TKI resistance correlations - 1289702

picklette
Posts:3

Have any correlations been made between the time taken to become resistant in patients who have received 1st, 2nd and 3rd generation TKIs?

For example, if a patient became resistant to Tarceva after 7months, would you expect a similar time frame for the patient to exhibit resistance when taking Afatinib or Tagrisso?

Thanks
Jackie

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Reply # - January 4, 2017, 04:44 PM

catdander
Posts:

Hi Jackie,

I've not heard of correlations per se. Taking afatinib after progressing on tarceva hasn't shown to be effective in stopping cancer progression and vice versa. If there is a t790m mutation acquired while on tarceva or afatinib then there's a good chance that tagrisso will have efficacy but any correlation to the timing is unknown. The mechanism of resistance to tagrisso is too new to have much of an understanding just yet.

You didn't ask but I won't hesitate to try to guess what else may be of help. Think of it as a bonus :)
This video has an excellent explanation of what nsclc specialists are doing today for their patients who've have begun to show progression on tarceva.
http://cancergrace.org/lung/2016/02/18/gcvl_lu_combinations_other_optio…

All best,
Janine

Reply # - January 7, 2017, 04:19 AM

picklette
Posts: 3

Thanks Janine and thanks for the bonus vid! :)

It took me 6 months to progress on Tarceva and never got to try Afatinib as Onc hadn't seen good results with other patients so after some chemo & a try at Nivo I tested positive for T790M & was put on Tagrisso.

My last scan showed complete metabolic remission though the primary is still visible on scans but at the back of my mind I'm very aware that the average time to resistance on Tagrisso is 10 months and I'm in my tenth month now! Obviously all patients are different but my choices going forward are limited due to chemo induced kidney failure last year so I was just wondering what correlations if any had been done.

I guess these things will be looked at in time but when more data is available.

Thanks again for getting back to me Janine
All the Best
Jackie :)

Reply # - January 7, 2017, 07:07 AM

JimC
Posts: 2753

Hi Jackie,

It's great to hear that the latest scan shows no metabolic activity. As far as the median time to progression on Tagrisso, although it's good to plan ahead, just remember that this is a statistic that applies only to a large number of patients, and is not necessarily predictive of how an individual will fare. And in any event, that median indicates that half of all patients get a longer response, some significantly so. No reason to think that won't be you!

JimC
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Reply # - January 7, 2017, 08:49 AM

catdander
Posts:

Hi Jackie,

I wonder if your kidney failure was due to a platinum drug. If so you will still be able to try a single chemo like alimta alone. People with EGFR mutations do very well with it. However, like Jim I hope you do very well on tagrisso for a very long time.

All best,
Janine

Reply # - January 8, 2017, 12:48 PM

picklette
Posts: 3

Thanks Jim. Thanks again Janine :)

The Kidney failure actually occurred after my sixth infusion of Alimta which I understand is quite a rare side effect of Alimta so I doubt they'll prescribe that again but I know there are other options it's just from what I can tell, they would mostly require me to have dialysis :cry:

I have read of people lasting a lot longer than 10 months on Tagrisso though so I'm hoping I'm one of those. Better to believe that I will be than worry I won't :-D

Thanks again both
Jackie

Reply # - January 8, 2017, 01:11 PM

catdander
Posts:

The assumption I'll make is that you will do very well long after the next best thing is on the market. :)

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