Wednesday 17 January 2018

A difficult choice of treatment for a large progressive GBM after chemoradiotherapy

From some studies it follows that:
- Avastin in the first line increases the quality of life and survival for partially resected GBM;
- combination of CCNU + Avastin is more advantageous than just Avastin for MGMT-methylated GBM;
- I can not also not use TMZ immediately after chemoradiotherapy, especially after CeTeg results for MGMT-methylated GBM;
- low Avastin dose (<3.6 mg / kg / week) with Telmisartan, is more beneficial than the Avastin standard dose and will not be so toxic for use with CCNU + TMZ.

As a result, after sleepless nights, I decided to try this combination:

The cycle of 42 days:

0 day - Verapamil 240mg, Disulfiram 500mg, Copper 4mg, DHA 1200mg
1 day - Avastin 6.5 mg / kg
1 day - Lomustine 75 mg /m2 (+ Verapamil 240mg, Disulfiram 500mg, Copper 4mg, DHA 1200mg)

2-6 days - Temozolomide 90 mg/m2 (+ Verapamil 240mg, Disulfiram 500mg, Copper 4mg, DHA 1200mg, Curcumin 2000mg)

7-41 days - Telmisartan 40-80mg, Disulfiram 300mg, Copper 2mg, DHA 900mg)

15 day - Avastin 6.5mg / kg
29 day - Avastin 6.5mg / kg
42 day - Verapamil 240mg, Disulfiram 500mg, Copper 4mg, DHA 1200mg

+ every day Melatonin/Agomelatin, Berberin, Shark Oil, Oxaloacetate, Honokiol...
If possible, DCA will be added 6mg / kg / twice every day.
If possible, the doses of CCNU and TMZ in the next cycle will be increased.

7 comments:

  1. This seems reasonable to me, given her MGMT-methylated status. I see you are alternating verapamil around the time of CCNU, with telmisartan in between CCNU cycles. Are you able to have her blood pressure monitored?

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    1. 2 days as an experiment, my mother drank Verapamil every 1.5-2 hours for 40 mg (total 240mg). Her blood pressure 110/70 did not fall even lower. So, we will try to take even more Verapamil.

      And we have a small change in the cycle, which is not so important - my mother took the first dropper Avastin a few days ago.
      Today before going to bed, she began lomustine and the first day of the cycle.

      Unfortunately, we had to cancel all other supplements: metformin, dca, chloroquine + sirolimus, celebrex due to a severe allergy (rashes all over the body). First of all, we'll try to return DCA.

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    2. I also had rashes appear all over my legs some time ago, while being on supplements and metformin. If I remember correctly, I started low dose naltrexone in that time.
      It turned out to be Pigmented purpuric dermatosis
      ( https://en.wikipedia.org/wiki/Pigmented_purpuric_dermatosis ), which went away on its own.

      I researched the rashes back then and another possibility was paraneoplastic syndrome, which "is a syndrome (a set of signs and symptoms) that is the consequence of cancer in the body, but unlike mass effect, is not due to the local presence of cancer cells. In contrast, these phenomena are mediated by humoral factors (such as hormones or cytokines) secreted by tumor cells or by an immune response against the tumor."
      Check https://en.wikipedia.org/wiki/Paraneoplastic_syndrome and Dermatomyositis, which is mucocutaneous type of paraneoplastic syndrome: https://en.wikipedia.org/wiki/Dermatomyositis

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  2. Stephen, Matjaz,
    sincere thanks to you for your attention and support!

    1. We have the 3rd day of drinking Verapamil every 1.5 hours at 40mg. Just a day 280 mg. No effect on mother's low blood pressure! On the contrary, surprisingly, low blood pressure returned to normal and became 120/80 after Verapamil!

    2. Our doctor said that the best way to take Temozolomide is to get up at 4am, take Temozolomide with water and go to sleep again.
    Although the instructions simply say what to take one hour before eating.

    3. I chose these brands of food additives for disulfiram (copper and DNA). I'm not sure that this is the best choice:
    https://www.iherb.com/pr/solgar-chelated-copper-100-tablets/41330
    (Copper as copper glycinate amino acid chelate†)
    https://www.iherb.com/pr/Jarrow-Formulas-Max-DHA-180-Softgels/252

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  3. Hi all,

    I was wondering if anyone has experience taking the perillyl alcohol (POH) mix via intranasal as well as the disulfiram at the same time? Is this safe to do so?

    My dad has been taking the POH and I want to start giving him the disulfiram, but not sure if its safe to do so as I read many times that you must not consume alcohol (given there's ethanol in the POH mix).

    Any insights/comments would be much appreciated!

    Thanks
    Elsa

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    Replies
    1. We did not use perillyl alcohol on disulfiram intake days and for several days after it.

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    2. This comment has been removed by the author.

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