Dear Doctors,
My cousin (41 years old, ex smoker, Italian, treated in Rome) has been diagnosed with multifocal BAC NSCLC four years ago. His tumor tested positive for K-ras and negative for EGFR and ALK. Over these years he has been treated with Cisplatin, Docetaxel, Avastin, Tarceva and Afatinib. One year ago he was enrolled in a clinical trial studying the efficacy of the experimental drug E7080, an angiogenesis inhibitor. Over the course of the past four years, periodic CAT scans showed an alternation of 'stable disease' and 'slight disease progression', but due to the poor results of the latest experimental treatment (no metastases but the nodules have increased in size and number in both lungs) his doctors have decided to interrupt his therapy. Do you know of any existing clinical trials for which he could be a good candidate? Would you recommend a transplant in his case? (sorry for the double question) Thank you so very much.
Sincerely
Reply # - October 30, 2013, 07:17 PM
Reply To: clinical trials for stage IV BAC NSCLC patient
It's possible that an immunotherapy like a PD1 or PD-L1 inhibitor will be helpful, but we really don't have any specific leads on bronchiolalveolar cell carcinoma as having different responsiveness to treatments.
Lung transplants are done only in very rare cases. It's not clear that they cure patients, as BAC is often a slow growing cancer, and many patients have late recurrences. Though transplants have often looked favorable after short follow up, many things in BAC look favorable if you focus only on short-term outcomes of the first few years. Lung transplants are definitely not a standard treatment for BAC, in part because they just aren't something that can be offered broadly to a significant population of patients.
Good luck.
-Dr. West
Reply # - October 31, 2013, 06:08 AM
Reply To: clinical trials for stage IV BAC NSCLC patient
Thank you for the prompt response, Dr. West.
Best Regards