adenocarcinoma stage 4 exon 20 mutation - 1263489

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4301kj
adenocarcinoma stage 4 exon 20 mutation - 1263489

My wifes pathology just came it with the exon 20 mutation, I have searched for any treatments that impact this and have had little success...can anyone help me out?

JimC
Reply To: adenocarcinoma stage 4 exon 20 mutation

Hi 4301kj,

As Dr. Pennell points out in his post "EGFR Mutations Demystified" (http://cancergrace.org/lung/2009/03/20/np-egfr-muts-demystified/ ), cancer driven by an exon 20 mutation tends to be resistant to EGFR TKIs such as Tarceva. Dr. West has discussed how he treats such patients here: http://cancergrace.org/lung/2013/02/13/cip-egfr-exon-20-mutation/

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>

4301kj
Reply To: adenocarcinoma stage 4 exon 20 mutation

Jim C, thank you for pointing me to Dr. Wests treatment discussions. Is there a way to follow up with Dr. West to understand how the patient he treated with Tarceva did after his posting from February, 2013? Do I contact him somehow on this site?

JimC
Reply To: adenocarcinoma stage 4 exon 20 mutation

Dr. West will see this thread and most likely respond. If he doesn't, I will let him know about your inquiry.

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>

Dr West
Reply To: adenocarcinoma stage 4 exon 20 mutation

Not remarkably well. Overall, since then, there is only a little more evidence that exon 20 mutations are not typically great responders to EGFR inhibitors. The best evidence, scant though it is, is that people with an exon 20 mutation are likely better served by being treated as if they have no EGFR mutation -- namely, starting with conventional chemo and then potentially giving Tarceva (erlotinib) as a later line of therapy. It might be helpful, but exon 20 mutations don't follow the same rule of "EGFR TKI is clearly the optimal therapy" that is pretty clear for exon 19 or exon 21 mutations in the EGFR gene.

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