Adenomacarcinoma with pleural metastasis, Iressa, next step?

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Adenomacarcinoma with pleural metastasis, Iressa, next step?

Dear Madame, Sir, 

My mum (68yrs) was diagnosed in february with Adenomacarcinoma with pleural metastasis.  As in her DNS sample in exon 21 of the EGFR gene p. L858R activating mutation is found in 57%. She's now  Iressa for 2 months now.  She is currently in good condition, with small weight loss.

(No genetic difference in codons 12 and 13 of exon 2 of the kras gene in the dns sample. No genetic difference was detected in codon 600 of the BRAF gene in the dns sample. No genetic differences were found in exons 18 and 19 of the EGFR gene. PD-L1 immunohistochemistry reveals membrane positivity in 2% of tumor cells).

As I'm new in this topic and don't have much information on this, could you help me to provide more info just to be prepared and informed about the future possibilities.

What happens if the targeted therapy stops to work after a while? Will it be possible to have a new NIVATS biopsy (from the cells with resistance) and see that are there any new mutations? If yes, are there other targeted therapies that may work in similar situations? Or in this cases only the chemotherapy and radiation therapy can be possible? Or clinical trials? Or in that cases the condition of the patient will decide if there will be any possibility to continue any treatments?

We are at the beginning of this new fight (she had breast cancer in 2004), and I'd like to see the possibilities to be prepared to help my mother.

Thank you very much for the answer in advance. And sorry for so many questions.






JanineT Forum M...
Hi Kate, Welcome to Grace.  I

Hi Kate,


Welcome to Grace.  I'm so sorry your mum and family are going through this.  

That's a lot of information about testing results. It looks like EGFR+ L858R.  Is that right? 

The short answer to all your questions is yes. 

Before you change treatment oligoprogression may be treated while the current treatment continues or take a break from. 

There is a ton of info on our youtube channel. Here are results from youtube search "cancergrace efgr".  Find our channel from there. You're asking all the right questions. Check out the videos they will help flesh out some explanations and more questions.  So check back in here with what you found or didn't find and I'll try again. :).  Mostly things change quickly and often in NSCLC care so, if you can, check in with a specialist at least during the decision making process. 


I hope your mum does well for many years, it's not even that unusual anymore. 



target therapy

Dear Janine,

Thanks for the reply, I will go through all the videos, and if I"ll have more questions I will come back later. Thank you again, it means a lot to us that you help and give us more info!

Kind regards,