Progression in disease and a new lesion in pancreas - 1259847

hellowall
Posts:8

Hi,

My mother is NSCLC Adeno CA Stage -4 with brains mets and on gefitinib since 27 July-13. We got the latest PET-CT on 11-oct-13. That is showing the progression in disease and a new lesion in pancreas neck/head in comparison to previous PET-CT dated on 19-jun-13. We will show the reports to oncologist in coming days. What we understand that gefitinib has stopped working. And is this new lesion in pancreas new cancer? We are afraid.
Please let me know what options are left for us.
Can we go for tarceva or anything else and how to deal with new pancreas lesion?

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Reply # - October 13, 2013, 09:03 AM

JimC
Posts: 2753

Hi Arvrai,

I'm sorry to hear of the progression. Since your mother has only been treated with gefitinib, most oncologists would favor switching to a standard chemo regimen, the kind that would be used as first-line treatment for NSCLC, rather than trying another TKI inhibitor such as Tarceva. You can read about first line treatment in the GRACE FAQ (and the links on that page) here: http://cancergrace.org/lung/2010/09/18/lung-faq-ive-just-been-diagnosed…

The only way to know whether the lesion in the pancreas is a lung cancer metastasis or a new cancer would be to biopsy it. That's a question to discuss with her oncologist.

JimC
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Reply # - October 13, 2013, 11:25 AM

Dr West
Posts: 4735

I'm sorry to hear of this progresison.

I would say that it is overwhelmingly likely that the new lesion is progression of her current lung cancer rather than a new, separate cancer arising there. While a biopsy is the only way to know that with 100% certainty, it's a judgment call whether a biopsy is warranted -- I suspect not, since the probability may be 99.5% without the biopsy.

If there's progression on Iressa (gefitinib), I agree that moving on to chemo would be the leading recommendation, rather than moving to another probably comparable and not clearly superior EGFR inhibitor after a relatively short progression-free interval.

Good luck.

-Dr. West

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