zzoe
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Posts:5
Thank you so much for this marvelous forum. It's incredible.
After 6 rounds of carbo/alimta and the last PET showing mostly gone (dim spot they couldn't tell was scar tissue or active), my husband is about to start maintenance therapy (dx stage IV NSCLC in May 2014)
He has an idea that his immune system needs a chance to "do its job" and wants to do Alimta every 6 weeks instead of 3 to give his body more time to recover in between.
I'd like him to follow the doctor's advice and do it every 3 weeks. In my mind, a six week cycle gives the cancer more chance to grow, but I don't really know anything.
Have you ever heard of anyone doing maintenance Alimta on a 6 week cycle?
Also, when is Avastin every brought into the picture?
Thank you again.
Forums
Reply # - October 7, 2014, 12:33 PM
Welcome to Grace mamasan,
Welcome to Grace mamasan,
I'm sorry it took so long to get back to you.
The idea of less can be done when cancer has responded well and is negligible in size. However there's no research done on how to do this with best results. Most lung cancer specialists would give a break in treatment instead of continuing treatment in fewer infusions. Again it's not set in stone.
An alternative to maintenance therapy is to stop treatment after 1st line and watch closely with CT scans until significant growth shows the need for 2nd line, in effect not doing maintenance at all. Following is a list of posts on this subject the 1st one video is the most recent, in effect if the patient needs/wants a break and has had good efficacy to 1st line watch closely and give the break. http://cancergrace.org/lung/tag/maintenance-chemotherapy/
I'm assuming your hubby doesn't have an treatable mutation?
On avastin, http://cancergrace.org/lung/2013/06/17/pointbreak-maintenance-therapy-u…
I hope this helps. Don't hesitate to inquire more.
Janine
Reply # - October 7, 2014, 07:27 PM
While it's reasonable to give
While it's reasonable to give Alimta on a longer interval than 3 weeks if a patient is having a hard time tolerating every 3 week infusions, the idea that outcomes are better with every 6 week treatment is not based on any evidence and isn't generally done. There is no reason to think that the immune system on its own fights cancer more effectively than chemotherapy -- if it did, holding chemo after first line treatment would be associated with a longer time before the cancer progressed than continuing chemo with Alimta (pemetrexed) every 3 weeks. The evidence clearly shows that continuing chemo in the setting of advanced NSCLC prolongs the time before a lung cancer progresses -- so that really counters the idea that the immune system alone should be prioritized over chemotherapy.
When Avastin (bevacizumab) is used in combination with first line chemo, it is often included with the maintenance portion of therapy. There is no evidence to address the potential value of Avastin when added to maintenance chemotherapy when Avastin isn't part of the first line regimen.
Good luck.
-Dr. West