My wife,66 years old with the following :
With COPD backround and a smoker,until 2008. Daiagnosed POORLY DIFF ADENOCARCINOMA.In February 2008,RUL Lobectomy, Pathalogical stage,T2N1MO T=3.7
Adujv.chemotherapy cisplatine+ nevelbine ( had 2 rounds,could not tolerate side effects).
In 2011, following routine,follow up, ct scan, a gradual increase in size of a nudoles in LUL and in LLL, which were observed and identified already prior to the lobectomy (2008).
C.T directed biopsy, to the tumor in the left lung (June 2011) ADENOCARCINOMA OF THE LUNG.
Recieved RADIATION (SBRT) to LUL (5000 rd) and RFA to LLL.
Continued follow up (CT SCAN) every three month.
In MARCH 2016, DIAGNOSTIC PET CT SCAN ,shows spreading and increase in size of tumors. Pathalogical recept. of FDG with high intensity in LLL( 4..4 x2.7 cm.)
Pathalogical recept. of FDG with high intesity,in RLL (1.4 cm.)
In addition, Pathalogical reception of H.I FDG in lymph node in the gate of the lung,on the left side.
Spreading of nudoles .
In genetic examination,FOUNDATION ONE,the following genetic were observed :NTRK amplification,KRAS G12V,ATM,APC,MCL 1,MSI Average High.
PDL 1 - STRONG POSITIVE.
Decided on Keytruda (first line) therapy 2mg/Kg/
JUST FOLLOWING 1ST. TREATMENT, RESULTS OF PET CT -(TO ESTABLISH BASE LINE), CAME IN WHICH SHOW NO PROGRESSION FROM PREVIOUS,PET SCAN (MARCH 2016), AS A MATTER OF FACT , SOME REGRESSION WAS OBSERVED.
NO TREATMENT WHATSOEVER IN MORE THAN 4 MONTHS,AND NO PROGRSSION (SOME REGRESSION).
WHAT DO YOU MAKE OUT OF IT ? AND SHOULD SHE CONTINUE WITH KEYTRUDA INFUSSIONS ,OR NOT ? VERY CONFUSED..
Reply # - July 26, 2016, 09:02 AM
Hi Joshua,
Hi Joshua,
Welcome to GRACE. I'm sorry to hear of your wife's recurrence, but heartened to see that Keytruda seems to have stopped the progression of the disease, and even shrunk the tumors somewhat.
One of the as yet unanswered questions about immunotherapies is determining the optimal duration of therapy. Some patients have just a few treatments, yet have a significant and durable response. Please correct me if I have misinterpreted, but it seems that your wife had just one Keytruda treatment, which has produced the described response. I think it is reasonable to wonder if further treatments would produce an even more significant response.
At this point if she is asymptomatic, one path would be to continue with close follow-up scans, and rechallenge Keytruda if progression appears. The alternative, resuming Keytruda now, has the disadvantage that if she remains stable you will not know whether that is because she resumed the treatment or if that's where she'd be without it. On the other hand, you may see further tumor shrinkage.
Either way, I hope that she continues to get good scan reports for a long, long time.
JimC
Forum moderator
Reply # - July 26, 2016, 12:40 PM
JimC,
JimC,
Thank you very much for your prompt reply .
We appreciate ,very much,your support.
Joshua