I had a radiation & excision of a myxoid liposarcoma tumour last year. I was NED for 10 months until I had back problems which turned out to be a recurrence & bone mets. As it turns out it was 'just hiding'. So I'm looking at my options for palliative chemo or immunotherapy.
My oncologist has ordered gene testing to establish the PD1 possibilities. My first oncologist wanted dox/ifos so I went for a second opinion. Dox/olara was approved in the UK June of this year but isn't yet in Ireland where I am. There are options but they mainly seem to be approved as second line treatment after anthracycline.
A lot depends on the outcome of the gene testing but I'm considering self funding olaratumab (dox is covered by insurance) as a first line. I'm 35, no underlying conditions & no mets anywhere other than my lumbar, so I'm as able as I'm ever going to be for a hard chemo regimen.
Playing the long game here, I'm considering this as my first step so I don't have any more problems than necessary with approval for second line treatments which have been mentioned like trabectedin, pembrolizumab & various others. Most seem to require previous anthracyclines & I don't want to have to battle for each new drug when the time comes. Time & relative health are on my side now so I don't want to paint myself into a corner.
Hypothetically where would you start? Dox/olara & then move onto the less debilitating & perhaps more promising lines of treatment? Or go straight to the PD1 route?
My onc is all about immunotherapy which is great but I have to think about funding & approvals & using my current health to my advantage in the long run.
Any suggestions or advice?