Impact of Surgery on Non-Progessing Nodules - 1270131

Hello Grace Team:

As a brief update, my wife continues on Tarceva as she approaches the 5 year anniversary of her diagnosis in September 2010. Over the past 21 months one nodule in her right lung has grown very slowly to the size of quarter and we have finally decided to have it removed via a VATS surgical procedure later this week. For a number of reasons (including location near the spine), surgery is the preferred choice versus using radiation. In any event, there are a couple of other very small nodules in the same lung that have remained dormant the entire time. Our current question is.... is there any evidence that having such a surgical procedure can place a degree of stress on the body/lung such that another nodule may then begin to progress?

As an aside, the doctors we have met with in Chicago and Boston strongly suspect that, based on the one growing nodule's behavior (indolent growth over 21 months), that this is likely T790M progression. As a result, we contemplated moving to either of the Clovis or AZ trials. However, because there is presently no evidence of progression anywhere else, we have opted to remove this one nodule and continue on Tarceva until/if we get to a point where we see a more significant degree of progression.

Thanks so much!

Dan

Spouse, DX at age 46 in 2010 with Stage 4 NSCLC (5 bone mets, and tumors in left lung and ovary); poorly diff; EGFR positive; exon 19 del; 13 days of radiation and started 150mg Tarceva (in September and October 2010, respectively); dropped to 100mg about 2 years later; primary lung tumor gone and ovarian tumor was stable until removed per hysterectomy in 2011; remains on Tarceva and now addressing one indolently progressing nodule in right lung.