Adenocarcinoma NSCLC IV - 1257132

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ikhlaq1
Adenocarcinoma NSCLC IV - 1257132

Hi Everyone,
I am new on this site, and want to discuss my brother's diagnose. He was diagnosed NSCLC IV Adinocarcinoma in March 2013, primary tumour in right Lung 5.4 cm .Note is made of a few small irregular soft tissue nodules in the left base largest measuring 10mm and few small mediastinal lymph nodes right supraclavicular lymph node 14 mm. He is EGFR negative, sending his sample to UK for Kras mutation but our oncologist said cant go for ALK because that is just for trial cases,and they won't do ALK mutation though I don't agree.Anyways he has 3 rounds of Cisplatin/Alimta and his primary tumour shrank from 5.4cm to 3.6cm and hope it will keep shrinking but his lymph nodes are stable, my question is that this regieme is good for lymph nodes as well or better to add Avastin as well? And he was former smoker and ALK and Kras mutation results negative for most of the smokers? Thank you in advance for your help and time for reading my post.

Dr West
Reply To: Adinocarcinoma NSCLC IV

ALK rearrangements are considerably less common in people with a significant smoking history, though certainly possible. KRAS mutations are seen commonly in lung adenocarcinomas (about 20-25%) pretty much independent of smoking history.

It's great that he has responded well to cisplatin/Alimta (pemetrexed), and this regimen would be good for pretty much all of the cancer, including the lymph nodes. It's just common to see some areas respond a little better than others. It's not clear how much Avastin (bevacizumab) adds -- a single trial showed a benefit with it added to the chemo regimen of carboplatin/Taxol (paclitaxel), but it hasn't been shown to improve survival in lung cancer in any other trial, leading many lung cancer experts and general oncologists alike to be somewhat skeptical about how much it really adds. I would say that while it may add modestly, it's not likely to be a critical addition.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

ikhlaq1
Reply To: Adinocarcinoma NSCLC IV

Hi Dr West,
Thank you for your prompt response. I have seen and read lot of people stories that they were stage IV NSCLC and after chemo thr tumour gone and even it won't came back in few cases like 3 years or even 5 years. Is thr any thing to do with immune system to improve the chances of blocking recurrence for long?

Dr West
Reply To: Adinocarcinoma NSCLC IV

No, not at this time. We are exploring new treatment options with "immune checkpoint inhibitors" like anti-PD-1 and anti-PDL1 immunotherapies for advanced NSCLC, but these are being applied to treat growing disease at this time.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

ikhlaq1
Reply To: Adinocarcinoma NSCLC IV

Dr west,
Thank you for your help, hope and fingers crossed that new immunotherapy will be available soon and will be very effective.