To stop Tarceva due to ground ground glass opacity , short of breath and cough

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To stop Tarceva due to ground ground glass opacity , short of breath and cough

My GGO was not resolved after been on antibiotic and 30 mg of prednisone for a week. I have cough and shortness of breath. My pulmonologist thinks about 3 reasons: tarceva toxicity, cancer related lymphangitis ( cancer cells blocking lymph vessels) or fungal bacretial infection.  Bronchoscopy cant be done because my condition with lack of oxygen. So the plan is to stop tarceva for 1-2 weeks and keep 40 mg of prednisone to see how it will affect my breathing . I really worry about this break.
At the moment I was on my way to change systemic treatment, which is tarceva to tarceva + crizotinib due to newly found MET mutation. I am afraid that crizotinib can add extra toxicity . 
I found in the literature that tarceva plus avastin works well for MET mutation with less toxicity than crizotinib combination. 
Probably I can start avastin now when stoped tarceva to secure from progression......? Then will add tarceva again....?

Is anyone has any related experience with tarceva breaks ? Any advice, please!

Thank you


JanineT Forum M...
Hi Vera, As for pulmonary

Hi Vera,


As for pulmonary lymphangitis I've written about it in your thread just prior to this one.  

Most often a break from tarceva isn't a problem.  However, on rare occasions, some show a fast paced progression after stopping tarceva but the vast majority of people do not experience this.  Note that you may find a lot written about this phenomenon because early on it was thought to be more common than it is. 


It sounds like the most urgent situation is your increasing shortness of breath.    Whether it's PLC or tarceva induced pneumonitis tarceva is at best not working at worst it's causing this fast paced decline so stopping tarceva for the foreseeable future is probably best.  If it's determined you have a bacterial infection it may be possible to return to tarceva after the infection is gone. 


Don't rule out chemo.  It works very well and can work as a place holder while improved targeted therapies are developed.  


This is a horrible situation in which no one should be put.  I'm sorry you're going through it and hope you find this is just a bump in the road. 

Best of hopes,


JanineT Forum M...
Hi Vera, I wanted to share

Hi Vera,


I wanted to share this article with you about shortness of breath and hope it's of some use.