Advanced NSCLC4 after 2yr6mo on Tarceva - 1258100

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Advanced NSCLC4 after 2yr6mo on Tarceva - 1258100

Sorry if question has been asked I searched, but am now more confused. Husband was dx with stage 3b on 12/10 at 39yrs old. Started clinical trial Chemo alimta/ carboplatin every 3 wks with Erbitux weekly. After 5 treatments he stopped and was then placed on Tarceva. Last pet scan 11 days ago showed progression, however, it is all still located within the left lung. What are your thoughts on Anti-KIR Antibody in combination with an Anti-PD1 trial -vs- Tarceva, with alimta, carboplatin and avastin? Aside from the cancer and sometimes HBP and lower back pain he is healthy. He has a severe rash on his hands and 3 toes from the Tarceva and a little bit on his forearms as well.

Reply To: Advanced NSCLC4 after 2yr6mo on Tarceva

I'm very sorry your young husband is going through this. I'm not a doctor so this is just my thoughts, but if he progressed early on tarceva it would seem prudent to move on to another promising treatment. He can come back to chemo at another time.

I will ask a doctor to comment on your question.

I hope he does well for a very long time to come,
forum moderator

Dr West
Reply To: Advanced NSCLC4 after 2yr6mo on Tarceva

I'm also sorry to hear about your husband's diagnosis. There's not enough information to say what to expect from the immunotherapy combinations, but they are certainly intriguing. Outside of a clinical trial, some people add chemo to Tarceva (erlotinib) for someone who is progressing after a long period of a good response on Tarceva or another oral EGFR inhibitor, others don't prefer to have them overlap. There's really no clear answer. A smaller proportion would give Tarceva with chemo and Avastin -- it's not very well studied, and in the absence of evidence it's beneficial, many people have reservations about potential detrimental effects of such an understudied combination.

Good luck.

-Dr. West

Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

Reply To: Advanced NSCLC4 after 2yr6mo on Tarceva

It is something we are still trying to figure out. We are getting a 2nd opinion on Monday, however, my husband now has his reservations about such combinations. We understand why staying on Tarceva might be beneficial as we feel it's still working in other areas. He had a scan 2 mo ago which showed some areas of new activity in his right lung, however, with his last scan it was clear. His Tarceva was increased 2mo ago to 250mg so, that might have nipped it in the rear. So, adding the alimta/carboplatin which, had possibly helped out when he was on the clinical trial also make sense. The Avastin is what my husband might be reconsidering as we think it might be a bit over the top. This is just so, difficult and very overwhelming. Thank you for your valued input.