1st Progression- Chemo, Tagrisso or Trial? What next? - 1290424

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stage4gf
1st Progression- Chemo, Tagrisso or Trial? What next? - 1290424

My fiance just showed slight progression in his chest/neck lymph nodes and a spot on his rib. He's been on gilotrif (afatnib) for 14 months. He had very small progression in January, but enough to do some localized radiation and wait and see. Now we know it's time to move on to the next treatment plan. We're scheduling tests to determine if he has the T790M Mutation. If he does, we'd hope he'd respond well to Tagrisso. If not, we're probably looking at standard chemo. Who has some success stories on either? Also, any one on a current trial they could suggest? Thanks as always!

JimC
Hi stage4gf,

Hi stage4gf,

I'm sorry to hear of your fiance's progression. Unfortunately a 14 month response to a first line EGFR TKI is pretty typical. But you're certainly looking at the right options for his next treatment regimen. Many patients with a T790M mutation respond well to Tagrisso (and even some without that specific mutation). On the other hand, patients with activating EGFR mutations tend also to respond well to standard chemotherapy. A regimen which includes a platinum agent plus Alimta, Taxotere or Taxol would be a good choice that has proven effective.

As far as trials, perhaps another GRACE user will respond, but you can also talk to your fiance's oncologist to see which trials might be appropriate for him.

Good luck with the upcoming treatment plan.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

scohn
Hi stage4gf.

Hi stage4gf.

Sorry to hear about your fiance's progression. I hope your new treatment gives strong and long lasting help.
I just wanted to mention one potential clinical trial you might want to look into depending on how the mutational information comes out. If it is an EGFR Exon 20 mutation (such as the T790M) there is a clinical trial run by ARIAD pharmaceuticals (just bought out by Takeda) which is designed to look at a new TKI designed specifically for EXON 20 mutations in EGFR and HER2.

The clinical trial can be seen at: https://clinicaltrials.gov/ct2/show/NCT02716116

There are also a number of trials currently being started using an immunotherapy drug along with other agents to help either stop cell division or help enhance cell recognition to the immune system, but they are less specifically targeted to EXON 20 than the above trial.

There is also the trial my wife is on, which is targeted towards adenocarcinomas (such as most EGFR NSCLCs) that have high PTK7 activity (NCT02222922). But they are no longer taking new patients for this drug until they start the official Phase 2 trials based on the Phase 1/1b dosage data.

Sending support and hugs for successful treatment!

Wife, non-smoker, dx 4/24/15 adeno NSCLC stage IV. HER2 Exon 20. 6/15 6x Carbo/Alimta; effective. 9/15 Alimta maint; ineffect. 11/15 - Opdivo; ineffect. 4/16 - ptK7 trial; effective 1.5 yr. 9/17 Gemzar; effective 16 mo. 8/18 -TAK788 Trial; ineffective. 10/18 Abraxane; effective. 7/19 Kadcyla; effective. 10/19 Carbo/Alimta/Keytruda followed by Alimta; ineffective. 4/20-Poziotinib; effective. 7/20-4/21 - Enhertu. 4/21-?? Abraxane/ramucirumab.