Thank you for your information and your encouragement. I will pass on this information to my sister and brother-in-law. Currently, he is being offered a clinical trial with 3 groups each receiving different meds. Group A receives Epiurubicin, Cisplatin, Fluorouracil and Cetuximab. Group B receives Cisplatin, Irinotecan and Cetuximab and Group C receives Oxaliplatin, Fluorouracil, Leucovorin and Cetuximab. Has anyone out there participated in this clinical study or had experience with these drugs? We are hopeful that when he meets with specialists at Cleveland Center and Duke that they may offer a treatment plan. It is encouraging to hear that some centers will treat stage 4 and consider surgery later. Is there a reason why the clinical trial would not include chemo and radiation? We are still so new to all of this and have so many questions. God Bless all of you for assisting others in need.