praying4mama
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Mama was Dx with NSCLC stage 4 adenocarcinoma with brain mets in 11/2013. With positive EGFR, she was on Tarceva for a little over 6 months but it stopped working. Cancer is progressing rapidly and she's too weak for chemo. We are still waiting for the result of T790m mutation. If positive she will be referred to UCLA for clinical trial. There is still a long waiting period because we were told by her oncologist that UCLA will do another biopsy for confirmation before treatment. She's currently on oxygen 24/7 at 5 liters for about 3 weeks now, has 2 PleurX catheters one in each lung and mainly bed bound. Will she qualify for the clinical trial? What options do we have? Is there another pill that she can take? Please help!
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Reply # - July 14, 2014, 08:01 AM
Reply To: Tarceva resistance. Now what?
Hello,
I'm sorry to hear of your Mom's rapid progression and symptoms. We can't tell you whether she will qualify for the trial; her doctors would be better able to evaluate her situation, and the trial staff will have the final word.
The only approved drug in pill form that your Mom might be able to take is Gilotrif (Afatinib), so you may want to discuss that with her doctors, as well as whether there is a trial drug which you might be able to obtain from its manufacturer on a compassionate use basis.
JimC
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Reply # - July 14, 2014, 04:47 PM
Reply To: Tarceva resistance. Now what?
I must confess that I really think Gilotrif after Tarceva is extremely unlikely to be a great alternative. To me, that's a desperation move that is often tried but very, very rarely meaningfully helpful.
I can't say whether she'd be eligible or not. The folks at UCLA could address that question better, if you want to reach out to them.
We're trying to get a Clovis trial with CO1686 (not sure it's the same trial as at UCLA) open ASAP at my own center, and I think that's by far the most compelling option other than perhaps CO1686 or AZD9291 on a compassionate use basis. However, I think that these companies will not be inclined to have patients get compassionate use drug instead of getting their trials completed, so that may be challenging to pursue.
Good luck.
-Dr. West
Reply # - July 14, 2014, 10:32 PM
Reply To: Tarceva resistance. Now what?
Thank you JimC and Dr. West for your replies. I found out today that Mama is negative for T790m mutation. Mama had a thyroid bx done last week result confirmed malignancy also. She's too weak for Afatinib. Is there any risk/benefit in continuing Tarceva? I read online some suggest to cont Tarceva anyway. I don't know if Mama should. I forgot to ask her oncologist. Her oncologist suggested hospice. My heart aches for her.
Reply # - July 15, 2014, 10:39 AM
Reply To: Tarceva resistance. Now what?
I am very sorry about the new developments. In some cases in which the cancer is progressing slowly on Tarceva, the drug is continued with the idea that it is still providing a limited "brake" on the progression of at least some of the cancer cells. But in a situation in which the cancer is progressing rapidly, it is much less likely to provide benefit, and it is not free of side effects.
As my wife's oncologist explained to us at our first meeting, treatment for stage IV lung cancer has two goals: increase the length of life and improve the quality of life. When it became clear that treatments were not slowing the progression of her cancer, he told us that we needed to focus on the second goal by switching from cancer treatment to comfort care, providing as much symptom relief as possible. That is what hospice seeks to do, and I hope it can do that for your mom.
Please know that you are in my thoughts at this very difficult time.
JimC
Forum moderator
Reply # - July 15, 2014, 11:22 AM
Reply To: Tarceva resistance. Now what?
Based on what you describe, it seems unlikely that she would be eligible for any clinical trial or expanded access program. I agree that palliative options seem reasonable in this setting. I'm sorry it has been such a rough journey. Hope this helps.