My elderly mother with underlying peripheral neuropathy with stage 3 b, egfr positive adeno ca is on her 6 th cycle of reduced dose pemetrexed after she acquired resistance to tarceva and is getting worsening peripheral neuropathy symptoms, what is the risk of taking a break from the chemo? Risk of cancer progression? Risk it won’t work again after the break? And if takes a break, how long would be safe amount of time to be off?
It’s not unusual for patients to take treatment breaks to allow time for troublesome side effects to abate. Breaks of a few weeks are common, often without any sign of progression in the interim. There is some risk of progression, but it can’t really be quantified, just as it’s impossible to say how long you can interrupt treatment without significant progression. But Dr. West likes to call the cancer battle a marathon rather than a sprint, and you try to get the maximum benefit from each line of therapy. With that in mind, if your mother continues without a break and the side effects become intolerable, she may need to switch to a different therapy, or take a treatment break. Changing treatments always bears the risk that the new treatment will not be effective, so it wouldn’t be a bad idea to take a break from Alimta, during which time we would hope that the neuropathy subsides (unfortunately, it doesn’t always do so) then resume Alimta, seeking to get the maximum benefit from it.
Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa