FC:AI ONE VIEW · v1.1
Russ Read-Barrow
Bath, UK
No known drug allergies · WHO performance status 0
No known drug allergies · WHO performance status 0
CORRECT AS AT
21 OCTOBER 2026
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21 OCTOBER 2026
Check the QR code for the latest version
Stage
IV
Metastatic
CEA
47.3
ug/L · 12 Oct 26 · ref 0–5.2
Cycle
5
of this block · 17th FOLFIRI+cetux overall
WHO PS
0
Fully active · 24 Aug 26
PD-L1
<1%
TPS · negative
Diagnosis
Moderately differentiated adenocarcinoma, rectosigmoid colon
ypT4a ypN1b (3/24 nodes) M1a V+ · Treatment began Dec 2021; primary resected Mar 2022
Where it is now: Lungs · mediastinal lymph nodes · liver segment VII (new, Jul 2026)
- Smouldering myeloma (diagnosed end of 2021, under haematology surveillance)
- Gilbert's syndrome (can raise bilirubin)
Molecular profile EXACTA report, 1 Sep 2025
KRAS/NRAS wild-typeBRAF wild-typepMMR / MSSHER2 IHC 0TMB-low · 3 Mut/MbPD-L1 <1% (22C3, 28-8)APC
p.S1415Rfs*4PathogenicFrameshift · tissue MAF 8.5% · cfDNA 0.62%
TP53
p.R342*PathogenicNonsense · tissue MAF 9.21%
VUS: RUNX1T1, FANCM, CIC, BCR, CYP2D6. Exploratory (Astron/ICC): MTOR and VEGFR1/2 protein positivity, HMGB1 overexpression
Current treatment 14 days cycles
FOLFIRI + cetuximab (rechallenge, 3rd block)
C119 Aug 26
C22 Sep 26
C316 Sep 26
C430 Sep 26
C514 Oct 26
C6TBC
Cetuximab500 mg/m²1000 mg
Irinotecan180 mg/m²400 mg
5-FU bolus400 mg/m²900 mg
5-FU infusion (46h)2400 mg/m²5000 mg
Folinic acid350 mg
Full doses, dose-banded · BSA 2.08 m² (84.5 kg, 185 cm, 16 Sep 26)
Plan: 8–12 weeks, then consider maintenance 5-FU + cetuximab if response is good. CT the week of 2 November, results 9 or 10 November.
CEA tumour marker ug/L
FOLFIRI + cetuximab blocks · 19 readings, Apr 2025 – Sep 2026
Key bloods 12 October 2026
Haemoglobin129 g/L LOW130–170
Red cells4.13 ×10¹²/L LOW4.40–5.80
White cells9.79 ×10⁹/L3.0–10.0
Neutrophils6.84 ×10⁹/L2.0–7.5
Lymphocytes1.95 ×10⁹/L1.2–3.65
ALT30 U/L10–50
AST39 U/L10–50
ALP190 U/L HIGH30–130
Bilirubin14 µmol/L0–20
Albumin44 g/L35–50
Globulin35 g/L19–35
Creatinine72 µmol/L59–104
eGFR>90 mL/min/1.73m²
Magnesium0.86 mmol/L0.7–1.0
Potassium4.0 mmol/L3.5–5.3
Adjusted calcium2.47 mmol/L2.2–2.6
Latest imaging
23 Jul 2026 · CT chest, abdomen & pelvis
Progression above and below the diaphragm, and a new liver metastasis
CT report, 23 Jul 2026, compared with May 2026
Before that: 12 May 2026, CT chest, abdomen & pelvis: “Good response to treatment within the mediastinum and lungs.”
Treatment history
- Dec 21–Feb 22Neoadjuvant XELOX ×4 · good partial response
- Mar–Oct 22Primary resected · liver met resected (R0) · adjuvant CAPOX
- Oct 22–Apr 23Lung mets appear, progress · SABR 55 Gy/5
- Jun & Aug 24Lung ablations (1 left, then 1 left + 4 right)
- Feb 25EBUS confirms mediastinal nodal disease
- Apr–Jul 25FOLFIRI + cetuximab ×6 · good partial response
- Feb–May 26Rechallenge ×6 · good response (CT 12 May)
- Jul–Aug 26Progression during the break · FOLFIRI + cetuximab restarted 19 Aug
Medication & protocol Current meds · 21 Oct
Chemo dayStandard pre-meds (Akynzeo, dexamethasone, chlorphenamine, atropine) · pegfilgrastim 24h after
SupportiveDexamethasone ×3 days · domperidone · loperamide · doxycycline + Plazon (skin) · Laxido · antihistamine · zopiclone PRN
OtherCitalopram 30 mg (breakfast) · melatonin 60 mg (evening) · metformin MR 500 mg twice daily (from cycle 5 day 7) · loratadine 10 mg
PausedMistletoe and most supplements / off-label drugs, during chemo on my oncologist's advice
What's next
- CT scan the week of 2 November.
- Results 9 or 10 November.
- Then the decisions: treat the liver lesion (surgery or ablation)? Continue, or step down (drop irinotecan)? What's the next line?
Know this profile? Patients with similar disease, oncologists, scientists and geneticists — I want to hear from you. Not generic advice, please.