fengchen
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My mom was diagnosed with a stage IV NSCLC adenocarcinoma around 2 months ago. She was treated ALIMTA+ Carboplatin,failed. Then she was treated with Crizotinib. She got better soon. After one month, Pleural effusion was inctreased. Now, about 5000ml Pleural effusion have been discharged. Pleural effusion was red and no cancer cell been discovered. What can we do next step. Sorry for my jerky English.
your kind assistance would be highly appreciated. Thank you very much.
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Reply # - December 2, 2014, 09:33 AM
Hello fengchen,
Hello fengchen,
Welcome to GRACE. I am sorry to hear of your mom's diagnosis; I hope that crizotinib (Xalkori) will continue to be effective for her.
Although in the context of an established cancer diagnosis the likely cause of a pleural effusion is the cancer, effusion can have other causes and by themselves are not necessarily an indication of cancer progression. There are a number of options for treating effusions, such as repeat thoracentesis to drain them, installation of a catheter to allow draining at any time or a procedure called pleurodesis, in which a substance is inserted into the pleural space in an effort to close up that space, preventing the accumulation of fluid. Dr. West discusses the option in his post on Options for Managing Recurrent Pleural Effusions.
Good luck to your mom and to you.
JimC
Forum moderator
Reply # - December 2, 2014, 07:56 PM
Because pleural effusions can
Because pleural effusions can be caused by many things and aren't reliably measurable, we don't consider an increasing pleural effusion as clear evidence of disease progression. Because of this, if there isn't evidence of measurable disease progressing significantly, we'd generally favor continuing on the current treatment.
If there's progression that is significant, if someone has an ALK rearrangement (as would be expected from her being on crizotinib (Xalkori)), there are now a growing number of second generation ALK inhibitors, such as ceritinib, alectinib, AP26113, or some others in clinical trials or commercially available in some parts of the world (alectinib is approved in Japan, ceritinib in the US, and the others in global clinical trials). Otherwise, alternative chemotherapy, such as with Taxotere (docetaxel) may potentially be helpful in patients who have already progressed on prior therapy.
Good luck.
-Dr. West