Greetings and grateful for your review and help!
Husb (now 62) had Stage1(<2cm) NSCLC-BAC in 2007, had LUL resected (definitive diagnosis!). CT followup and in past 1-2 years had lesions in each lung(<8mm) Then recently each 8-11mm. Before bx was accomplished-on 3/1/15 had left leg weakness and MRI revealed 7 brain lesions (most less than 5mm, one at 3cm, one at 6cm) Finished 12 rds WBR 3 wks ago, and lung bx result showed lung adeno Ca.ALK+ (no mention of BAC) CT/PET all neg for any other mets. Has been on Crizotinib for 10 days. Off Dexamethasone tomorrow. MRI done 4/20 and will discuss with rad and med onc on 4/23. He is doing quite well-though tired. No obv neuro signs he or I noting since the Dex initiated.
My question:-since Ceretinib is thought to be more effective against brain mets-shouldn't this be considered sooner? Was told that the protocol is to start with Crizotinib. Should we expect that the WBR is really going to offer the best therapy - and the Crizotinib is working to snuff out other microscopic mets?
Is Crizotinib best choice with multiple brain mets(ALK+)following WBR? - 1269274
dldl94
Posts:17
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Reply # - April 22, 2015, 09:17 AM
Hi dldl94,
Hi dldl94,
I'm sorry your husband's cancer has moved to the brain. Once BAC leaves the lung it's no longer considered pure BAC but at least in part has begun to act more like the more common adenocarcinoma.
I will ask a doctor to comment on the question about ceretinib and brain mets compared to crizotinib.
I hope your husband does very well now for a long time.
Janine
Reply # - April 22, 2015, 09:42 AM
Although ceritinib is
Although ceritinib is believed to have better activity in the brain (this has never been formally compared in a study), ceritinib is only currently FDA approved following treatment with crizotinib. Following WBRT which should control the brain metastases for some time, the choice of crizotinib makes sense. The radiation oncologists may consider further treatment to the larger lesions measuring 3/6 cm depending on the response observed on the MRI.
Reply # - April 22, 2015, 12:32 PM
Thank you so much! Appreciate
Thank you so much! Appreciate your answer!
Reply # - April 26, 2015, 08:34 PM
All brain mets have decreased
All brain mets have decreased by ~25-30% 1 month after WBR. Hallelujah! Sorting out Radiosurgery options now. Is having his lung tissue checked for PD-1 in event immunotherapy ever a consideration.
Reply # - April 27, 2015, 08:39 AM
That's great news. I hope the
That's great news. I hope the brain mets continue to shrink.
Thanks for sharing the good news!
JimC
Forum moderator
Reply # - April 27, 2015, 09:05 AM
Great news D!
Great news D!