Tarceva Resistance - 1247937

Hi Stefano, I'm sorry tarceva has stopped working but since you have done so well on tarceva then you are likely to have other really good options. There is much written on the subject so please use our search feature (you may need to log off first if you are using an explorer browser).
I will contact a doctor to give input on your question.

The best of luck moving forward and do please let us know how things go.

Janine
forum moderator

Hi Stefano,

Just thought I'd chime in with a link to the GRACE FAQ on second-line therapy: http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o… There are also several links at the end of that post which may be helpful.

JimC
Forum moderator

Hallo Stefano. There's actually a new post on this very topic by Dr West in the FAQ:
http://cancergrace.org/lung/2012/08/05/acquired-resistance-faq/
In it he emphasises that a) there's no consensus yet on how to treat acquired resistance; and b) that it depends on the nature and the extent of the progression. He's also written about whether to continue the targeted therapy (eg Tarceva) when treating resistance with chemotherapy:
http://cancergrace.org/lung/2012/06/19/chemo-with-or-without-ongoing-eg…
and about whether to continue it alongside a "local" treatment such as radiation:
http://cancergrace.org/lung/2012/06/09/ar-local-rx/
These are great posts and I really recommend them.
There are a lot of trials out there. Maybe you could say what country you are in, so as to narrow it down a bit? Very best.

Hi Stefano -
I am sorry to hear that tarceva may not be working as well as it used to. But you should know that this is an area of incredibly active research. As the moderators have pointed out, there are a fair number of detailed posts about this topic. I urge you to consider a consultation at a research center if that is possible as the options for treating patients with tarceva resistance are evolving rapidly. New concepts like keeping the tarceva going long term (sometimes with chemotherapy) and getting a repeat biposy to look for resistance mechanisms are becoming increasingly important and community oncologists aren't always able to hear quickly about the newest ideas on these matters. There are also a lot of promising trials available. You will have options!!

I don't know why it took me 30 months to ask to be referred to the comprehensive molecular testing clinical trial sponsored by the Lung Cancer Consortium (my testing was done at NIH...I live in the metro DC area), but that testing is now informing the best clinical trials for my Tarceva resistant NSCLC adenocarcinoma.

I should add that if I had been tested earlier, I think that I would not have benefited from the dramatic annual advances in EGFR-related research options that have emerged since my initial diagnosis.

I would encourage you to ask to be referred for this comprehensive testing (available at most of the major cancer research centers in the US) and to seek a second opinion from that center about the best way to move forward to control and treat your cancer.

I actually don't think that a big battery of tests is available from most larger cancer centers: the Lung Cancer Mutation Consortium (LCMC) is comprised of 14 centers in the US (http://cancergrace.org/lung/2011/03/07/lcmc/), and I'm not sure even they are regularly offering a big panel of molecular marker tests on a free, research basis to people right now (or this may be at some centers but not others). Outside of the limited number of centers in the LCMC, I think the options for testing may be larger and easier than at smaller community centers overall, but I don't think that there's a readily available battery of tests for rarer molecular markers that don't have an established treatment matched to them.

-Dr. West

Thanks for clarifying the actual availability of this testing and the current applicability of the results, Dr. West. I think much of this testing will help inform future research targets even more than point patients in my circumstance to current trials and treatment options. Anyway, knowledge is power and I hope this data will be found to be useful by researchers. And it is additional evidence of how fortunate, lucky, and grateful I am that I continue to be able to access so many opportunities to fight my cancer.

That's actually why I was asking Stefano where he lives - the availability of mutation testing, and of relevant clinical trials, varies wildly across different countries and even within the same country.

Very best of luck with the Alimta/Tarceva combination.
Here's a recent podcast/webinar that covers Lucanix:
http://cancergrace.org/lung/2012/06/13/immunotherapy-for-lung-cancer-pa…