Egfr mutant lung (egfr e746_s752delinsv (exon 19 deletion)

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Baskibv
Egfr mutant lung (egfr e746_s752delinsv (exon 19 deletion)

My wife is taking treatment for EGFR mutant lung cancer that had spread to her brain. She started with tagrisso and later after resistant went thru chemo drugs and they are not helping.  We are planning to try erlotinib (tarceva). The recent molecular shows the mutant as EGFR e746_s752 (exon 19 deletion ) and same as it was before 2 years ago except it had formed resistant to egfr c797s so tagrisso did not work. 

We would like to know if anybody gone thru treatment with tarceva and how effective it was to the Brain. Please share you experience about that drug and if you had taken it for cancer that spread to brain. Another option is to try trial drug poziotinib. Thanks in advance.

Jim C Forum Mod...
Jim C Forum Moderator's picture
EGFR positive lung cancer

Hi baskibv,

 

I'm sorry to hear of your wife's cancer progression in the brain. Is this the only place where the cancer progressed on Tagrisso and the chemo drugs? Did any of the prior treatment regimens keep the remainder of the cancer stable (no significant growth)?

 

I ask these questions because although it is true that most lung cancer treatments can be at least somewhat effective in the brain, the typical intervention for brain metastases is radiation, either focused or whole brain radiation, depending on the number of metastases. And if the remaining cancer remains stable, then the current treatment regimen is often continued. Is this an option which has been discussed or utilized?

 

Jim C Forum Moderator 

Baskibv
Hi

Hi Jim,

With the initial treatment of 9 months, the cancer is brain and lung were completely gone and it was only lingering near the left shoulder humeral head area. Dr. continued for several months to make sure Tagrisso is working on it and once we are sure they are coming back then we had to switch regimen. She tried a trial drug after this to avoid chemo but that formed a big cyst like mass near the overy and we had to stop it immediately and move on to chemo med. Chemo med is working on some area but it also formed new spots in other organs and several spots in brain. Radiation doctor wanted to do whole brain radiation but he is ready to wait a month to see if tarceva is going to work or not. He also said it can penetrate the brain barrier somewhat and that is the reason i want answer from people who went thru it.

JanineT Forum M...
Hi baskibv,  I too want to

Hi baskibv, 

 

I too want to welcome you to Grace.  I'm so sorry your wife is progressing.  I don't know if you and she have had a conversation with her oncologist about oligoprogression (what Jim was talking about, progression in just 2 or 3 places) or whether it would be appropriate for your wife.  For more information, below are 2 links to an article and a video with transcript on the subject.

https://cancergrace.org/post/importance-oligo-oligometastatic-or-oligoprogression

https://cancergrace.org/post/local-therapy-limited-acquired-resistance

 

As Jim mentioned above, focused radiation to brain mets may be an option called stereotactic radiosurgery (SRS).  Besides systemic therapy, it's the least invasive treatment for brain mets.  It's possible to do a few at a time as needed and spare the more negative effects of whole brain radiation.  This is a post (#9) from Dr. Loiselle, a radiation oncologist that might be helpful in a conversation with your wife's medical and radiation oncologist.  But it's possible that tarceva (a systemic therapy) will be of help and radiation won't be necessary. 

 

I hope treatment gets your wife's cancer under control. 

Best of luck,

Janine