My husband has been on Tagrisso since Dec. 2015. He had great response initially but now has progressed from the neck down (which includes primary mass, small pleural effusion, osseous mets) and tomorrow the oncologist will be discussing treatment going forward.
Interestingly, brain-wise stable, no new mets. My husband wants to stay on Tagrisso due to stable brain mets which he has not had in a while. He had 2 gamma knifes in 2015.
My husband otherwise feels great.
Is there a combo drug, Tagrisso and ???? so that my husband can stay on the Tagrisso to help control brain mets and another drug that would take care of the neck down?
Would this progression mean another mutation and Is it correct to assume that another biopsy would need to be done?
Thanks for your help.
Kate
Reply # - June 8, 2016, 07:34 AM
Hi Kate,
Hi Kate,
I am sorry to hear of your husband's progression on Tagrisso. At this point, there isn't much evidence in favor of combining Tagrisso with another agent, although there are some trials looking at adding an immunotherapy agent or c-MET inhibitor. If you're looking to stay with EGFR-directed therapy, there is also the possibility of using the combination of afatinib and cetuximab, which works well for some EGFR-positive patients regardless of the cause of their resistance.
One question that you may want to raise with his oncologist is whether he/she believes it is correct to assume that Tagrisso really has prevented progression in the brain, since it has only been a little over six months since he was treated with Gamma Knife, the same interval from the previous GK. Perhaps the lack of progression in the brain has more to do with the radiation.
As far as a new biopsy, that would most likely only be suggested if you were looking for a specific mutation being targeted by a new agent in a clinical trial, as there is no approved drug in the context of acquired resistance to Tagrisso based on a new mutation.
JimC
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