iressa + radiation? - 1252519

nguh
Posts:3

mom in asia diagnosed NSCLC-aden with minor pericardial effusion a month ago and started on iressa. seems to be working well after 3 weeks. still in shock but have been researching all possible options.
1. read articles on local radiation that can potentially lengthen time to develop resistance. Is radiation a possible parallel treatment along with iressa?
2. her oncologist is planning chemo as 2nd line treatment and Terceva as 3rd line... is there anything else we can do/research right now to assess other possible treatment options?

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Reply # - January 12, 2013, 02:01 PM

Dr West
Posts: 4735

There's not much data on local radiation leading to longer time to resistance. That's a reasonable question for a research protocol, but that's definitely not the prevalent standard, and I think very few, if any, lung cancer experts would recommend this for someone with advanced NSCLC.

There are still open questions about what the best approach is for acquired resistance after initial treatment with an EGFR inhibitor like Iressa (gefitinib) or Tarceva (erlotinib). Here's a link to a discussion of management considerations, and several further links, about acquired resistance in someone with an EGFR mutation:

http://cancergrace.org/lung/2012/08/05/acquired-resistance-faq/

Good luck.

-Dr. West

Reply # - January 13, 2013, 01:44 PM

nguh
Posts: 3

Thank you so much Dr. West for the quick reply. I have one follow-up question. It looks like the tumor has not spread to other parts of her body (her brain, liver, and bone scans are all clean). However, since there are signs of minor pericardial effusion, Mom is considered stage IV and her oncologist is not considering any local treatment. Do you agree that only whole-body treatment makes sense even though the cancer has not spread far?

Thanks again -- we cannot tell you how appreciative we are for your website...

Reply # - January 13, 2013, 08:41 PM

Dr West
Posts: 4735

If the pericardial effusion is from the cancer, which it is very likely to be, then yes, systemic (whole body) treatment is the appropriate one, even if it hasn't spread far. It's a common question, but unfortunately, if the cancer has spread to the fluid outside of a lung or the heart, it can go anywhere.

-Dr. West

Reply # - January 13, 2013, 10:11 PM

nguh
Posts: 3

Thanks much for the inputs, Dr. West.

At this moment, we are lucky the response to Iressa is very good, more than 70% shrinkage in just 2 wks. Hope it goes a long way !

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