Extensive SCLC - 1242686

rsmith8167
Posts:4

My mother in law was dx with extensive SCLC in July 2011 we have done 6 rounds of chemo, 6 rounds of cyber knife and 14 WBR. The doctor also thinks the cancer has gotten into her bones so Monday we started Zometa. My question for you is after the 6 rounds rounds of chemo we did a CT scan 3 months later and it showed the lung cancer has gotten to the size it was when we started chemo, I know that isn\'t good by what I have read on this web site. Her dr wants her to look into trial study\'s I have found one and wanted to see if you have heard anything about it is Linisitinibor or Topotecan. I know Topotecan is the next round of chemo she would get anyway because it came back so quickly. So also can you please tell me what you know about the study we go Tuesday to talk to the dr and I would like to have as much info I can so I know what questions I should ask.
The trail study number is NCT 01533181

Thank you so much for doing what you do on this web site I know a lot of people look at you for answers you are doing a wonderful thing here. Thank you again for answering my questions.

 

I hope i didn't post this twice if I did I am sorry I am trying to learn this site.

Forums

dr aggarwal
Posts: 4

Dear rsmith,

Topotecan is currently approved second line therapy for SCLC. If your mother is up to it and feels well, it would make good sense to have her consider the clinical trial. Linsitinib is a small molecule drug, that targets the insulin growth factor receptor, and thus blocks a pathway that has been shown to be involved in the growth of cancer cells. It is a drug that is currently in clinical trials for both small cell and non-small cell lung cancer.

I personally do not have experience with the drug to tell you about the side effects etc. Some questions to consider asking the physician: how many patients have been on the study, what are the side effects that they are commonly noticing and what your mother can realistically expect if she decides to proceed with this.

Hope this helps,

Dr. Aggarwal

Dr West
Posts: 4735

There are so many studies that there's a good chance none of the doctors or other people here will have direct knowledge of the agent or the trial. However, the doctor should go over what is known and the anticipated benefits and risks of the trial/agent.

Good luck.

-Dr. West

rsmith8167
Posts: 4

I need help please my MIL just got her PET scan results from doing 6 rounds of Topotecan and her small cell lung cancer has grown. When we did a PET scan in May the cancer was 6.53 cm. and now it is 9.0 x 5.0 x 4.0 cm we were also told she had some fluid around her heart. My question is this normal to get fluid like that around the heart with small cell lung cancer? Do you know of any trails she can try and the DR also mention another Chemo we could try please give me some info so we can understand what is going on. My MIL also has a bad cough and having a lot of pain. The DR gave us 3 choices more Chemo. Trail study or we could do nothing and she might have 6 months.

Thank you for being here to answer question and for being here to talk to.

certain spring
Posts: 762

Hallo again, rsmith8167. Sorry to hear that your mother-in-law is worse. I think it's quite common for SCLC to grow quickly (just as it is common for it to shrink quickly), but very frightening all the same.
I think you had three questions:
1) about fluid round the heart ("pericardial effusion")
2) about trials
3) about different kinds of chemotherapy

1) Pericardial effusions are common in lung cancer, both SCLC and NSCLC. The fluid can be drained via a "window procedure", which Dr West describes in this thread:
http://cancergrace.org/forums/index.php?topic=798.0
2) Clinical trials. Can you tell us what your doctor is suggesting? He/she is best placed to know what's available where your mother-in-law lives.
3) Different chemotherapy drugs. Same thing - if you can tell us the names of the treatments your mother-in-law's doctor has mentioned, we can give more information. We know she has had Topotecan already.
Some other treatments that are used in extensive SCLC might be Cisplatin (or Carboplatin) and Etoposide, and Irinotecan.
best wishes

rsmith8167
Posts: 4

Thank you certain springs for replying my MIL did Carboplatin and Etoposide first for 6 rounds and then she did Topotecan for 6 rounds so I am not sure what they would do next, and I was just wondering if anyone had heard of any trail studies going on that we might look into I have a email to a Dr. and hoping she gets back to me soon about some trail studies.

catdander
Posts:

I just want to make sure you have read this, http://cancergrace.org/lung/2010/08/07/treatment-of-small-cell-lung-can…
and this is a link to several blog posts on research efforts on sclc. http://cancergrace.org/lung/category/lung-cancer/core-concepts/sclc-ext…

There are several threads on ex sclc in our forum under lung cancer/sclc/ex or just click here, http://cancergrace.org/forum/lung-thoracic-cancer/sclc/extensive

If your looking for a trial http://clinicaltrials.gov/ is very searchable.
Dr. West said in a recent post, "Unfortunately, there just aren’t many trials for SCLC that has been treated with more than one line of therapy. There are some trials that have more liberal eligibility criteria and are intended for people with any of several different kinds of cancer. However, because SCLC is becoming less frequent over time and many patients don’t do more than two lines of therapy, it’s very hard to find trials dedicated to relapsed SCLC, especially after second line." http://cancergrace.org/lung/topic/clinical-trials-for-sclc/

I hope this helps,
Janine
forum moderator

catdander
Posts:

rsmith, We are working on making the threads easier to find and access so I've moved your thread to the ex sclc forum. It won't change your address to your thread.
Janine
forum moderator

rsmith8167
Posts: 4

My MIL has been put on hospice. We had a MRI of the brain and they found a lot of cancer spot on her brain and the dr told us she didn't think we should do chemo anymore we are all heart broken. I would like to know what you think I could expect as the end gets close. They have her on dexa so she is eating good. I also know SCLC grows fast without treatment, I am just trying to figure out how much time we have left with her. She is also on oxygen 4 liters and her O2 stats are only about 76-88. I know you cant give me a date or anything I just really would like to know what I can maybe expect.

Thank you so much for being here to help I look forward to any help you can guide me with

Dr West
Posts: 4735

I'm very sorry to hear about her progression. I'm afraid we can't offera real timeline without knowing more about the specific person's case, but with progressing brain metastases, it's usually a matter of weeks to 1-2 months.

The most common pathway of the dying process is a gradual decline and sleeping more, eating and getting around less and less, then eventually not waking up. I describe this in more detail here:

http://cancergrace.org/cancer-treatments/2011/05/06/faq-dying-process/

However, it certainly varies from person to person.

-Dr. West