Drs.,
Diagnosed with stage 4 large cell neuro-endicrine lung cancer that spread to some bone areas & some lymph nodes , July 2010. Did about 6-7 wks. chemo with breaks. During that time my dr. had my tissue sent out & it came back with the egfr marker. Stopped chemo, which had kept me a little bit above even. Since non-smoker I was put on tarceva. I was called complete remission in april 2011. Always had a very bad cough, didn't go away with remission.Kept coughing, long story short my dr. suggested conventional 3-d rad. Broncoscopy showed tumor was pressing on breathing tube. Did 18 treatments, got a damaged, burnt esophoges that I'm still going thru. Last pet-scan showed small progression of lymph node in neck area & a small new area around liver. Dr. has suggested new round of chemo starting in jan. Is this the correct course of treatment to pursue or is there another option? Thank you.
steves
chemo after tarceva - 1250758
steves
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Reply # - November 29, 2012, 04:03 PM
Reply To: chemo after tarceva
What to do in the setting of "acquired resistance" after a good response of someone with a driver mutation on the targeted therapy for that mutation is an open question. Chemo is a very fair idea, and some people would favor continuing the targeted therapy. Here's a discussion of the issue, with links to some additional posts covering the options:
http://cancergrace.org/lung/2012/08/05/acquired-resistance-faq/
Otherwise, some centers have clinical trials with new targeted agents specifically for people with acquired resistance to an EGFR inhibitor like Tarceva (erlotinib) or an ALK inhibitor like XALKORI (crizotinib). These also remain a strong option for someone in your situation.
-Dr. West
Reply # - November 29, 2012, 04:08 PM
Reply To: chemo after tarceva
Hi steves, I'm very sorry you are going through all this. We won't be able to tell you what the correct course will be. It's a decision that must be made by you and your doctors. A second opinion with a lung cancer specialist is never a bad idea. There is much ongoing research and practices happening with people who have done well on tarceva and now progressing; known as acquired resistance. One very up to date action is to keep those who have done very well on tarceva on tarceva and add to. I suggest you begin with these links and a search on this site. (If you have problems with a search try it logged off). You will learn there is no one right answer but I think you will come away with a good understanding of your choices and some specific questions on which our doctors will be happy to comment.
From the "Focused Cancer Info" tab http://cancergrace.org/lung/?cat=26
On acquired resistance http://cancergrace.org/lung/2012/08/05/acquired-resistance-faq/
And an excellent blog post describing the many benefits of 2nd opinions. http://cancergrace.org/cancer-101/2011/11/13/an-insider’s-guide-to-the-second-opinion/
Good luck, read, and start asking questions.
Janine
forum moderator