Hi, I am 790M positive and have been on Tagrisso for 6 weeks. The first scan showed primary lung tumor has slightly enlarged compared to the last ct (which was taken a month before I took Tagrisso). Some small nodules have also enlarged, but some other areas of the lung have decreased in size. Pleural effusion build up slightly increased from the last CT.
Is it possible the enlargement of the tumor and fluid built up happened during the one month period before I took Tagrisso and not because Tagrisso is not working? In this case, should I continue taking Tagrisso and wait for the next 3-4 weeks to get another scan or should I switch to chemo right away?
If Tagrisso is not working, is it possible that I have another mutation in addition to 790M? Should I then look for other targeted therapies before starting chemo? My biopsy free test taken 2 months ago showed smaller percentage of TP53 in addition to 790.
Does anyone know of clinical trials that are promising after chemo for EGFR positive?
Thanks
Reply # - April 26, 2016, 10:57 AM
Hi sunday and welcome to
Hi sunday and welcome to Grace. Before I comment on your concerns I need to let you know that we don't tell anyone what they should or shouldn't do. As our guidelines state, "Please don’t ask what you “should” do. We can provide general information, and we’re delighted to do it, but we can’t provide medical advice to people who aren’t our patients. We could get into legal trouble, and we don’t want to try to replace the local team that has access to more relevant details, such as scans, labs, and the ability to evaluate a person directly. “Should” is the one word on the forum that is a trigger that we’re crossing a line." http://cancergrace.org/grace-discussion-forums#guidelines
It's very possible the cancer and PE grew during the time between scan and beginning tagrisso and hadn't shrunk back before the next scan. It's reasonable to talk to your doctor about staying on tagrisso longer to see if it's working. It would be unfortunate to stop a treatment that could provide good lifestyle for maybe years too early.
New or worsening symptoms are good signs of progression conversely lessening of symptoms is a good sign of efficacy. Let you oncologist know of any new or worsening symptoms.
There are trials but no approved next generation of EGFR TKIs yet.
All best,
Janine
Reply # - April 26, 2016, 01:00 PM
Thanks Janine for the
Thanks Janine for the information.
Reply # - May 2, 2016, 10:43 AM
Generally speaking, we repeat
Generally speaking, we repeat the CT scan in 4-6 weeks for patients if the initial response assessment is mixed or unclear. That seems reasonable to consider in situations like these.
Reply # - May 9, 2016, 11:22 AM
Sunday,
Sunday,
How are you getting on? Are you still on Tagrisso?
Many thanks