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NSCLC adenocarcinoma KRAS G12D - treatment strategy


AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

Hi Daniel,

I am so happy to have found your page. I am the support person for my mother, who has stage 4 NSCLC adenocarcinoma KRAS G12D. I have been studying how to best treat her since I discovered that people are finding help via off-label drugs and supplements several weeks ago. I have some questions, I was hoping you could help me.

First, she is due to get her last chemo/immuno combination of carboplatin/pemetrexed/Keytruda on Monday and then is supposed to continue along with Keytruda and pemetrexed. She has had GI problems recently and doesn’t feel as if her gut health is great, so she was thinking it might be best to stop Keytruda and just continue on with the pemetrexed - or stop altogether. If it were your mother, would you have any advice? She has been in the hospital for various problems after chemo/immuno for two out of the three so far, and certainly wouldn’t mind stopping, but I don’t have much experience in this area. Do people do well with just pemetrexed or nothing at all, just repurposed drugs and supplements?

Next, I have read in various medical journals that NSCLC adenocarcinoma is an estrogen-driven cancer. In your understanding, is this true? And if so, is it true that someone with an estrogen driven cancer should stay away from Resveratrol, Milk Thistle, Black Seed Oil, and other supplements that may exacerbate the cancer to produce more tumors?

I also wanted to ask what main off-label drugs and supplements you would typically prescribe for NSCLC adenocarcinoma KRAS. I have a list I have been working on, but I would love some confirmation of what you think are the most important drugs and supplements... of what you think would be a great strategy. This is so hard. I am so thankful there are people like you (and specifically, you) out there helping people.


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

Sorry if I wrote this just to Daniel. I’m new here and don’t really know how this forum works. I’d truly love to hear from anyone who might have any insight on this!

Here is a theoretical plan, if anyone has any feedback on it, I’d be very thankful to hear.

 

NSCLC Stage 4 Adenocarcinoma KRAS G12D Mutation

Between meals apart from supplements, each once a day

  • Cranberry and Pomegranite juice, diluted for sugar
  • Tea from ND Green Tea Liquid Extract with Resveratrol (1/2 tsp. = 2.2g)

2 hours Before Breakfast

  • Claritin/Loratidine (1 tablet @10mg)
  • B Supreme (1 capsule @ 100mg Thiamin + 50mg Riboflavin + 50mg NE Niacin + 50mg B6 + 340mcg DFE Folate + 250mcg B12 as methylcobalamin + 2000mcg Biotin + 100mg Pantothenic Acid + 30mg Choline + 200mg Trimethylglycine)
  • Optiflora Probiotic (1 capsule @10 billion CFU)
    • OR SHOULD I USE ProbioMed 50 (1 capsule @50 billion CFO)
    • OR SHOULD I USE ProbioMed 100 (1 capsule @100 billion CFO)
  • Metamucil (heaping teaspoon) - can interfere with Metformin - don’t take at the same time

Breakfast and Dinner

  • 1 tablespoon EVOO
  • Antiparasitic
  • Hi-Po Vitamin A (1 drop @2500mcg RAE)
    • TOO MUCH? SHOULD THIS BE USED AT ALL? IF SO, ONLY AT BREAKFAST?
  • E Annatto Tocotrienols - 90% delta and 10% gamma (1 softgel @300mg)
  • EGCG (1 capsule @225mg)
  • Liposomal Vitamin C (as Sodium Ascorbate) (2.5ml @ 200mg/ml = 500mg)
    • OR SHOULD I USE Stellar C (1 capsule @ Vitamin C (as Ascorbic Acid and Acerola) 600mg = Acerola w/25% Vitamin C + Citrus Bioflavenoids w/50% hesperidin + Rutin 50mg + Quercetin 50mg)
  • Full Spectrum CBD Oil 
    • Dinner: Onco-Adjunct (2 dropper squeezes = 4ml Frankincense Essential Oil 250mg + Total Full Spectrum Hemp Cryogenic Extract Cannabinoids 250mg + Holos Nano MCT 500mg + Cannabigerol 7mg)
    • Breakfast: Charlotte’s Web 60mg Full-Spectrum CBD (.5ml @ 60mg/ml = 30mg)
  • Onco-Adjunct (1 capsule @ Curcumin Complex 300mg + Quercetin Complex 200mg + Frankincense 100mg)
  • Onco-Adjunct (1 capsule Whey Protein - Berberine Complex 600mg)
  • Resveratrol Supreme (1 capsule @ Trans-Resveratrol 200mg + Quercetin 200mg)
    • WITHHOLD FOR POSSIBLE ER+ CANCER?
  • Omega 3 (1 softgel @1.2g fish oil concentrate = 1g Omega 3 Fatty Acids = 662mg EPA + 250mg DHA)
    • DO I NEED ONE WITH HIGHER PERCENTAGE DHA?
  • DFH Twice Daily Multi (1 capsule)
  • Mushroom
    • Breakfast: Real Mushrooms Turkey Tail (1 capsule @500mg)
    • Dinner: Real Mushrooms Reishi (1 capsule @500mg)
  • Mushroom Blend (1 capsule @600mg = 75mg Reishi blend + 75mg Chaga + 75mg Lion’s Mane + 75mg Cordyceps Blend + 75mg Maitake + 75mg Shiitake + 75mg Agaricus + 75mg Turkey Tail)
  • Liver DTX (1 caplet @ 100mg Milk Thistle Extract + 300mg proprietary blend of Schisandra extract, Dandelion extract, Reishi mushroom extract, Turmeric extract, and artichoke extract)
    • WITHHOLD FOR POSSIBLE ER+ CANCER?

Lunch (TRY NOT TO GIVE AS MANY SUPPLEMENTS AT LUNCH SO AS TO GIVE THE BREAKFAST SUPPLEMENTS TIME TO PROCESS THROUGH THE LIVER???)

  • Atorvastatin (1 pill @10mg)
  • Metformin HCL (1 pill @500mg)
  • Omega 3 (1 softgel @1.2g fish oil concentrate = 1g Omega 3 Fatty Acids = 662mg EPA + 250mg DHA)
    • DO I NEED ONE WITH HIGHER PERCENTAGE DHA?
  • Hi-Po D3 (3 drops @2000iu/drop = 6000iu)
  • Vitamin K (1 softgel @2500mcg)
  • Liver DTX (1 caplet @ 100mg Milk Thistle Extract + 300mg proprietary blend of Schisandra extract, Dandelion extract, Reishi mushroom extract, Turmeric extract, and artichoke extract)
    • DOES THIS HAVE MORE BENEFIT OR DETRIMENT TO THE LIVER BY BEING HERE? IE THIS HELPS THE LIVER BUT ALSO GIVES IT MORE TO PROCESS?
    • WITHHOLD FOR POSSIBLE ER+ CANCER?

.5 - 1 hour before Bedtime

  • Melatonin (working up to 20mg)

 

Any thoughts on this, any answers to the questions I have asked, any suggestions or concerns would be greatly appreciated. Thank you so much.


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

I can’t find a way to edit the above post; but I did want to add that the theoretical plan above is not medical advice and I am not a doctor of any kind. The plan was made with one person in mind and hasn’t been utilized.


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

I also wanted to edit to take out the brand names I failed to remove, as I am not interested in promoting any business, but in getting feedback for the actual combinations, dosages, timing. Sorry.


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 

@abidingtoday 

Gut health is crucial and especially butyrate dysbiosis:

The association between gut butyrate-producing bacteria and
non-small-cell lung cancer.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/jcla.23318

Effect of sodium butyrate on estrogen receptor and epidermal
growth factor receptor gene expression
https://pubmed.ncbi.nlm.nih.gov/1517234/

Dose for sodium butyrate: 3 to 5 grams twice a day. I'd alternate

with tributyrin. 

Blog post (my blog) on Butyrate:
https://synergiesforcancertreatments.blogspot.com/p/butyrate.html

EGCG
https://www.nature.com/articles/s41598-020-62136-2
You'll need a higher dose, a single 225mg capsule is not going to
do much.
Clinical trial using 3200mg/day in combination with milk thistle (2700mg)
https://clinicaltrials.gov/ct2/show/NCT01239095
I'd take at least 800mg/day with some citrus fruit.

Gallic acid
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7186892/
(Gallic acid in foods: strawberry, grapes, blueberries, apples, walnuts)

Hope this helps and best of luck.

 


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

@johan 

Thank you so much for responding and for the helpful information.

I see milk thistle is in the study you cited for EGCG. Do you have any thoughts on how we can find out without tumor biopsy if she does have an ER+ cancer? Right now, I feel like milk thistle is the king of liver support, and I am so fearful of it making things worse. I’ve heard Tudca recommended as a replacement, but so many people haven’t even heard it it. That’s scary to me. Would upping the mushrooms help? I know that EGCG by itself, and certainly in combination with many other supplements and drugs, is very taxing on the liver. I want to find the best way to help the liver while also being certain not to promote the cancer growth!


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

@johan 

 

Also, is butyrate dysbiosys the same as Tributyrin by any chance?


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

@johan

As far as Probiotics, since butyrate dysbiosis is a Postbiotic - do you think the 50 billion CFU would complement that the best?


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @abidingtoday

@johan 

Thank you so much for responding and for the helpful information.

I see milk thistle is in the study you cited for EGCG. Do you have any thoughts on how we can find out without tumor biopsy if she does have an ER+ cancer? Right now, I feel like milk thistle is the king of liver support, and I am so fearful of it making things worse. I’ve heard Tudca recommended as a replacement, but so many people haven’t even heard it it. That’s scary to me. Would upping the mushrooms help? I know that EGCG by itself, and certainly in combination with many other supplements and drugs, is very taxing on the liver. I want to find the best way to help the liver while also being certain not to promote the cancer growth!

Even if milk thistle has an estrogenic effect it's pretty weak and this might even be very good as it will compete: https://doctormurray.com/the-positive-estrogenic-effects-of-milk-thistle-extract/

 

 


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @abidingtoday

@johan 

 

Also, is butyrate dysbiosys the same as Tributyrin by any chance?

Dysbiosis is an imbalance in microbiota homeostasis, very relevant in your mom's type of cancer (and in most cancers IMO):

The association between gut butyrate-producing bacteria and
non-small-cell lung cancer.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/jcla.23318

Hence the need to supplement (sodium butyrate and/or tributyrin), use certain probiotics and make dietary adjustments.

 


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @j
Posted by: @abidingtoday

@johan 

Would upping the mushrooms help? 

 

Definitely will not hurt, you can use supplements or add plain white button mushrooms to her diet.


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @abidingtoday

Here is a theoretical plan, if anyone has any feedback on it, I’d be very thankful to hear.

 

NSCLC Stage 4 Adenocarcinoma KRAS G12D Mutation

Between meals apart from supplements, each once a day

  • Cranberry and Pomegranite juice, diluted for sugar
  • Tea from ND Green Tea Liquid Extract with Resveratrol (1/2 tsp. = 2.2g)

2 hours Before Breakfast

  • Claritin/Loratidine (1 tablet @10mg)
  • B Supreme (1 capsule @ 100mg Thiamin + 50mg Riboflavin + 50mg NE Niacin + 50mg B6 + 340mcg DFE Folate + 250mcg B12 as methylcobalamin + 2000mcg Biotin + 100mg Pantothenic Acid + 30mg Choline + 200mg Trimethylglycine)
  • Optiflora Probiotic (1 capsule @10 billion CFU)
    • OR SHOULD I USE ProbioMed 50 (1 capsule @50 billion CFO)
    • OR SHOULD I USE ProbioMed 100 (1 capsule @100 billion CFO)
  • Metamucil (heaping teaspoon) - can interfere with Metformin - don’t take at the same time

Breakfast and Dinner

  • 1 tablespoon EVOO
  • Antiparasitic
  • Hi-Po Vitamin A (1 drop @2500mcg RAE)
    • TOO MUCH? SHOULD THIS BE USED AT ALL? IF SO, ONLY AT BREAKFAST?
  • E Annatto Tocotrienols - 90% delta and 10% gamma (1 softgel @300mg)
  • EGCG (1 capsule @225mg)
  • Liposomal Vitamin C (as Sodium Ascorbate) (2.5ml @ 200mg/ml = 500mg)
    • OR SHOULD I USE Stellar C (1 capsule @ Vitamin C (as Ascorbic Acid and Acerola) 600mg = Acerola w/25% Vitamin C + Citrus Bioflavenoids w/50% hesperidin + Rutin 50mg + Quercetin 50mg)
  • Full Spectrum CBD Oil 
    • Dinner: Onco-Adjunct (2 dropper squeezes = 4ml Frankincense Essential Oil 250mg + Total Full Spectrum Hemp Cryogenic Extract Cannabinoids 250mg + Holos Nano MCT 500mg + Cannabigerol 7mg)
    • Breakfast: Charlotte’s Web 60mg Full-Spectrum CBD (.5ml @ 60mg/ml = 30mg)
  • Onco-Adjunct (1 capsule @ Curcumin Complex 300mg + Quercetin Complex 200mg + Frankincense 100mg)
  • Onco-Adjunct (1 capsule Whey Protein - Berberine Complex 600mg)
  • Resveratrol Supreme (1 capsule @ Trans-Resveratrol 200mg + Quercetin 200mg)
    • WITHHOLD FOR POSSIBLE ER+ CANCER?
  • Omega 3 (1 softgel @1.2g fish oil concentrate = 1g Omega 3 Fatty Acids = 662mg EPA + 250mg DHA)
    • DO I NEED ONE WITH HIGHER PERCENTAGE DHA?
  • DFH Twice Daily Multi (1 capsule)
  • Mushroom
    • Breakfast: Real Mushrooms Turkey Tail (1 capsule @500mg)
    • Dinner: Real Mushrooms Reishi (1 capsule @500mg)
  • Mushroom Blend (1 capsule @600mg = 75mg Reishi blend + 75mg Chaga + 75mg Lion’s Mane + 75mg Cordyceps Blend + 75mg Maitake + 75mg Shiitake + 75mg Agaricus + 75mg Turkey Tail)
  • Liver DTX (1 caplet @ 100mg Milk Thistle Extract + 300mg proprietary blend of Schisandra extract, Dandelion extract, Reishi mushroom extract, Turmeric extract, and artichoke extract)
    • WITHHOLD FOR POSSIBLE ER+ CANCER?

Lunch (TRY NOT TO GIVE AS MANY SUPPLEMENTS AT LUNCH SO AS TO GIVE THE BREAKFAST SUPPLEMENTS TIME TO PROCESS THROUGH THE LIVER???)

  • Atorvastatin (1 pill @10mg)
  • Metformin HCL (1 pill @500mg)
  • Omega 3 (1 softgel @1.2g fish oil concentrate = 1g Omega 3 Fatty Acids = 662mg EPA + 250mg DHA)
    • DO I NEED ONE WITH HIGHER PERCENTAGE DHA?
  • Hi-Po D3 (3 drops @2000iu/drop = 6000iu)
  • Vitamin K (1 softgel @2500mcg)
  • Liver DTX (1 caplet @ 100mg Milk Thistle Extract + 300mg proprietary blend of Schisandra extract, Dandelion extract, Reishi mushroom extract, Turmeric extract, and artichoke extract)
    • DOES THIS HAVE MORE BENEFIT OR DETRIMENT TO THE LIVER BY BEING HERE? IE THIS HELPS THE LIVER BUT ALSO GIVES IT MORE TO PROCESS?
    • WITHHOLD FOR POSSIBLE ER+ CANCER?

.5 - 1 hour before Bedtime

  • Melatonin (working up to 20mg)

 

Any thoughts on this, any answers to the questions I have asked, any suggestions or concerns would be greatly appreciated. Thank you so much.

@abidingtoday

I don't see any problems with any of the above supplements. And I'd definitely add the butyrate/tributyrin supplements.

You've included a few drugs (metformin, statin) that seems fine, and I'd consider LDN:

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6126779/


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

@johan

Thank you so much for your help. I’m still so new to this and it’s all so overwhelming, so getting your thoughtful feedback means a lot to me.

One thing I forgot to mention is that she has mets to spine, pelvis, sternum and skull - I’m not sure I’ve adequately included things to address that. I’ve read (I can’t remember where) not to go with calcium supplements... D and K are on the list... a lot of the drugs to help bones seem to have likely bad side effects. Her spine has compression fractures. And she had osteoporosis (I found out) even before she got sick out of the blue with this cancer just three months ago. Do you happen to know of any good supplements I’ve left off the list for addressing the bone issue? I haven’t been able to get very far in this area.


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @abidingtoday

@johan

Thank you so much for your help. I’m still so new to this and it’s all so overwhelming, so getting your thoughtful feedback means a lot to me.

One thing I forgot to mention is that she has mets to spine, pelvis, sternum and skull - I’m not sure I’ve adequately included things to address that. I’ve read (I can’t remember where) not to go with calcium supplements... D and K are on the list... a lot of the drugs to help bones seem to have likely bad side effects. Her spine has compression fractures. And she had osteoporosis (I found out) even before she got sick out of the blue with this cancer just three months ago. Do you happen to know of any good supplements I’ve left off the list for addressing the bone issue? I haven’t been able to get very far in this area.

I'm surprised it's been only 3 months. To address the bone mets you might want to include Honokiol:

https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.22551

You can check on the supplements I find most useful in cancer treatment here:

https://synergiesforcancertreatments.blogspot.com/

I would always start by increasing butyrate, it has remarkable epigenetic effects and also helps restore endogenous melatonin, which is very important IMO. And add supplements considering synergistic potential.

Finally, I'd add some magnesium, I didn't see that on your list.

Best,


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

@johan

Thanks!

Honokiol looks great, I had that on my list to research more. I’m thinking 225mg liposomal Honokial at night with melatonin?

For Magnesium - does magnesium bisglycinate buffered chelate 150mg sound good? Would that be taken before food with probiotics?

I also found a supplement called Tri-Butyrin Supreme, 300mg/day. I think it looks good? Maybe that would be in the morning with the probiotics, etc?


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

Actually 300mg for the magnesium.

The daily multi has 15mg zinc, 2mg boron, 200mcg selenium and 150mg iodine. Do those sound like enough?


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

I wanted to find just a good trace minerals supplement which included magnesium and all of the above to avoid having multiple pills for these minerals; but they basically all include copper and iron, which I believe are no-no’s for cancer - at least copper.


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @abidingtoday

@johan

Thanks!

Honokiol looks great, I had that on my list to research more. I’m thinking 225mg liposomal Honokial at night with melatonin?

For Magnesium - does magnesium bisglycinate buffered chelate 150mg sound good? Would that be taken before food with probiotics?

I also found a supplement called Tri-Butyrin Supreme, 300mg/day. I think it looks good? Maybe that would be in the morning with the probiotics, etc?

For a therapeutic dosage you'll need more, 2-3 grams Honokiol per day and in divided doses, for at least 14 days.

The magnesium is OK, more is better, chemotherapy depletes you from magnesium.

Tri-Butyrin Supreme, looks good! Tributyrin has a bit of a bad smell, not sure if this particular product has that feature, I'd take it with some yogurt, probiotics yes, and maybe some fresh orange juice.

 

 

 

 


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @abidingtoday

I wanted to find just a good trace minerals supplement which included magnesium and all of the above to avoid having multiple pills for these minerals; but they basically all include copper and iron, which I believe are no-no’s for cancer - at least copper.

Absolutely @abidingtoday, avoid iron and copper supplementation. In cases of anemia, which is a problem for almost everybody with cancer, add alfalfa to the diet (or via a supplement) and nettle tea (which is also an estrogen blocker).


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 
Posted by: @abidingtoday

Actually 300mg for the magnesium.

The daily multi has 15mg zinc, 2mg boron, 200mcg selenium and 150mg iodine. Do those sound like enough?

yes that's perfect


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AbidingToday
(@abidingtoday)
Joined: 7 months ago
Posts: 129
Topic starter  

@johan

Can I ask what brand of Honokiol you might recommend? I can’t find one that has magnolol included with the Honokiol. I read on the synergy website you listed above that Honokiol is synergistic with magnolol. That is an amazing website by the way. Is it yours?


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 

@abidingtoday 

Great question. If you look at the glioblastoma study with mice, the HONO-MAG combination showed an impressive synergistic effect. It's not easy to get pure magnolol but I'd recommend getting a quality pure Honokiol product and taking it with a good magnolia bark extract ( https://supplementhound.com/best-magnolia-bark-supplements/ ).

Yes, I started that blog over 5 years ago when my sister-in-law got sick with stage 4 ovarian cancer, to organize and document my research, and I also wanted the share the story of my father-in-law who recovered from a glioblastoma, now a 19-year survivor. 

 

 

 


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johan
(@j)
Joined: 4 years ago
Posts: 1030
 

@abidingtoday 

Dramatic response to inhaled dobesilate in a patient with lung squamous cell cancer
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4544079/

 

 


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