Maintenance Options for Brain Mets (Adeno. Lung Ca) - 1253071

Hi Rob, I hope you are feeling alright. I'm not a doctor but more of a receptionist here on Grace. I will contact a doctor to comment on your queries. It may take a day to receive a reply.
I hope you do well moving forward and don't hesitate to ask followup questions.

Janine
forum moderator

I've just been looking for a blog/post I think was very recently released by Dr. West but I can't find it. It speaks to the idea that systemic therapy such as tarceva (if you're egfr positive) and alimta may have some activity in the brain for a section of the population.

But this is a thread that discusses the idea, http://cancergrace.org/lung/topic/any-way-to-control-brain-mets-after-f…

Perhaps someone can help find the post?

Presuming that your seizures are from brain mets, symptomatic brain metastases are considered a contraindication to Avastin. Also, I should mention that we really don't know how much incremental value bevacizumab adds to maintenance chemotherapy.

Janine had mentioned Tarceva (erlotinib), which can certainly have activity against brain metastases, but that is much more likely in someone with an activating EGFR mutation. I don't consider any systemic therapy to be so active against brain metastases that this should really factor into the decision-making process -- this isn't really well-studied enough to base decisions on this, nor is the suggestive evidence for any agent really compelling enough to lead me to make any clear suggestion. If anything, Alimta (pemetrexed) is probably the standard chemo agent most associated with responses in the brain, but I'm sorry to say that I really don't think there's enough good quality evidence to answer the question meaningfully.

-Dr. West

Hi Rob, just speaking as a fellow-patient, it's great to hear that the brain mets are stable. Long may that last.
Janine, you are so much more than a receptionist - I cannot let that pass!

sweet.