Hi all. My mom has been on almost a month long break from TKI therapy because after about a month and a half of being on Iressa, her liver enzymes spiked, she had an oral thrush infection, and also developed a h. pylori infection (the treatment for h. pylori requires omeprazole twice a day for two weeks which would render any TKI ineffective). Scans after a month and a half of Iressa showed improvement but because we need to be able to control the dosage of of her treatment in order to stay on top of the liver enzymes, the decision was made to switch to Tarceva. I was wondering if anyone has made this switch and what differences in side effects there were. I also wanted to know if anyone had ever taken a month long break from a TKI (Iressa, Tarceva, Gilotrif, or Tagrisso). Thanks everyone.
I’m sorry to hear of these complications your mom has been facing. The side effects from Iressa and Tarceva are very similar, but I can see the value in switching to Tarceva since the dose can be adjusted from 150 mg all the way down to 25 mg. Some patients are just very sensitive to Tarceva, and do quite well at lowered doses (even 25 mg), reducing toxicity without compromising efficacy.
It’s not unusual for patients to take a break from a TKI, and in most cases it isn’t an issue. If she hasn’t seen a dramatic increase in cancer-related symptoms, then it probably shouldn’t be a problem.
Good to her with Tarceva.
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