Carboplatin alone (monotherapy) ?

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daxys
Carboplatin alone (monotherapy) ?
My mum's oncologist decided that the next line of the treatment for my mum will be carboplatin monotherapy. The reason for carboplatin alone and not in combination with paclitaxel are low neutrophils (1.59) and low white blood cell count (3.59). Does anyone know anything about the efficacy of carboplatin alone? I am really afraid as we had really rapid progression on single agent pemetrexed in 2nd line. Also reports say that chemotherapy with just a single agent is the worst option after first line afatinib. Time on monotherapy treatment reported in retrospective analysis of LUX-Lung trials was just 2.3 months (which means almost immediate progression). My mums treatments so far are described here: https://www.inspire.com/daxys/ Thanks in advance!
scohn
Carboplatin
Hi daxys. So sorry to hear about your mum's progression, and hope the carboplatin provides some relief. I can't speak specifically to the mono therapy aspect, but my wife was on Carboplatin/Premetrexed and it worked great for her in terms of getting a 50-60% reduction in the tumor. After several rounds of the Carbo/Prem she went on the Premetrexed maintenance, which did nothing (led to progression fairly quickly). So, I assume the complete lack of Premetrexed effectiveness means the effectiveness of the dual combo was due to almost solely to the Carboplatin. Carbo is certainly the stronger of the two agents. My sense is that Carbo alone can also be harsh on WBCs, so make sure your mum's oncologist takes a good watch on those. After the first couple of treatments my wife had to take neulasta, which did a great job of keeping her WBCs up. All the best to you and your mum! Scohn

Wife, non-smoker, dx 4/24/15 adeno NSCLC stage IV. HER2 Exon 20. 6x Carbo/Alimta; effective. 9/15 Alimta maint; ineffect. 11/15 - Opdivo; ineffect. 4/16 - ptK7 trial; tumor reduc/stable 1.5 yr. 9/17 Gemzar; effective for 16 mo. 8/18 - TAK788 Trial

JimC
Carboplatin alone (monotherapy) ?
Hi daxys, In the early years of lung cancer chemotherapy, it was discovered that combining a platinum agent with another form of chemotherapy tended to be more effective than monotherapy, due to a synergistic effect. Since many patients begin chemotherapy with such a combination, and since platinum agents such as carboplatin tend to cause significant problems with bone marrow function if continued past 4-6 cycles, later lines of chemo tend to be monotherapy with other agents. But if a patient hasn't previously used a platinum agent, or if it's felt that enough time has elapsed since the original platinum agent was used, then there really is no reason you couldn't try carboplatin alone. On the other hand, if pemetrexed was ineffective, there are other chemo agents that could be added to the platinum therapy. As a side note, if you would like to establish a signature for your GRACE account, you can go to your dashboard and add it there. You may need to edit it a bit, since there currently is a 255 character limit, something I'm looking into to see if it can be changed. 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>

daxys
Carboplatin alone (monotherapy) ?
Thanks to both of you for your replies. Scohn, I suppose your wife's great response to carboplatin/paclitaxel was in the 1st line (?). Could I ask what her mutation was/is?

I'm here on behalf of my mom (72) who was diagnosed with NSCLC IV.stage (without distant methastases, only in lymph nodes and mediastinum) in April 2016- EGFR positive (mutation G719X)

scohn
Carboplatin
Hi daxys. My wife has HER2. HER2 is in the same class of molecules as EGFR. She has the most common HER2 mutation, a mutation in Exon 20, very similar to mutations and insertions on EGFR Exon 20. In fact currently she is on a trial drug that was developed to work on both HER2 and EGFR Exon 20 mutations. Yes, the carbo/premed was 1st line, but she also was on Gemzar alone, which works similarly to Carboplatin but not as strongly, as a 3rd line, which also did (mostly) fine for a while.

Wife, non-smoker, dx 4/24/15 adeno NSCLC stage IV. HER2 Exon 20. 6x Carbo/Alimta; effective. 9/15 Alimta maint; ineffect. 11/15 - Opdivo; ineffect. 4/16 - ptK7 trial; tumor reduc/stable 1.5 yr. 9/17 Gemzar; effective for 16 mo. 8/18 - TAK788 Trial