Adenocarcinoma & Alimta failed - 1273171

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akshay
Adenocarcinoma & Alimta failed - 1273171

Is Any body on Abraxane and carboplatin?

My Dad was diagnosed with locally advanced NSCLC Adenocarcinoma in Sept'15 and was given Alimta with Carboplatin.
After 3 cycles of the combination, his tumor size reduced by about 25%. So his doctor said to continue for 3 more cycles of the combo and then 1 cycle of Alima alone, before next scans.No Hair Loss,No abnormal WBC counts. We were very positive that the results will be favorable and the tumor will shrink further. But the results of the scan showed that the tumor grew back to about its actual size. I don't know how the drug worked before and then stopped working.

Now after 6 cycles of the combo and after suffering some side effects that have made him weak he has to again undergo chemo with new drug combo of ABRAXANE and Carboplatin.

Please let us know how can this next round of chemotherapy work?
Can this line of treatment show good results. Can ABRAXANE prove better than ALIMTA? What can we expect with respect to side effects?

Please help me and my dad.
Thanks.
Akshay

catdander
Welcome to Grace. It sounds

Welcome to Grace. It sounds like you've just begun this journey to find the best info for your dad. I'm going to post several blog posts from our fabulous faculty to get you started on understanding what he and you are up against.

http://cancergrace.org/lung/2010/04/05/an-introduction-to-lung-cancer/

One of my favorite quotes on Grace is from Dr. Weiss, "Every cancer therapy has two purposes: to improve duration of life, and to improve quality of life. Every other measure of chemotherapy success, such as response rate or progression-free-survival, is a surrogate to these two true goals. I am using the broken record as my pseudo-apology for repeating this mantra repeatedly on GRACE, to my colleagues, and in my mind every time I make a treatment decision." http://cancergrace.org/lung/2010/04/16/introduction-to-first-line-therap...
Toward the bottom of the post he says, "When First Line Therapy Fails
Successful therapy controls cancer for months or longer, but the cancer eventually learns to grow around even the best regimens. As long as you have good tools ready to treat the cancer after progression, it does not have to be a tragedy.
Successful therapy controls cancer for months or longer, but the cancer eventually learns to grow around even the best regimens. As long as you have good tools ready to treat the cancer after progression, it does not have to be a tragedy. "

Most anywhere you are your dad should have an option to get a 2nd opinion. This blog post is excellent. http://cancergrace.org/cancer-101/2011/11/13/an-insider%E2%80%99s-guide-...

I'll continue with on another post to answer a couple of your questions directly.

I hope your dad does better on his next treatment.
Janine

catdander
Akshay,

Akshay,

If you've read the posts you've found that it's not uncommon to benefit from one chemo drug after another has stopped working. In general the better one responds to chemo the better that person is likely to respond to another and vise versa. Too it's a realistic expectation that a chemo drug will stop working after having stabilized or shrunken tumors. Unfortunately, eventually cancer learns to grow past any boundaries previously in place by chemo (in that way cancer earns its reputation).

One note of caution, most people become hypersensitive to platinum drugs like carboplatin specifically after 6 cycles. For that reason it is common to spot carbo after 6 cycles and use a single chemo drug or other targeted drug afterward.

Abraxane has shown very good efficacy on its own. The side effect problems are usually with peripheral neuropathy (numbness, tingling and/or pain in the hands and/or feet). This side effect unfortunately only becomes worse with time on the offending drug. Drugs like gabapentin have helped many. Stopping the offending drug will stop the side effects however the longer the continued problems with peripheral neuropathy the less likely this side effect will go away. Some people don't have this issue at all (or is controlled with meds) and abraxane is very likely to be a good benefit.

Immunotherapies have been shown to be of great benefit and may be an option. Drugs that target mutations like egfr, ros1, and alk have pills available that can have great efficacy. There are trials that may be appropriate and available. If your dad can't get these options from the cancer center he's going to perhaps he can be seen at a large research center such as mentioned in the post about 2nd opinions.

I hope you've gotten some info that is helpful and I hope your dad does well for a very long time.
Janine