After 8 weeks onc took me off trial. No tumor response and new activity noted on scan. Since I haven't had chemo yet . (dx 2013, stage iv, tarceva 3 plus years, tried vaxira (cuba), now failed this.)Onc stated "since this immuno didn't work, other immuno probably won't work either.
I know immuno so new that nobody really knows but i can't help but think if it was a trial, how can such a statement be made?
Im egfr exon 19, two guardant 360 tests showing no t790 but doesn't show egfr either, shows nothing. Cough and shortness of breath getting worse.
Am i looking aa standard chemo next?
I like what i read about tecentriq but onc says no. I guess getting it back under control first would be priority?
Cancer still contained in lungs and on images it looks like infiltrate but my onc says i show no symptoms for it to be infection and my scans have always shown "infiltrate " areas which there is new one showing on last week scan.
Thoughts moving fwd ? Thank you so much in advance
D
Failed trial of Epacadostat and durvalumab - 1289088
captain72
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Reply # - November 4, 2016, 03:11 PM
Hi captain72,
Hi captain72,
I sorry you didn't do well on the immunotherapy trial. Unfortunately it's not surprising it failed. It has been the experience of oncology researchers that those who have a driver mutation, specifically egfr and alk haven't shown much if any efficacy with immunotherapies. One intriguing theory is that people with a driver mutation usually have just the one mutation that drives the cancer and those without a driver mutation have an overload of mutations that finally caused lung cancer. This generation of immunotherapies seems to work on tumors that have lots of mutations not those with just the one type of mutation such as egfr. I'm not sure that makes sense.
It's not usual to lose the egfr mutation but it is common to have false negatives especially if the test tissue is limited. It's more possible that you have a t790m mutation because it's likely you still have an egfr mutation as well. Tagrisso has shown a little efficacy for those without t790m. I'd hate to miss the opportunity to have as good a run on tagrisso as you had with tarceva just because the test gave false results.
Chemo is the next standard treatment to try. Someone who's done well with tki often do well with alimta and it has the least side effect profile. With or with a platinum for the first 4 cycles is very appropriate option to look at with your onc.
Please keep us posted and don't hesitate to ask questions.
Best of luck,
Janine
Reply # - November 4, 2016, 03:25 PM
Janine,
Janine,
Thank you very much for taking the time to respond. I wasn't aware of altima working well with prior successful tki response. Ray of hope.
I've brought up tagrisso to my onc, he's hesitant. I am waiting results from dana Farber remote second opinion program to see what they have to say.
Thank you again
Reply # - November 5, 2016, 06:55 AM
You're very welcome. I think
You're very welcome. I think the second set of eyes will be quite helpful. Since 3rd generation tki drugs and the testing that goes along with are so new an opinion from someone who sees a lot of this type of situation will be helpful.
Janine