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    • Dr West The standard of care in this setting is very clearly combination chemotherapy with a platinum doublet for patients who are fit enough for chemo and don't have a driver mutation like an EGFR mutation or ALK or ROS1 rearrangement. A clinical trial is a fine alternative, but the standard of care is che (More)
    • We decided to have my mom tested for PD-L1 expression after reading a number of articles. The test came back negative. She is scheduled to start a clinical trial for nivolumab + ipilimumab as first-line treatment. My mom is NSCLC stage IV. Based on her negative result, are there other options we sho (More)
    • Dr West These are issues that are better discussed with your own oncologist, as I've not seen the scans and have none of the relevant details. -Dr. West (More)
    • Thank you very much ,I appreciate very much your quick response. Does your answer apply also to the fact that progression is evident in the previous ct. scan in March 2016,compared to a ct. scan 6 months earlier ? The no progression refers to the period,between April 2016 and July 21,2016 ? Thank (More)
    • Dr West I think there's good reason to question whether you need to be on a new therapy in the absence of any evidence of progressing disease. It makes good sense to discuss this with your oncologist. It may be appropriate to continue surveillance without any therapy in the absence of clinically significant (More)
    • Dr West I think there's good reason to question whether you need to be on a new therapy in the absence of any evidence of progressing disease. It makes good sense to discuss this with your oncologist. It may be appropriate to continue surveillance without any therapy in the absence of clinically significant (More)
    • My wife,66 years old with COPD and a smoker untill 2008/ diagnosed poorly diff nsclc adenocarcinoma .Lobectomy RUL. Feb.2008/ Stage T2N1MO T=3.7 . Aduj chemo Cisplatine+Nevelbin ,2 courses (could not tolerate).Follow up ct scans gradual growth in nudole LLL,and in LUL (both were identified before su (More)
    • Just had (Thursday)my first,first line' Keytruda infusion.On Friday came in my PET-CT results. It seems there was no progression of my tumors in the last 5 months. Seeking an answer to the question, hould I continue with the Keytruda plan,or stop and have just a close follow up. (More)
    • 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‚Ķ.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 http://www.lungcancerfoundation.org/patients/ros1/ 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)

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