My mom , my only family (I have no father, brother, sister)
NSCLC stage IV adenocarcinoma ALK+/ EGFR- /never smoked
here is my mom's brief medical record..( I'm Korean and sorry for my poor english)
04/2011 diagnosed NSCLC stage IV
05/2011 Chemo - Cisplatin + Gemcitabine
10/2011 Chemo - Alimta (clincal trials; crizotinib vs. alimta)
05/2012 Chemo - Crizotinib (for clinical trials)
01/2013 For brain mets, whole brain radiotherapy
07/2013 get resistance on Crizotinib (ct scan : 07/10/13)
08/2013 start LDK 378
09/2013 Suspicious small nodule in left lobe while taking LDK 378 (ct scan : 09/25/13)
-R/O artifact vs. R/O true metastasis
10/31/2013 CT scan
Here is my mom's brief medical record
We are waiting for CT result. If it turned out for true mets, I think there are few chemo left like Taxol, Vinorelbine, Irinotecan, Carboplatin or rechallenging with Crizotinib or Alimta..
Are these therapy can be effective and hopefull to my mom although get resistance on targeted therapy( rapid growth type)...?
I was inspired by Dr.west's post( Ongoing targeted therapy plus new therapy ), so I suggested to my doctor. but he said he can't (because it is clinial trials)
Reply # - October 31, 2013, 08:14 PM
Reply To: Suspicious small nodule in left lobe while taking LDK
I'm very sorry to hear of your mother's diagnosis and possible progression. Nevertheless, I think it's premature to conclude that LDK378 is ineffective based on a questionable small nodule.
If you ask what might follow, whenever progression is more definitively identified, the drug Taxotere (docetaxel) is one that she hasn't yet received and still has a proven survival benefit in patients who have received prior chemotherapy. Otherwise, it's possible, though I think unlikely, that another 2nd generation ALK inhibitor like CH5424802 (alectanib) from Chugai/Roche or AP26113 from Ariad will be effective after having received LDK378. There is also some modest but provocative results showing that people with advanced NSCLC and an ALK rearrangement may be good responders to the investigational drugs in the class of heat shock protein (HSP90) inhibitors, so perhaps it's possible to find a trial with one of these agents.
Good luck.
-Dr. West