My mother was diagnosed with NSCLC in 2014 and was on Chemo for a year until it started to not work. She is stage IV because of a pleural effusion in addition to a small nodule in her right lung. Chemo did result in stabilizing the tumor and resolving a nearby early stage lymph node metastasis. She is otherwise very healthy. keeping her weight, and exercising. She did well on chemo, other than high blood pressure, but the chemo started to not work.
So, for almost a year she is on Opdivo. the first 6 months there was no signs for concern. Now, after nearly a year, she had a PET scan and she is going in for a lung biopsy and there is concerns about some area in the pancreas and under her arm pit. We are terrified, since we believed that the immunotherapy was going to be the solution until the next great breakthrough.....So, my question that I cannot seem to find anywhere, is can people in this situation go back onto a chemo drug treatment after immunotherapy....and is this type of possible set back a typical occurrence. The oncologist said early on that immunotherapy sometimes looks worst before it gets better.
Any thoughts you can share with me? I find it difficult to find anything other than positive information on Immunotherapy....For those that find this drug does not work due to their individual histology, what are the options?
Any help you can offer me and me family would be grateful to hear. Please pray for her, she is everything to us. God bless and Thank you
Reply # - July 19, 2016, 09:06 PM
Hello,
Hello,
I'm sorry to hear of your mother's progression. Immunotherapy has gotten plenty of hype lately, because some patients respond very well to it, and have what is known as a durable response, one which lasts a long time (years as opposed to months). But such responses only tend to occur in 20 to 30 percent of patients, so there are many patients for whom the response, though good, doesn't last that long. As with any treatment, especially those which are the "latest and greatest", spectacular successes get more press than responses that are incrementally better than those provided by older treatments.
Lost in the hype is the fact that many patients respond well to chemotherapy, even as a later line of treatment. It is certainly an option after immunotherapy, whether an established agent such as Alimta or Docetaxel, or a new drug in clinical trials. There are also other immunotherapy drugs and combinations currently being tested in trials. You didn't mention whether your mother's cancer cells were ever tested for targetable mutations, but if a past or current biopsy uncovers such mutations, targeted therapy may also be an option. In fact, even patients without an EGFR mutation can derive some benefit from Tarceva.
So please do not feel that there are no further options, and please let us know what you find out and what treatment is chosen.
JimC
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