My fiance is on his fourth month of Tagrisso after 14 months on Afatnib. His most recent scans show improvement in his lungs and bones. There has been slight growth in his lymph nodes but it's more likely they're stable and the 1mm change was due to treatment effect and/or a recent illness. Regardless, he has two supraclavicular lymph nodes that are at 1.2cm and 1.7cm and causing pain and discomfort. Considering the Tagrisso seems to be working on the rest of his body, including his brain, it's too early to say he's not responding, correct? Due to the discomfort, we'd like to pursue additional treatment options. He's obviously nervous about standard radiation side effects since it's so close to his throat. What about radiofrequency ablation, alcohol ablation or cryoablation? Is SRS an option?
Additionally, is there a chance that these lymph nodes don't carry as much of the T790 mutation as the rest of his cancer? Could there be an additional mutation that we should test for like Met? Or could it just be carrying the original EGFR mutation and something like an afatnib pulse as a chaser could help? Just trying to think outside the box.