stash
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85 year old female NSCL cancer stage 3b, Rt lung biopsy EGFR+ relatively stable on Tarseva 2.5 years, now left lung biopsy Egfr-, Alk-, Pdl1-,T790M-. Do all Egfr+ cancers stay Egfr+? Are T790m + cancers always Egfr+? Is it wothwhile to test for Ros1? Other than tradional chemotherapy and radiation are there any other diagnostic or treatment options? Thank you sincerely, Dr. S.W
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Reply # - April 16, 2016, 11:01 AM
Hi stash,
Hi stash,
There's no reason to doubt the positive results of the original EGFR testing, although it is possible to get a false negative (especially if the tissue sample is small), since at times only some of the cancer cells bear that mutation. Cancer cells can continue to mutate, so anything is possible, but it's also possible that the cancer in the other lung represent a second primary lung cancer.
If the sample from the left lung is fairly large, then treating with another EGFR inhibitor may not be the best choice, immunotherapies do not seem to be very effective for EGFR mutated lung cancers, so standard chemotherapy may be the best choice.
JimC
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