Does standard chemo treat bone metastasis? - 1294101

Hi Irina,

Standard chemotherapy tends to be as effective as any systemic therapy in treating bone metastases, as such therapies treat cancer wherever it is found in the body, with the possible exception of the brain due to the blood brain barrier, where response may be lessened. Adding an EGFR inhibitor would only be considered if your cancer has been found to have an activating EGFR mutation, but even in that situation most oncologists do not feel that there is enough evidence to justify adding an EGFR inhibitor to the chemotherapy regimen. One reason for this is that sequential use therapeutic agents tends to be preferred, allowing a patient to get the maximum benefit from each agent, rather than "using up" several at once.

Treatment of bone metastases may include the use of radiation in order to palliate symptoms such as pain, as well as to prevent fractures. You may want to discuss this option with your oncologist.

The papers you cite show interesting results, but as you indicate the small populations make it difficult to draw any firm conclusions from the data, and larger, randomized trials would be necessary before such approaches gain clinical acceptance. The evidence is especially weak in the case study of an herbal regimen in one patient, as quite unusual results can occur when looking at just a single patient.

JimC
Forum moderator

masalovai,

It doesn't matter if the lung cancer metastasized to bone or organ if the systemic treatment works it works where ever it is except the brain. As Jim said chemo doesn't often make it into the brain because of the protective barrier known as the blood/brain barrier.

The treatment that targets bone mets are the Bisphosphonates such as zometa.

So when reading research about bone mets, metastatic lung cancer, etc., systemic treatment efficacy includes efficacy anywhere outside the brain including bone but there are no specific anticancer agents that target bone.

I hope you do well and are feeling alright.
Best hopes,
Janine

Unfortunately, there hasn't been any new developments in metastatic bone health since the advent of bisphosphonates. Even though they are 8-10 years old drugs like zometa are still the standard of care for bone mets plus systemic treatment. There are also orthopedist centered treatments such as vertebra strengthening procedures to help combat bone mets. http://cancergrace.org/cancer-101/category/cancer-101/general-lung-canc…

The study you mention above seems to be the only clinical trial on nsclc and Disulfiram. This trial really only shows that it's safe and worth studying more but much too small to say adding disulfiram raises survival rates. There are ongoing trials for other cancers so that's better than nothing. If trials in breast cancer and prostate cancer turn out positive then it's more likely to be considered to be studied in lung cancer. It's difficult to get funded for this level of research and it doesn't sound like there's much monetary incentive to study disulfiram for the pharmaceutical cos. That's why the wonderful organizations that raise money for breast cancer are so important. I used to be jealous that breast cancer got all the attention and funding but it's paid for good research that benefits lung cancer as well.

Our faculty occasionally comments on the forums but not regularly like they used to. I know they can add a lot of reassurance and credence to the discussion and that's why we use the blog and forum posts as resources. I hope we are still able to help you understand your options moving forward.

All best,
Janine