Alimta and the brain sheath barrier - 1249849

Hello Stefano, I hope this helps. Also there is much written about acquired resistance to tarceva. You may know this but... Use our search to find tons of information. (you may need to log off to access the search feature or you can use google starting with, " site:cancergrace.org space before search term ". This is a good forum thread on the subject, http://cancergrace.org/topic/egfr-tki-and-acquired-resistance

Dr. West's quote below stills stands,

" It's not very well studied, but the idea that chemotherapy can't get into the brain because of the blood-brain barrier is oversimplified. There's actually evidence that the response rate of metastases in the brain is in the same ballpark as that of measured disease outside of the brain:

http://cancergrace.org/lung/2007/10/24/chemo-for-brain-mets/

There have been some vague hints that Alimta (pemetrexed) and Camptosar (irinotecan) may be particularly effective for brain metastases, but frankly I'd say that the amount and quality of that evidence isn't enough for me to be at all inclined to make clinical decisions on the basis of that work. There's really no meaningful work to suggest that one lung cancer treatment is significantly more effective against brain metastases compared"

Let us know how we can help moving forward,
Janine
forum moderator

I don't really have anything to add. To my knowledge, there isn't really any new work in this area. We don't rely on chemo to treat cancer in the brain and definitely consider radiation to be the main treatment for lung cancer metastatic to the brain, or possibly surgery for just one or a couple of metastases.

-Dr. West

Stefano:
13 months ago I was diagnosed with "innumerable" small brain mets. Oncologist recommended WBR, but consulting radiation ontologist counseled two rounds of Alimta (pemetrexed) and Carboplation first then a new MRI. After two triweekly rounds of pem (i.e ., Alimta) and carbo ALL brain mets disappeared and have not returned (latest MRI: a week ago).I have never had radiotherapy. Did Alimta pass the Blood Brain Barrier? Sure seems like it to me!

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dx NSCLC adenocarcincoma 10/2011; 7 cm primary tumor in LLung, "innumerable" small (mostly less than 1mm) brain mets, "innumerable" skeletal bone mets; large calvarial bone met; tumor on r adrenal, extensive lymph node involvement; 6 triweekly rounds Alimta & Carbo, with 4 rounds Avastin. All tumors shrunken substantially or disappeared.Lymph nodes clear. Bone mets sclerosed. Began maintenance chemo w/ Avastin and Alimta; after 3 mos continued interval decrease, . PET revealed tiny SUV in primary, now down to .5 x. 1 cm. August PET showed NED.