Hello
I have been on Tagrisso for 7 months and the main lung mass ( 3.5cm ) and a hilar lymph node ( 1,5cm ) are the only active hot spots.
Brain seems to be under control. No new mets. Might have a slight case of radionecrosis from SRS on 3 mets done last October 2015. There is some slight increase of inflammation around two shriveled irradiated old mets.
My onc now seems to agree ( I was waiting for this for months) that tackling the lung tumor with radiation would be an acceptable way to proceed.
How do you deal with the systemic Tagrisso therapy if radiation is spread out over several treatments ?
Would I have to stop it and then resume when all the radiation treatments have been finished?
Will I risk rebound progression during this time? I know it's supposed to happen less often than first predicted? What do the statistics tell us ?
How high are the risks of pneumonitis if you combine radiation of the lung and TKI's ?
I'm getting myself ready for the next step and I'm trying to balance pros and cons .
Thanks for any help with my decision.
Kempten
Reply # - November 29, 2016, 07:00 AM
Hi Kempten,
Hi Kempten,
Congratulations on doing so well. Most oncologists feel it's important to halt tki treatment during radiation treatment. Pneumonitis is a dangerous complication, it can be deadly. Like the chemo drug gemcitibine with radiation concurrent treatment can also enhance the value of each in ways that can't be safely regulated. The very small chance of a rebound effect is less dangerous when weighed against the very real complications that more commonly arise from concurrent tki/radiation treatment.
All best of luck moving forward.
Janine
Reply # - November 29, 2016, 07:58 AM
Thank you as always Janine.
Thank you as always Janine.
I do have symptoms ( cough on and off and occasional hoarseness ) whenever the tumor reaches a certain size. The cough can be pretty debilitating at times . It tends to come in coughing fits especially when talking, so I hope the insurance will ok the treatment.
My onc said that my systemic disease is at a very low level right now and the Guardant 360 test came back stating that the mutation load had dropped below detectable levels except for the original EGFR mutation that remains at 0.3%. He did not want to put me through chemo at this time but feels the growing lung tumor and lymph node should be treated.
thanks again
Kempten
Reply # - November 29, 2016, 09:11 AM
I may have been unclear, it
I may have been unclear, it wouldn't be the first time. The mention of gemzar was an example of a chemo that is never used with radiation while other chemos (even platinum doublets) are considered for use as a concurrent chemo/radiation. I give this example to say there are times when oncologists push boundaries but there are limits such as with gemzar/radiation and it seems from the links below tki/radiation as well.
Below is a link to results for a new term oligo progression. While this doesn't perfectly pertain to you (you want a more traditional radiation treatment/treating a symptom/cough which can certainly be debilitating) the linked discussions do have specific similarities that do pertain; radiating a tumor while taking a tki. These discussions have specific data from recent and ongoing studies.
The first topic by Dr. Weiss is the most recent. He's been one of the leading advocates of these studies so I'd say it's the most up to date info from the horses mouth (a saying used to mean from the person who knows). http://cancergrace.org/search-results?q=oligo%20progression
I hope this makes more sense. ?
Janine
Reply # - November 29, 2016, 09:47 AM
thanks again Janine,
thanks again Janine,
very helpful information.
I will check everything out on this subject
Kempten