Chemotherapy options - 1255565

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, http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o…

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.
http://cancergrace.org/lung/category/lung-cancer/core-concepts/metastat…

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

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.

JimC
Forum moderator

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