Hello Friends - Thank you & God Bless!
The good news is that I just passed the 6-year mark! But after many ups and downs, I now have progression with new mets and Taxotere is on the schedule for next week. With so many options out there, I wanted to ask the forum if there may be a promising treatment that we could also consider.
My history is listed below. My wonderful Oncologist had mentioned Tecentriq, but he now seems less sure with my EGFR status. I was also looking at the results for Dacomitinib trials given my Exon 19 Deletion... With my previous Lepto, my Doctor wants me stay on the Tagrisso as well.
February, 2011 - Initial Diagnosis of Stage lllB NSCLC
March, 2011 - Biopsy shows Exon 19 Deletion
April, 2011 - Begin Targeted Treatment with Tarceva
December, 2013 - Progression is Confirmed
January, 2014 - Begin Alitma + Carboplatin
April, 2014 - Chemo Not Effective & Stopped due to Progression
May, 2014 - Tarceva Started for Second Try
July, 2014 - Biopsy shows T790M Mutation
August, 2014 - Clovis Trial Started with Rociletinib
September, 2015 - Progression to Brain (Leptomeningeal Carcinomatosis) but asymptomatic
October, 2015 - Whole Brain Radiation
December, 2015 - Fresh Scans again indicates Brain Cancer plus minor progression in lungs/bones
December, 2015 - Begin Tagrisso
April, 2016 - Stable Scans but Increased unknown Pain on Left Side Abdomen and Back
December, 2016 - New Scans Show both Stable and Progressive Disease (new liver mets) but Tagrisso is continued
December, 2016 - Brain Scan is Clean showing No Cancer
December, 2016 - Guardant360 Blood Biopsy Shows only EGFR Exon 19 Deletion and AR R608 Mutation
February, 2016 - Fresh Scans show more Significant Progression in Lungs, Liver and Bones
Not sure why the Guardant360 showed no resistance mutations.
I appreciate your time - Take Care!
Reply # - February 21, 2017, 07:30 AM
Hi Opekoe,
Hi Opekoe,
Your oncologist is hesitant to try an immunotherapy because with a driver mutation like exon 19 you probably don't have a high PD-L1 expression and won't benefit from immunotherapy. Otherwise a chemo regimen would be the standard of care/treatment with a proven benefit. There are trials including those with combination of drugs that include immunotherapy that might be available to you. Your oncologist should be able to help you locate one or a 2nd at a large research/teaching hospital can help. Don't be hesitant to speak to your onc about the possibility of seeking a 2nd opinion they are always happy to get a 2nd head in the game.
Guardant360 is a liquid biopsy (blood) test that has a pretty good rate of finding mutations that are in a person's cancer though it's not as accurate as tissue biopsy. So it's not hard to believe something was missed. Even though I would insist my husband get a blood biopsy if he were to recur because of his zero track record of catching cancer in a needle biopsy. The science is getting there.
It's common to stay on tagrisso as long as you might be benefiting in some areas.
I hope you respond to whatever your next treatment is.
All best,
Janine