Client Story

Metastatic BRAF-Mutated Colorectal CA 

A father and son hiking in the woods

Presentation

A 43-year-old client, sponsored by his employer, established care with PHM after being diagnosed with metastatic colorectal cancer, with a BRAF V600E mutation and a prognosis of approximately 18 months.

He experienced a partial response to his first-line chemotherapy regimen of FOLFOX and Avastin and was nearing the end of his 12-cycle treatment.

Seeking guidance on the best next steps, his stated goal is to eradicate the disease, even if it affects his quality of life, and he is hopeful for a surgical option.

“I’m not leaving this Earth without trying my damnedest.” 

PHM Actions

PHM presented a range of treatment options, discussing regimens with the best evidence and outcome data, as well as potential clinical trials. Utilizing established relationships with targeted therapy experts, PHM arranged an international virtual consultation at no cost.

The team identified an aggressive trial at the NIH and coordinated virtual screening meetings, which the client was excited about.

PHM collaborated with the local provider to advocate for necessary imaging, including a PET scan, MRI of the liver, and repeat biopsy and sequencing.

Additional support included a consult with Child Life Services to help the client and his wife communicate his condition to their four children, ages 4 to 16. PHM also identified an acupuncturist and provided guidance on managing neuropathy, a common side effect of chemotherapy.

Outcome

This client expressed significant excitement around an aggressive clinical trial we identified at the NIH, and is seeking enrollment:  

Surgery: resection of primary colon tumor and debulking of liver disease (can harvest for TILs), placement of hepatic arterial pump  

Subsequent initiation of floxuridine (FUDR) infused into the hepatic artery (HAI); addition of investigational IL12 cytokine via HAI  

Layer on systemic chemotherapy (FOLFIRI) 

The PHM Difference

This young father of four expressed ambitious care goals, and PHM was able to identify “shoot for the moon” options, educating him on the trade-offs between evidence-based therapies and investigational approaches. This provided a glimmer of hope for his family.

A mother and daughter laugh in nature.

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