65yr female with metastatic poorly diff esophageal adeno who is progressing after 3 months of FOLFOX/nivo with overt intra-abd disease. Caris- MET amplified, PDL1 60%, Her2 0, ARID1A and RHOA mutated. What would you offer next? Excellent PS.
she also has a non-occlusive IVC clot. Would you avoid ramu in that case?
thats really unfortunate to hear. outside of a study would do taxol + ramu (if no major neuropathy for FOLFOX ) or FOLFIRI + ramu. if you had local study for new MET inhibitor that'd be interesting to pursue, prior studies didn't show benefit so maybe that in 3rd line?
if bland thrombus that is being anticoagulated, I don't see that as a reason to avoid ramu.
