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Title : Surgery, Avastin or Study Drug Abemaciclib ?
link : Surgery, Avastin or Study Drug Abemaciclib ?

Surgery, Avastin or Study Drug Abemaciclib ?

My husband (54yr.) is ~12 months post total surgical resection of GBM unmethylated (got standard treatment of radiation, temodar, and additional 1 mo. of  study drug -IV plerixafor-to enhance radiation effects) Over the past 4 months. MRI is showing increased changes that appear to be evolving treatment changes probably from Plerixafor enhancement of radiation  (+ more swelling) and it appears ther could be a small nodule of  GBM tumor recurrence. His symptoms have also increased (some speech stumbling, small focal seizures, plus a grand mal).  Thus he was put on dexamethasone (steriod 4 mg twice daily (now down to 6mg daily)  and increased Keppra from 2000mg daily to 3000mg daily) .  Next the NO wants to start Avastin (the NO is NOT for surgery).  We are trying to decide on a few options and will get one more MRI  and possibly PET CT to see if tumor recurrence is more definitive.

Choices:
1.  If MIR confirms additional growth, then Surgical removal of tumor first (surgeons recommendation)
2.  Avastin for swelling and to shrink tumor and perhaps add on Optune (NO's recommendation)
3.  2nd opinion of NO at UCSF site suggests Study drug Abemaciclib  due to gene testing of my husband's tumor pathology that shows CDKN2A, CDKN2B.  If we take this route then NO AVASTIN can be used.

Trying to figure out best option for highest functioning and quality of life. 

Your Thoughts Appreciated.

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