lindatruong79
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Posts:1
Hi all,
My mom is currently on Afatinib 30mg dose (down from 40mg) due to the side effects which she had.
On 30mg dose side effects seem better but now she has been feeling nauseous and not eating as much as she finds it hard to keep food down. She has been given anti nauseous tablets but doesn't seem to help as it is making her drowsy. She recently had a scan and tumour has reduced from 8cm to 1.6 cm with no seen activity in the lymph nodes. She was diagnosed with stage 4 mets to lymph nodes in May 2016.
My question is is it possible to reduce the dose to 20mg and still keep cancer stable?
I'm very worried as she seems to be losing weight drastically.
Please help.
Linda
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Reply # - August 27, 2016, 12:31 PM
Hi Linda,
Hi Linda,
I'm very sorry your mom is having difficulty with afatinib. When a drug is tested in clinical trials the dose is usually set at the highest amount people can handle and becomes the amount at which the dose is set in practice if approved. But that also means there are plenty of people for whom the dose causes too many side effects. It also means the dose may be higher than needed for those who are so sensitive, hence lowering the dose. Lowering anti cancer drug doses is a very common practice in oncology.
Afatinib is known to cause more side effects than other EGFR TKIs. It's a pretty new drug to the clinic so there's not a lot of anecdotal info on dose reduction. If a drug is showing efficacy but causing too severe side effects it becomes infeasible to take no matter how effective it is. So lowering the dose incrementally is a good way to continue with a treatment in hopes that you can find the sweet spot.
I hope this helps,
Janine
P.S. Anti-nausea drugs usually carry the side effect of drowsiness but it may be a better alternative until a change can be made. Taking as directed is very important for these drugs as well. Usually taking them before one gets nauseous (prophylactically) works while waiting until you're nauseous often doesn't help.
Reply # - August 27, 2016, 03:00 PM
Hi Linda,
Hi Linda,
In addition to the good information Janine has already provided, I'd just add a couple of other suggestions to reduce nausea. As she said, taking anti-nausea medications on a regular basis rather than as needed is very important, and eating smaller, more frequent meals/snacks can be beneficial, as well as taking a walk in the fresh air (or inside a large building such as a shopping mall if necessary) can also help. If she's having trouble keeping food down and losing weight, avoiding spicy or difficult-to-digest foods is best, but if appetite is depressed it's recommended that whatever sounds good to the patient and is tolerated well is the right choice; calories tend to be more important than a perfectly balanced diet. Some GRACE members have come up with some pretty odd choices, but if whatever is chosen maintains weight and stays down, go with it.
JimC
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