It is time again for some advice from this wonderful and knowledgeable team.
What is the efficiency of Alimta to cross the BBB ? I read that they are still trying to figure this out, but there seems to be evidence of acceptable BBB penetration from some patients whose brain mets have responded nicely .
What is your experience with this chemo agent in your patient population on their brain mets ?
The suggestion was made for me to move on to a carboplatin/ Alimta/ combo possibly remaining on Tagrisso also.
The reason for this : " there might be minimal leptomeningeal involvement of the medial left parietal lesion
I've been on Tagrisso for 17 months with rescue SRT to brain mets and lung mass to stretch out my time on Tagrisso.
My tumor load is probably still very low and ctDNA might not show up in the blood at this point.
There is also nothing to biopsy at this time.
The doc also said she did not want to put me through a lumbar puncture because of the often negative results .
Do you guys have any other ideas ? I'm still trying to stay away from WBR.
The doc was not to crazy about the ongoing Tesevatinib trial. I also would have to travel for this from Mass to Washington DC. She also did not think doubling up on Tagrisso would be preferable.
Last guardant liquid biopsy ( quite a while ago ) showed T740M went down to undetectable . Only original EGFR was still floating around .
Thanks so much for any input