Tecentriq in EGFR positive patients

Portal Forums Cancer Treatments / Symptom Management Patient Experiences Tecentriq in EGFR positive patients

This topic contains 3 replies, has 3 voices, and was last updated by  samdig1 6 days, 2 hours ago.

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May 7, 2017 at 9:21 pm  #1290704    

samdig1

How well does Tecentriq work on EGFR positive patients who have progressed on Tarceva and/or Tagrisso? I noticed that Tecentriq can be used for EGFR patients and am wondering if there is any promise there.

May 8, 2017 at 12:34 pm  #1290705    
catdander forum moderator
catdander forum moderator

Hi samdig1,

At this time there hasn’t been a lot of benefit shown from PD-L1 inhibitors against those with an EGFR mutation. It appears that those who have a significant smoking history do best. This is possibly due to the fact that smokers cultivate many mutations over the years and this is what the PD-1 and PD-L1 inhibitors respond to. Those with an EGFR mutation most often have little to no smoking history and the EGFR mutation seems to be the only (driver) mutation that drives the cancer. There seem to be a connection but again we don’t fully understand the mechanisms of action.

There are currently clinical trials testing combinations of drugs with immunotherapies that have had promising results for those with single driver mutations. It may be possible to join one. It’s usually best to join a trial when trying an unproven therapy for many reason. One reason is those who administer and collect the data keep a vigilant watch over the participants to avoid adverse affects of an untested treatment. Costs as well play a part. Insurance usually won’t pay for an unproven treatment.

Here is a post on the subject of Tecentriq, http://cancergrace.org/lung/2016/09/01/oakpos/

Hoping for the best,
Janine

July 21, 2017 at 7:24 am  #1291117    

ashes123

Janine,
I have to start every post on this site with thank you so much. This site is invaluable to cancer patients; I can explain this if it helps. Your post from May 28, 2017 12:34 pm, suggests there may be immunotherapy with other drug combination trials that are showing some success for egfr patients. Can you give any examples of either trials or specific combo’s that rumor has it, may work? I am a daily user of clinical trials.gov and also researching options for my wife. We are usually ahead of our oncologists on new drugs/trial drugs, but I have not really seen anything suggesting any combo’s are showing promise. Even if you only have rumors we will take them; I think my wife is progressing again. Please give us some bread crumbs/path that we can try to investigate. My wife is egfr/t790
Thanks.

July 21, 2017 at 11:24 am  #1291118    

samdig1

Ashes123,

I happen to have a library of trials I’ve compiled in my bookmarks. One trial showing some promise in T790m positive patients who have progressed is Tagrisso + Portrazza:

https://clinicaltrials.gov/ct2/show/NCT02496663?term=AZD9291+and+Necitumumab&rank=1

Another trial that has been talked about a lot is Tarceva + MET or MEK inhibitors:

https://clinicaltrials.gov/ct2/show/study/NCT02143466?term=Tatton&recrs=a&rank=1&show_locs=Y#locn

If you are looking specifically for immunotherapy trials, here is one I have heard of but have no idea of the success. This trial has the same chief investigator as the first trial I showed you (Dr. Jonathan Riess). I would definitely contact him because he is leading around 5 trials for EGFR patients who progress. This trials is for Afatanib and Keytruda:

https://clinicaltrials.gov/ct2/show/NCT02364609?term=UCDCC%23250&rank=1

Where are you located? Depending on where you are and where you are willing to travel for trials, I can point you to more. Let me know, and good luck.

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