Is it common to have same chemo used in 1st line treatment? - 1246505

gabitaylor
Posts:6

My dad has ten rounds of carboplatin and alimta. He had some shrinkage in eight of the treatments. The last one showed some growth. He has not had any chemo treatments for seven months. His last CT Scan showed growth so his oncologist wants to start him on the same chemo.

I would lie to know if this is done often.

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Reply # - August 8, 2012, 12:27 PM

catdander
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gabitaylor, Assuming your dad has stage 4 nsclc...This isn't what oncologist recommend for second line treatment. Studies show that over 6 cycles of a platinum drug like carboplatin doesn't help further edit that to say usually has more toxicity than benefits. Your dad has already had 10. Especially after a person has shown progression on it. As a matter of fact once someone has shown progression on a cytotoxic chemo drug like alimta it isn't likely to be beneficial a second time around.

I know I've shown you this link before but want to make sure you have another chance to read it. It explains what oncologist do after the initial treatment. http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o…

This is a discussion you've asked about before the same applies here unless I've misunderstood your question. http://cancergrace.org/topic/what-has-worked-best-as-second-line-treatm…

Janine
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Reply # - August 8, 2012, 12:38 PM

JimC
Posts: 2753

Hi gabitaylor,

It looks like I was writing my response while Janine was posting hers, but here it is for what it's worth:

Usually when a patient progresses after first line therapy, a different drug is chosen since it is assumed that the cancer has become resistant to that treatment. You can read some of Dr. West's comments on choosing second line treatment here:

http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o…
http://cancergrace.org/lung/2008/01/24/selecting-2nd-line-nsclc-rx/

Of course, all rules can be broken and as Dr. West points out there is room to individualize treatment choices for each patient. It may be that your dad's doctor is thinking that your dad had such a good response to first-line treatment that he would like to return to it to see if it is still effective.

JimC
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Reply # - August 8, 2012, 10:05 PM

Dr West
Posts: 4735

I really agree with these comments. Not only would nearly all experts advise stopping a platinum-based doublet after 4-6 cycles at most, but we would have very little enthusiasm for returning to a regimen that someone has progressed on previously, especially if there are other identifiable alternatives. We would generally anticipate better results from a treatment approach that a person hasn't received already.

-Dr. West

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