likun166
![]()
Posts:10
Hi all,
My dad has got NSCLC IV for 2.5 years and been on Tarceva about 14 months. Recently when he went through blood test, he found the blood count of cancerous cell increases from 80 to 600. Currently he is on a new round of Chemo. My question is whether this means Tarceva has already stopped working. Is there possibility that after two rounds of Chemo Tarceva can regain its effects? Should my dad stop taking Tarceva now? If Tarceva really stopped working, what else can he do? Continuous chemo? Any advices will be appreciated.
best,
lifeng
Forums
Reply # - October 18, 2013, 11:00 AM
Reply To: Tarceva stopped working?
Hello lifeng, Welcome to Grace. I'm very sorry your dad has stage IV nsclc. My husband does also so I understand your confusion.
Most lung cancer specialist consider blood test not to be enough evidence to change treatment. In the last paragraph of his blog post on serum tumor markers Dr. West says this about treatment changes, " I would personally be very reluctant to stop a treatment that is not associated with progression on CT just because a tumor marker or SUV is rising." http://cancergrace.org/lung/2007/06/16/tumor-markers-in-lung-cancer/
and here is a forum discussion on the subject, http://cancergrace.org/forums/index.php?topic=5778.0
On what options he may have after progression,
http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o…
http://cancergrace.org/lung/2012/08/05/acquired-resistance-faq/
It's very likely your dad would have many fewer side effects without the extra chemo. If he really hasn't progressed on the CT he should have the option to quit the chemo and stay solely with tarceva.
Please let us know of followup questions after you've read through some of the links.
All the very best,
Janine
forum moderator
Reply # - October 18, 2013, 07:23 PM
Reply To: Tarceva stopped working?
As Janine suggested, these issues come up often, and I've described the approaches in the links she provided.
As a general principle, I and most other experts think it's regrettable to make sweeping conclusions and change treatments just on the results of a blood test in lung cancer, if the scans don't clearly demonstrate significant worsening. It can lead to discontinuing a good treatment earlier than needed.
There is no clear best approach to what to do after progression on an EGFR inhibitor, but we typically favor chemo, with or without continuation of the EGFR inhibitor, unless there is an available clinical trial for people with an EGFR mutation who have developed acquired resistance to the EGFR inhibitor.
Good luck.
-Dr. West
Reply # - October 19, 2013, 08:15 AM
Reply To: Tarceva stopped working?
If he is found to have progression, you might want to discuss rebiopsy with his oncologist. My nsclc resistance turned out to be a transformation to sclc, which has a very different treatment plan. Approximately 14% of tarceva resistance is a mutation to sclc. I am being treated with an sclc chemo and radiation regimen now and being kept on tarceva.