Brain Metastasis

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Brain Metastasis

After five years of taking Tarissa for his EGFR with bone metastasis lung cancer, the doctor found progression to the brain.  They are recommending brain radiation for him.  What is the prognosis for someone to have progression to the brain?  Is brain radiation a good recommendation?   My understanding is that there will be permanent damage to the brain with brain radiation.

Thank you.

JanineT Forum M...
Hi Rebecca, Welcome to Grace.

Hi Rebecca,


Welcome to Grace.  I'm sorry there is progression in the brain.  Unfortunately it's common for an adeno nsclc to progress to the brain.  It sounds like an appropriate plan especially if they are using stereotactic radiation (SRS). It doesn't distroy healthy tissue like standard whole brain radieation (WBR) which can lead to problems down the road.  Either is probably better than nothing.


Usually radiation is used pretty soon after dianosis to mitagate the symptoms which can be quite difficult to manage.  SRS, stereotactic radiosurgery is used when possible.  It causes very few side effects and distroys only the tumor, leaving healthy tissue alone.  WBR, whole brain radiation causes side some effects such as fatigue but does go away.  There is a chance that cognative issues will arise up months to years later with WBR but not with SRS.  If there are only a few spots in the brain SRS is usually chosen and treatment with the egfr drug can continue. 


This video is from the Targeted Therapies 2019 Patient Forum.  This is on youtube and includes a playlist of videos from the 2019 forum. 


I can usually tell what drug a person is talking about even if it's misspelled but you've hit right in the middle of 2 egfr tkis.  :)  Irissa and tagrisso.  I bring this up because if your friend has not taken tagrisso yet he may be able to move to it if his cancer has mutated to add the t790M mutation.  (note that tagrisso is now used firstline egfr with or without t790m but tagrisso doesn't work if you progress on iressa and don't have t790m.)


I hope he gets rid of the brain mets and continues on with the TKI for a long long time.



Thank you, Janine.  He is

Thank you, Janine.   got the egfr tkis incorrect.  He is actually taking erlotinib (terceva).  The dr has increased the amount from 100 mg to 150 mg. Does it make a difference?  Also, his insurance company recently changed his terceva to a generic type due to cost, does it make a difference in effectiveness?



Jim C Forum Mod...
Jim C Forum Moderator's picture
Generic Tarceva

Hi Rebecca,


Generic Tarceva just came on the market earlier this year. At times the concern about a generic would be in terms of quality control in the manufacturing process, but generic Tarceva is produced by a reputable manufacturer and should be just as effective as brand name.


Jim C Forum Moderator