This is my first post here as my mother just got diagnosed with stage IV NSCLC adenocarcinoma in Aug. 60yo, never smoked. EGFR/ALK/ROS1 mutations -ve. She has been coughing since Mid Feb and the symptom had gone worse in recent weeks, including more frequent and difficult cough. PET scan suggest the cancer has metastasized to adrenal gland, neck lymph node on the right and also a bit to the back bone.
We are situated in Hong Kong and through government clinic we have the chance to participate in a clinical trial of using MEDI4736 + tremelimumab as 1st line treatment. The selection process will take 3 weeks probably and with 50% of the chance, candidate could be put in control group that only standard chemo treatment will be given. We have consulted a second opinion in the private sector and got a recommendation to proceed with standard chemo (Carboplatin + Pemetrexed) instead to avoid worsening of tumor and symptoms.
I am more inclined to take the traditional approach first but would like to obtain opinion on this case. In particular:
1. Will a 3-week wait worsen the situation of the tumor? In worse case, it may be a 3-week delay but still going back to chemo treatment if we fall into the control group.
2. Do you think it's worth to secure a chance in testing the new drugs? Is there any clear advantage in using the new drugs as a 1st line treatment (in view of no PD-L1 testing first performed)?
3. Is standard chemo still a first choice as 1st line treatment in this situation? If chemo is desired, I have heard of adding bevacizumab to the chemo combination would be better but my doctor at private sector is inclined not to add it at first stage. Any opinion on this?
Many thanks for all the comments in advance and my prayers to all of you on the same journey as my family.