Tarceva for BAC? - 1247444

ilsa06
Posts:6

Hello Dr West:

I have just watched the video that was posted on facebook regarding Tarceva in EGFR wild mutations. I was wondering if there was any information as ASCO regarding the Tarceva and BAC.

Thanks in advance!
T

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Reply # - August 29, 2012, 06:20 PM

Dr West
Posts: 4735

No, there really isn't anything new about Tarceva (erlotinib) and bronchioloalveolar carcinoma (BAC). Essentially, I'd summarize the current expert view as being that BAC should really most appropriately be treated like any other adenocarcinoma if it needs systemic treatment. Specifically, if it has an EGFR mutation or ALK rearrangement, it is best treated with an EGFR inhibitor or crizotinib, respectively. Otherwise, it is best treated with a chemotherapy-based treatment, if treatment is needed. Probably the main difference is that a significant proportion of BAC lesions will grow so slowly that they don't necessarily merit intervention with systemic therapy just because there is disease visible, as it may progress so slowly that the treatment could be worse than the disease, and there is no clear advantage to starting treatment long before the disease becomes problematic in terms of causing symptoms or becoming a remote threat to survival. Some non-BAC cancers will be this indolent, but this situation is most commonly seen for BAC tumors.

-Dr. West

Reply # - September 5, 2012, 05:17 PM

ilsa06
Posts: 6

To add to this conversation I went to my doctor today and was to start my 28 day chemo treatment - my doctor had changed my treatments from 21 days to every 28 days.

I have recently had strange eye swelling and the doctor took me off the Avastin part of the treatment and just gave Alimta. I am also making some changes to my diet to see if it is the Avastin or some new items added to my diet that is causing this strage eye swelling (very puffy under eyes, almost looks like I have black eyes because of the discoloration).

I am BAC KRAS mutation mixed mucinous/non-mucinos (peutz-jegers disease as well) Stage IV being treated since Oct 2011. My scans have shown significant improvement and doctor is extremely please in my progress. My health if fantastic - I breath no breathing issues can tolerate exercise very well.

My doctor has mentioned the possibility of suspending chemo for awhlle as i am doing so fantastic and the BAC I have appears to be very slow growing and I will kept under a close watch with scans every 2 months.

Have you ever hear of this being done with any BAC patients? My doctor is one of the top specialists in the field and has all my trust. I was just curious if this is often done with BAC patients.

Thank you in advance.

Ilsa

Reply # - September 5, 2012, 08:45 PM

Dr West
Posts: 4735

It's something I feel very comfortable with. I offer this approach routinely for patients with an indolent cancer.

As for the puffy eyes, I'd suspect it's from Alimta (pemetrexed). It's not a well-described side effect, but the more I know to look for it, the more I recognize it in a minority of patients who are on Alimta.

http://cancergrace.org/forums/index.php?topic=2914.0

-Dr. West

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