Hello All - Well, after 5 years and 3 mos. on Tarceva, my wife had to switch to Tagrisso in January 2016 when she developed three brain mets. Now, 4 months later, she is progressing again, so she will be switching to traditional chemotherapy (not sure of the combo just yet). The two brain mets that were not radiated in January are growing again (after shrinking significantly in January/February) and the cancer has presented itself in a miliary pattern across both of lungs. Interestingly, while all of these micro-nodules in her lungs have developed in the past 2 months, another pre-existing suspicious nodule remains stable. In any event, my question is... does the team have any general data on how EGFR+ cancer generally responds to traditional chemotherapy? As an aside, I also suppose that one of the issues we are dealing with is as of yet we do not know what the mutation is of the "new" cancer as it is presenting itself. I suppose it may not be EGFR+. In any event, we look forward to your thoughts.
09/2010 - Diagnosed, stage 4, lung, bone mets and 1 brain met; ovarian tumor (EGFR+, exon 19 del); prescribed Tarceva
06/2015 - Removed one nickel sized progressing tumor from lung (it developed indolently over 2 years); stayed on Tarceva
12/2015 - Excellent response to Tarceva until 12/2015, when three brain mets developed; radiated largest brain met with SRS and watched two smaller mets; switched to Tagrisso Jan. 1
01/2016 - Started Tagrisso; reason to believe not T790M+
05/2016 - Progressing in brain; military pattern in both lungs; switching to traditional chemotherapy
Reply # - May 3, 2016, 04:17 PM
Hi Dan,
Hi Dan,
I'm so sorry your wife is moving on from the TKIs that have served her well for a long time. There haven't been specific trials to collect data about whether mutants respond better to chemo. With that said most oncs are beginning to think people with an egfr mutation tend to respond well to chemo as well.
As a lay person who keeps up to date on what's happening, it's seems possible that people with mutating cancer as from tki treatment the cancer could become more susceptible to respond well to immunotherapy. That's just a theory from a lay peep.
I hope your wife does well moving forward.
All best,
Janine
Reply # - May 5, 2016, 07:52 AM
From the 2009 IPASS trial,
From the 2009 IPASS trial, the response rates to chemotherapy for EGFR mutant lung cancer were excellent. In general, the response rates for EGFR mutant are better than EGFR wild-type lung cancer. We've all had a few EGFR mutant patients who had lousy responses to chemotherapy, but it is uncommon. Hope this helps.
Reply # - May 5, 2016, 04:04 PM
Hi Dan.
Hi Dan.
Sorry your wife is having to move on from the TKIs. I hope she has a great and long lasting response to the chemotherapy.
Keeping in mind that each person can respond to treatments very differently, my wife (who has an HER2 mutation, a receptor in the same class of receptors as the EGFR) responded very well to chemotherapy (carbo/alimta), with about a 60-70% reduction in main tumor size and likely full remission of two bone mets after 6 treatments (one every three weeks). However, after the main treatment, the Alimta maintenance had no effect.
Sending lots of thoughts and prayers to you for a great response from the chemo.
Stan