My father was diagnosed with stage IV EGFR+ (L858R) NSCLC in May of 2011. Started on Tarceva, after minor progression in liver after about 4 months moved to carboplatin/paclitaxel + bevacizumab for 6 cycles with good response. Moved to maintenance with pemetrexed and bevacizumab until the last scan showed progression in bones, lungs, and especially significant progress in the liver. At this point we are struggling with what to do next. We are in the SF Bay Area and have access to Afatinib through expanded access (although I'm not sure if that rules out adding cetuximab), but we are somewhat skeptical about that option given the relatively short response on Tarceva and the fact that he progressed in the liver the last time, which is where we are most concerned now. Oncologist is recommending gemcitabine and cetuximab, which is not a combination that I have heard of in lung cancer. At Kaiser so phase 1 trials are out of the question. What gives us the best chance (EGFR inhibitor or chemo) for a response at this point? If chemo, is this combination reasonable? Dad seems to physically be ok.
Fri, 02/15/2013 - 11:08#1
What next? Afatinib, Chemo? - 1253823