT showed significant reduction of size of tumors.

Continued with the same regeim for 3 more cycles but dose reduced (Gemzar and Oxaliplatin) by 20 % due to febrile neutropenia after initial 3 cycles.  

CA Came down from 29 to 11
PET CT: Showed resolution of subcarinal lymphnode and cervical lymphnodes. Significant reduction of peritonial deposits from prior study, peritoneal deposit along the hepatic surface now measures 1.3 x 1.823 earlier (1.8 x 2.8 & 2.3 x 3.2) and NO ACTIVE DISEASE on the scan based on SUV uptake.

Her oncologist told us that he is very happy with her response and reports and wants to stop all treatment for now and has askes for a 3 month followup with a CA-125 test.

(1) Is No evidence of active disease same as no evidence of disease?
(2) Initially he had told us that he might continue Avastin after her treatment but did not consider this necessary for now.  What do you think about this?
(3)  Are the tumors considered dead if their is no SUV uptake and is this sufficient to stop any futher chemotherapy?

[Annekathryn Goodman, M.D.]

Hi There
thank you so much for the update

it is possible that currently, your mother is in remission.
there is alot of controversy about whether avastin is reasonable. In the absence of seeing any disease, it may be reasonable to wait and use avastin when she recurs again.

with her low blood counts it does make sense to take a break.

I suspect she has some live cancer cells that are too small to see on the scan. It is unlikely that all the tumor is dead. But this is a good time for her to recharge for the next time she needs chemotherapy.

best wishes