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    • I am not quite sure why my daughter's Dr took her off the Crizotinib after 4 months. She is a performance level of 1 with Stage IV NSCLC (ROS1+). The size of the mass in her lung had decreased but the other sites seemed stable. She apparently is tolerating the drug although the Dr has not mentioned (More)
    • Dr West This is a very complex situation that requires an individualized approach. I really can't make a recommendation on a complex case of a patient I've never met, based on scans I've never seen. Legally, I and GRACE can offer information that includes useful principles for other people, but I/we can't (More)
    • Dr West, Any thoughts? Ive already had upper right lobe removed….Met with surgeon today, good news is he can do VATS & a wedge resection on upper left lung, unless when he gets in there possible he might need to take the whole lobe and (possibility of having trouble findin (More)
    • Dr West I'm sorry, but this is really exactly what I am not able to do. GRACE is here to provide general information for patients and caregivers. I am not able to give personal recommendations on individual cases, and it is illegal for me to do so for people who are not my patient. Thank you for understandi (More)
    • Hello Dr.West, I'm writing you again hoping to give me some of your advice... Because we are facing new situation with my father (he was diagnosed with BAC-nonmucinous , CL-chronic lymphocyte leukemia and heart disease), I would really need your opinion what do you think. The blood results showed (More)
    • Hi fanos, We ROS1ers have a ROS1 cancer page hosted by the Addario Lung Cancer Foundation at We also have a closed group on Facebook named "ROS1 Positive (ROS1+) Cancer"--if you want to join, send me a message on FB and identify yourself, an (More)
    • This is to Janet Freeman-Daily who mentioned the ROS1 group. My daughter is ROS1 positive so I am interested in your group. How can I find it? I googled "ROS1 across cancers" with no results. (More)
    • Dr West We have no information to speak to that question. (More)
    • Has Selumetinib for NSCLC (ROS1 rearrangement positive) shown any promise?? How does that drug compare with pemetrexed? Are there any clinical trials or results available? (More)
    • Dr West Chemotherapy is the current leading recommendation. Many people have observed that patients with a ROS1 rearrangement often respond very well to a regimen that includes pemetrexed. -Dr. West (More)
    • Thank you for your prompt reply. If Alectinib is not recommended for 1st or 2nd line treatment--what are the possibilities for 2nd line treatment of the ROS1 rearrangement when the crizotinib fails? (More)
    • Dr West No. ROS1 is a distinct molecular marker, and crizotinib tends to work especially well for it, while several of the second generation ALK inhibitors do not, so we cannot generalize results from ALK-positive patients to those with a ROS1 rearrangement. -Dr. West (More)
    • Does this information also apply to the ROS-1 positive NSCLC Stage IV? (More)
    • Dr West I'm very sorry to hear about your mother's diagnosis and recent issues. Pneumonitis tends to come on early when it occurs, but this is an uncommon to rare side effect in a new drug that we just don't have a lot of experience with yet. It will make sense to make a very careful judgment among ever (More)
    • Dear Dr. West, My mother was placed on Tagrisso as first line agent because of some evidence of possible leptomeningeal disease on MRI after WBR and some evidence that Tagrisso at 160 worked for a few patients with it. She is being followed at the NIH. She now has a possibility of very early in (More)
    • Just as my oncologist was ready to submit my tissue for PD-l1 testing to get me on Keytruda after Alimta maintenance failed me, Oodivo was approved. We decided to save my tissue and the expense of testing since Opdivo had no requirement. I see a time when these very expensive drugs will be required (More)
    • Dr West I think that at age 42, that's a lot of surveillance for a very long time, and I would be very surprised if there's never anything that leads someone to favor taking it out. Particularly if there's a single focus, I think it's very appropriate to deal with it definitively. My comments are more relev (More)
    • Dr. West, A month ago, my husband had a solid pulmonary nodule in his right lower lobe detected as an incidental finding on abdominal CT. It measure 2.5x2.6x2.2cm. PET was negative, but did show "minimal fdg uptake not significantly above background" radiologist stated that although there was not (More)
    • Dr West There is a small but real risk of pneumonitis, which is a significant side effect if you get it -- but only a very small minority of patients do.. I think the benefit outweighs risk if someone needs a new treatment, but not necessarily if the current treatment is working. Good luck. -Dr. West (More)
    • Dear Dr West, I really appreciated your article above. I am currently in Clovis Tiger I trial, taking Rocelitinib due to Stage IV non-small cell lung cancer (adenocarcinoma) that is EGFR positive. After about 7 months, my disease is stable and I have no significant side effects. I read your article (More)

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