FCR: Every Thing You Have Ever Wanted to Know
For a majority of patients with CLL and needing therapy, FCR chemoimmunotherapy combination is very much an option. A number of recent clinical trials have confirmed the value of this chemoimmunotherapy combination and many oncologists now consider this combination the “gold standard”. But like all things having to do with CLL, there are a lot of details you should know before you make the decision to go for this acknowledged “big gun”.
For example, how many cycles of therapy should you have? Most protocols call for six (monthly) cycles, but is that a carved in stone number? Who is most likely to benefit? What are the adverse effects that you can expect? Should you be on any prophylactic medications before, during and after the FCR therapy? Are you better off with lower chemo dosage versions like FCR-Lite? Is PCR indeed a kinder and gentler version of FCR? Is FCO a better choice, where the new monoclonal antibody Ofatumumab (Humax-CD20, brand name “Arzerra”) replaces Rituxan? How about life after FCR, for those that have relapsed after their FCR remission? As you can see, many important questions; and we will attempt to cover as many of them as possible at our next CLL Workshop.
- The workshop will be held on Saturday, August 14, 2010, 1:00pm – 5:00 pm in Columbia, Maryland.
- Only patients and their care givers who are registered members of Updates may participate. No drug or healthcare industry representatives, please!
- Click on the “Register” button below if you wish to attend.
- There is no charge for attending the workshop. CLL Topics and Updates are run entirely on voluntary donations. Everything we do depends on the generous support of our patient community.
- As before, we will keep your registration information confidential; there will be no recording of any kind of the workshop, no name tags etc. You can disclose as much (or as little) about yourself as you wish during the discussion session. As I did after our first workshop, I will publish my slides and discussion notes on this website for the benefit of those that cannot attend our workshop.
If the last workshop we held was any indication, I expect this one will be a very interesting one as well. Last time we discussed general issues. This time around, we get down to the nitty-gritty details of the single most important chemoimmunotherapy regimen to have made its debut in the last decade. Seating is limited in our rented conference hall, so please register as soon as you can. We will cut-off further registrations after we have reached our maximum capacity.
This is going to be the last Workshop for 2010 since I will be heading back to India in September for a six month visit to take care of my elderly mother. Fortunately I have broadband internet access at my Mom’s house and you won’t even know I am gone – except when it comes to face-to-face meetings like this.
I look forward to seeing some of you at the workshop.
Registration is complete at this time.
12 comments on "Is FCR in Your Future?"
I wish you well for this workshop, as I consider that FCR has given me my life back – at least for a few years, and I’m grateful for that.
As regards CAVEATS, NEVER have FCR without prophylactic antivirus drugs – Shingles isn’t funny. And be aware that there may be other side effects – I can’t be certain it’s down to FCR, but my short term memory is slightly worse than it was (which can be annoying to good people who’ve told me things I’ve subsequently forgotten).
I dont know if you’ll ever hold a workshop in the UK, but all being well I’d come if you did.
Best wishes also for your Chaya, and to your Mom. I know what caring for an elderly relative at a distance is like….
I am not certain we can attend, but I would like to echo Mr. Hanney. My husband got FR, not completely successfully, with only Bactrim as prophylactic medication. His case of shingles was/is awful…he is still on 1200 to 1800 mg of neurontin and it has been almost a year – he broke out September 23rd – he remembers the date.
When you discuss the “flavors” will you include just FR? That is the Ohio people, isn’t it? And FCR is MD Anderson?
Please have a safe trip to India.
I had FCR eight years ago, at the age of seventy with no other health problems, and am still in remission and enjoying the best health in years–e.g. many fewer infections. Obviously, it was the right treatment for me. I think that in the time that has passed the doctors are better able to identify who will benefit; if not, that’s what they should be working on.
Have a good discussion–would that we all could participate.
This Workshop will be very hepful that will take many benefits.
The subject at discussion is one of the most important for the majority patients with CLL.
The more we know,the more we can make informed decisons.
Thank you Chaya for your wonderful work.
Jorge/Ana
Good luck with your Mum, Chaya. She lucked out to have such a compassionate daughter as you.I just got back from a holiday with my 81 year old Mum and it was so good to actually be with her, rather than worrying about her from a distance.
Really good to hear of such positive remission times from cathienicholl for FCR, long may it last, shingle free.
Hi Chaya,
May I have your suggestions on what articles in “updates and archives” would be good to review prior to the workshop? As you know, I am new to CLL.
For example:
http://updates.clltopics.org/1282-chlorambucil-vs-fludarabine-which-is-better
I am still getting familiar with the ‘language’ of CLL. The comments in this article from the patients and your responses to them were very helpful in clarifying the discussion.
Thank you for your reply.
db
I am looking for someone who would like to share a ride from the Tidewater region of Virgina going to the August meeting in Columbia, MD. I will be visiting my father in the VA Beach area, but I can drive to meet someone in the Newport News, Norfolk or Hampton area as well.
My other option is to take the Amtrack into Washington,D.C and offer to share expenses to with someone to travel from the train station to the meeting. If anyone is interested, please contact me:
Rita Krasnow
KrasnowJ@aol.com
Dear Chaya,
God bless you and thank you for your clarity on this copmlicated medical condition. I am 60 years old and underwent FCR in 2007. Six months later I relapsed and began a clinical trial with Dastatinib,(Bristol Myers Sprycell). A two year trial that ended due to the complications of a serious fluid build up in my chest and lungs .While this treatment somewhat stabalized the CLL it had many unpleasant side effects.We are now in a watch and wait cycle for 6 months . Yesterday my PLT count was 63 and I will need to start some treatment soon .I am treated at MGH in Boston.The next trial option is a combination of FCR and Dastatinib .There are no gentle treatments for CLL and I wonder how long can I poison my body and what will I loose by doing so ? Thanks for listening and for ALL you do for us.
Mike D
I am 52 and after being diagnosed with CLL 4 years ago had my first round of FCR. My white cell count dropped from 384,000 to 7,000. This seems like an amazing result. I feel great!
Tomorrow I start my second round. Why is it necessary to take more chemo. Aren’t I at risk for killing good white blood cells, red cells and platelets? If I’m in the normal range now, why don’t they wait to see whether I climb higher again before more treatment?
Dad4kids:
You may want to read an earlier article on Updates titled “How much chemo is too much?” http://updates.clltopics.org/2036-how-much-chemo-is-too-much
I strongly suspect you are not close to a “CR” (complete response) after just one cycle of FCR. If you stop now, chances are that in a matter of months the numbers will start to creep back up – end of a very short lived remission.
The point of continuing with the monthly cycles is to get a far deeper clean-out of the CLL cells and thereby increase your chances of a long lasting remission. Dipping your toe in the water with multiple therapies in quick succession is the surest way of becoming resistant to many of the drugs involved – which leaves you with few options left when the CLL really gallops ahead full speed.
I do not know your specific situation. But what you are suggesting (stopping FCR therapy after just one cycle) is probably not something you should do, not without serious consultations and frank discussions with your doctors. Just my two cents.
A.Fredrick
It is very timely to have just rejoined CLL Topics because three weeks ago I had my first FCR cycle after nine years of some rituxen maintenance; then Cytoxan-Rituxen-Prednisone; then Fludarbin-Mitoxantrone-Dexamethazone. Before I started the FCR three weeks ago, I saw a very good Infectious Disease doctor who understands cancer. I have severe Bronchiectasis, and have been on infusions, twice daily, of Aztreonam for 40 days. I started with Vancomycin as well, but stopped at day 19 because of side effects. I’ve also taken Clindamycin orally. After three cycles of FCR, I’m recommended to consider stem cell transplantation if my lung disease is under control. If so, I’d have two more cycles of FCR before stem cell transplant. To be sure, stem cell transplant sounds great if it works, but I’m apprehensive of doing it. I want to know about any statistical data on successes, side effects, and deaths from stem cell transplants for a person age 68.
A. Fredrick:
we have several articles about allogeneic stem cell transplants (“mini-allo” transplants) both on this website as well as our flagship website http://www.clltopics.org. You can search for them using the search box at the top right hand corner of the websites. Lots of details to understand, this is a complicated decision and it is important to understand the pros and cons.
Good luck!
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