How soon after starting Alectinib should brain MRI be done? - 1274373

Hi ownit,

That's a good question. If you're not having symptoms from the brain mets it might be worth waiting another couple of weeks. But I will ask one of our oncs to comment.

I hope the brain mets do respond to the new Alectinib, there's lots of hope to be had withit. :)
Janine

Hi ownit, thanks for the question. Most patients with known brain metastases get surveillance MRI scans periodically, and it appears you are on a 3 month interval which is very common. It is generally a good idea to keep on a somewhat regular schedule so you don't miss changes that can be addressed with a change in treatment or perhaps radiation, but the exact time of 3 months isn't that critical.

No one knows the best time to look for response to a drug like alectinib, but most clinical trials use 6 or 8 week intervals for scans to keep the endpoints like "progression free survival" the same between trials and so in practice we end up copying this. In reality though, drugs like alectinib can start to work within days, and often responses can be seen within a week or two. I think an MRI 5 weeks after starting alectinib has a good chance of accurately reflecting whether the tumors are going to respond, but if they were stable they could certainly still shrink on the next scan. I don't think waiting longer is likely make much of a difference since both stable and shrinking are good.

Hi ownit, just curious to see how you are doing with the Alectinib and the brain mets??? I hope you are doing very well!