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Dr West,
my father take tarceva on the first line treatment, and that time three brain tumors. after 15 month, the lund is stable, but the brain's tumor has been much larger than before, the number is much than before. he has headach and other symptoms. then, we began to pulsed tarceva 4 0 0 0. the sympotoms is relief. now, i need help, how long pulsed tarceva will working by your experience, and if i add 1 pill or 0.5 pill (150mg) on the third day or forth day, wether will accelarting the resistance of tarceva. hope Dr west will give me some advice. need your help. thanks a lot.
Lee
Forums
Reply # - February 9, 2014, 08:53 AM
Reply To: wheter pulsed tarceva will accelarating the resistance
Hi Lee,
Welcome to GRACE. Glad to hear that the cancer in your father's lung is stable and that he has found relief from his headaches.
Pulsed Tarceva really hasn't been studied much in clinical trials, so the answer to your question on acceleration of resistance is probably that no one knows. There is a trial at Memorial Sloan-Kettering Cancer Center in New York that seeks to compare varying dosages of Tarceva, including pulsed dosing, but that study is still recruiting: http://www.clinicaltrials.gov/ct2/show/NCT01967095?term=pulsed+erlotini…
As far as how long pulsed Tarceva may be effective, that's also impossible to say, even more difficult than projecting how long standard doses would provide a benefit. Standard dosages have been well studied, with median efficacy around a year or so (although some patient do much better), but there just isn't enough evidence on pulsing.
I hope it works for your father for a very long time!
JimC
Forum moderator
Reply # - February 9, 2014, 09:53 AM
Reply To: wheter pulsed tarceva will accelarating the resistance
Jim's exactly right. Any answer you get is going to be completely made up, based on no evidence. I have treated just a handful of patients with pulsed tarceva, all of them with very unique situations, and there is nobody with a large world experience in this.
I am not a believer in making up new regimens and presuming that more treatment is better - that is a very bad, overly simplified presumption. It's very likely that more drug will lead to more toxicity but not benefit.
The best treatment for brain metastases is radiation, specifically whole brain radiation if a patient has had multiple brain metastases. I think it would be very unwise to just escalate the dose of Tarceva (erlotinib) to treat brain metastases if there Is still room to treat them more properly with radiation.
Good luck.
-Dr. West