I was diagnosed with adenocarcinoma NSCLC in March 2015. Lung biopsy showed EGFR 19 mutation. In May 2015, I began 150 mg Tarceva. In July 2016, I began to progress. In November 2016, lung biopsy showed T790M and I entered a clinical trial program combining Tagrisso (80 mg) with necitumimab. In April, 2017, I stopped taking the neci due to side effects. I continued on Tagrisso. In October 2017, I began to progress on Tagrisso. A subsequent biopsy showed that, in addition to EGFR, I now have ALK rearrangement. Yes, I have concomitant EGFR and ALK.
I continued taking Tagrisso and added Crizotinib, 200 mg 2x per day. A CT in December 2017 showed a small reduction in tumor size, but in April 2018, I began to progress. Since all the progression thus far was in the primary tumor in my upper left lobe, I had 5 rounds of SBRT targeting the primary tumor. A recent CT scan showed that although the primary tumor was reduced in size, other small tumors (less than a centimeter) were now appearing in my lower left lobe. My PDL is zero. My oncologist has recommended a combination of carboplatin, pemetrexed and pembrolizimab.
I would like to obtain a second opinion. I'm not sure whether to seek a second opinion from an oncologist who specializes in EGFR or ALK. Any thoughts would be appreciated.