Tarceva after Gilotrif - 1293313

Hi westcoaster,

Welcome to GRACE. We don't have specific data to be able to say definitively whether Tarceva would likely be effective after Gilotrif, but the two drugs are similar, so there may not be a benefit to switching to a very similar therapy.

One question is whether the progression is significant enough to warrant a treatment change. It's not uncommon for lung cancer to progress so slowly on an EGFR TKI that the best choice can be to remain on the current therapy. As Dr. Pennell has stated:

"The first thing to keep in mind is, not every patient who is developing acquired resistance needs to change what they’re doing. Sometimes, if the cancer is beginning to grow, it can grow in a very slow, asymptomatic way. In other words, it’s not causing symptoms, every time you do a scan it’s a little bit bigger, but the patient feels fine, is not having a lot of side effects from the drugs — you can continue to watch these. This can be anxiety-provoking, but I’ve watched patients for six months, nine months, sometimes longer before we really need to make a change. In the same vein, we know that about 20% of patients who develop acquired resistance don’t develop resistance everywhere in the body. Maybe only one or a couple of the tumors are growing, and if you biopsy those you can see that new mutations and mechanisms of resistance can arise in individual tumors while the rest of the cancer remains under control." - http://cancergrace.org/lung/2016/02/18/gcvl_lu_combinations_other_optio…

As Dr. West is fond of saying, sometimes bad brakes are better than no brakes. It's also good to get the maximum benefit from each treatment regimen, preserving other options for later use.

JimC
Forum moderator