Adjuvant chemo or gefitinib - 1293647

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jess123
Adjuvant chemo or gefitinib - 1293647

Hello all
My mum was diagnosed with lung cancer and underwent lobectomy right upper lobe on october 27th, post surgical histopathology came up with T2aN0M0 staging as before surgery PET scan had her at T3N0M0, 2 hilar nodes were taken and tested for metastasis both were negative, mum was advised she needs chemo post surgery to be started by atleast 4 weeks, as it was an open surgery mum didnt recover by then but is much better now and has seen another oncologist for that, however this oncologist suggested mum can have geftinib instead and advised to send samples for genetic testing the results of which will take another month or so, tumour size was 2cmx2.5cm, but due to visceral pleural invasion mum was T2a, I would like to ask whether geftinib is commonly given post surgery in these types of cases? Has anyone had it??thank you for taking the time to read this, her margins were clear in the report. Thanks again

JimC
Hi jess123,

Hi jess123,

Welcome to GRACE. Congratulations on your mum's excellent surgery results. Adjuvant therapy is given in an effort to eliminate any remaining cancer cells in the body. There isn't good evidence that a short course of a targeted therapy (such as gefitinib) in the adjuvant setting provides a significant benefit. Targeted therapy tends to be given indefinitely, until there is evidence of progression, but when there is currently no evidence of disease, you don't really know whether the targeted therapy is necessary, and continuing it indefinitely when you might already be cured is not an attractive option.

Dr. West discusses these issues here: http://cancergrace.org/lung/2014/02/02/adjuvant-targ-rx/

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>

catdander
Hi jess123,

Hi jess123,

I'm sorry to know about your mum's cancer but hope she is already cured. To address timing, Dr. Wakelee has written a very readable blog/post on the subject of curative resected nsclc treatments. On chemotherapy after surgery she writes,
“Chemotherapy after surgery seems to work best when started 4-8 weeks after surgery. Some patients will have recovered enough to receive treatment earlier than 4 weeks, but that is unusual. There is some data to support chemotherapy as far as 12 weeks after surgery, but if a patient has still not recovered enough for chemotherapy by 12 weeks after surgery, it is unclear that chemotherapy given later than this will be of any benefit.”

For the entire blog here’s the link.

http://cancergrace.org/lung/2010/05/17/systemic-therapy-for-resected-nsc...

Let us know how else we can help and very good luck,
Janine
forum moderator

jess123
Thanks Jim and Janine for

Thanks Jim and Janine for your quick replies, much appreciated

onthemark
As discussed on a different

As discussed on a different thread and a recent paper by Dr. West, adjuvant therapy shows benefit up to 18 weeks after treatment, although it is not clear that a tumor of this size with pleural invasion should be treated adjuvantly with chemo.

See the discussion here:

http://cancergrace.org/topic/stage-1b-non-small-cell-lung-cancer#post-12...