Chemotherapy options - 1255565

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Chemotherapy options - 1255565

Dear Dr. West,

I have included case history in signature.I would appreciate your opinion on my foll. queries.
I'd like to know what are the chemo options left for me? And will it be beneficial to re induct Alimta since it was used as a 1st line in 2010.

Thanks & Regards,

Reply To: Chemotherapy options

Hi Bal., Welcome to Grace and I hope you are feeling alright.

It is a practice of oncology specialists in our faculty to return to a drug that has worked in the past and the person didn't progress significantly on it; such as alimta for those who responded to it during 1st line treatment with a platinum.
Alimta too has had fewer adverse events connected to it, many people feel quite well while on single agent alimta. So this sounds like a really good option.

Studies have shown alimta, tarceva (even those neg. for EGFR mutation), and taxotere to be responsive in 2nd line treatment. There are other drugs oncs give in these situations also. Here is a blog post that speaks to this,

This is the link from "focused cancer info"/archives "metastatic/recurrent nsclc..." Toward the top of the list is a post on why doublets aren't given after first line. I say this just because you've received and not experienced hypersensitivity on quite a bit of platinum.

Let us know if this helps and don't hesitate to ask,
forum moderator

Reply To: Chemotherapy options

Hi Bal.,

Just to add some personal experience: My wife had carbo/alimta as first-line treatment and responded well. When her cancer began to progress after a year and a half of Tarceva maintenance, she added alimta to the Tarceva and got several months of benefit from it.

Hope you get good response to whatever therapy you choose.

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>

Dr West
Reply To: Chemotherapy options

I would refer to the link Janine provided about 2nd line options, which are meant to cover a range of alternatives for 2nd line or later. I'd say that I generally have very little enthusiasm for going to doublets after 1st line, and especially in someone who has been on platinum doublet therapy for so long.

As Jim noted, I and other experts often consider it very reasonable to return to an agent on which someone didn't progress but just stopped because of a transition to something else. Because of this, I think Alimta (pemetrexed) would absolutely be an option. Aside from that, I think clinical trials or some of the other less commonly used alternatives I mentioned in the link Janine gave would be the leading alternatives.

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: Chemotherapy options

Dear Janine, Jim and Dr. West,

I am really thankful for your valuable suggestions, it'll certainly help me.

Thanks & Regards,