Revisiting former chemo - 1248768

kate0228
Posts:36

Do oncologists ever revisit a drug that you were treated with in the past? Once you have slight progression on a drug, will they ever try the drug on you again?

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Reply # - October 6, 2012, 10:27 AM

kate0228
Posts: 36

I guess I should have said that my husband did well on Tarceva for 6 months then had slight progression. Went on Carbo/Alimta for 5 rounds = stable. Scan after 2 rounds of alimta alone, slight progresson. Would carbo or Tarceva be an option again?

Reply # - October 6, 2012, 10:33 AM

catdander
Posts:

Kate,

Once a person has clearly progressed on a chemo drug doctors don't go back to it.
It is thought that resistance isn't reversible.

However, doctors are looking at TKI's such as Iressa and tarceva a bit differently because they can have the affect of slowing down disease in someone who has had good results. Kind of like bad brakes being better than no brakes.

Janine

Reply # - October 6, 2012, 10:47 AM

kate0228
Posts: 36

I like the analogy! His doctor moved him off Tarceva the second he saw progression - even though he said the progression was very slight. Looking back at the scans, it looks like the hilar lymph nodes were smaller but the increase was in the GGO. Looking at the last scan on alimta alone, he has one nodule that went from 1.5 to 2.5 cm and again, slight increase in GGO. Going to do another scan this week so Louisville and MDA can talk about it all and figure out which way to go.

Reply # - October 6, 2012, 03:40 PM

Dr West
Posts: 4735

Here's a post that specifically covers the options we might consider for slow progression on an EGFR inhibitor:

http://cancergrace.org/lung/tag/acquired-resistance/

Please note that some of the concepts are discussed in more detail in the links that follow the post.

We might sometimes return to a chemo on which someone had a response and then had it discontinued because they reached a fixed amount of treatment, but we don't generally return to a chemo treatment on which a person progressed. Particularly with carboplatin, there's a problem that many and perhaps even most patients will eventually develop a hypersensitivity/allergic-like reaction to it if they're on it for too long.

-Dr. West

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