kanderse99
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Posts:1
Hello-
My father is 61, healthy diagnosed with stage IV NSC adneocarcinoma of the lung may 1, 2016, no mets, confined to the chest. No genetic mutations present. He had chemo carboplatin/amlipta 5 rounds, tolerated well. His second PET showed that the cancer was responding and it looked better. his doctor would like to do 1 of 2 things.
1) Amlipta mantinence therapy
2) The checkmate study. Amlipta, obtiva, or both. From what I understand there is no placebo arm.
I am looking for advice on how to make the best decision. My dad has not been tested for PDL-1. Does anyone have advice or experience with this trial?
Thanks,
B
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Reply # - October 12, 2016, 10:03 AM
Hi B,
Hi B,
It sounds like your dad is in good shape and has choices and that's a good place to be. We have an excellent series of posts on clinical trials that would help you get a good understanding of how trials work,
http://cancergrace.org/cancer-101/2013/01/06/clin-trials-ramalingam-pt-…
http://cancergrace.org/cancer-101/2013/01/18/how-are-clin-trials-develo…
http://cancergrace.org/cancer-101/2013/01/27/ramalingam-clin-trials-pt-…
Will the trial be at least as good as standard of care? Alimta (I think that's the drug you're referring to) is a standard treatment option in your dad's case and is one of the possible plans through the trial.
One of the questions trying to be answered by the trial is is opdivo better than SOC (standard of care). Opdivo was shown to be better than soc in 2nd line treatment in previous trials that led to its FDA approval however there is lingering doubt that this is really the case for those with a driver mutation found in many people with nsclc who never smoked or had a very short smoking history. Opdivo alone may or may not be beneficial for your dad (if he was/is a smoker or if he doesn't have a driver mutation chances are better opdivo alone will be efficacious). This arm of the trial will provide more data to help determine who is likely to benefit. At this time most onc want all to have a chance to try one of these drugs at some point.
The third arm you've mentioned is a combo. This arm has the least data so the least understanding what will really happen in clinical practice. There is lots of hope that a combo will improve survival for those with and without driver mutations or a high percentage of PD-L1 on the cancer cells. Only data from trials like this will tell.
Cont...
Reply # - October 12, 2016, 10:22 AM
Having cancer and having a
Having cancer and having a loved one with cancer is stressful enough without adding the extra worry about trying untried treatments. However these trials have loads of restrictions that help protect those on the trial. It's been said many times (by trial oncs and patients) that those on trials get the best medical care. I believe that to be true but also it means that the person will spend more time at the cancer center than usual.
In its 100 even 200 year history immunotherapy is moving quickly today with several new soc options in nsclc, but we have a long way to go to be able to answer the question about which is the best choice for a particular person. Please keep us up to date with your dad's thought process and continue to ask questions as you and he move through the process.
All best for you and your dad.
Janine