Keytruda in advanced NSCLC with new brain mets - 1294276

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Keytruda in advanced NSCLC with new brain mets - 1294276

Hi everyone,
I'm very new to this forum so I tried my best to ask an appropriate question so forgive me if this is still too specific :)

My father w/ staged 4 NSCLC (after undergoing tumor resection, chemotherapy, radiation to mets site) was newly dx with brain mets (3 sites) through MRI. The thing is, his tumors in the lungs and adrenal glands (metastatic site) were considered "well-controlled" for the past 10 cycles of Keytruda he has received.

However, would the newly-found brain mets while being on Keytruda considered as "disease progression" and resistance to the drug? Or is brain mets normally locally treated while patients continue receiving Keytruda?
Is there a place I can find the guideline for some cases similar to him?

*A note is that since he was doing "well" on Keytruda, the oncologist decreased the dosage from 150mg to 100mg for the past 2 times.

Thank you!

Hi bvan95,

Hi bvan95,

Welcome to GRACE. I'm sorry to hear about your father's brain mets, but it's great that he's otherwise getting a great response to Keytruda.

Although new brain mets indicate disease progression, oncologists often distinguish progression in the brain from that in other parts of the body. This is due to the difficulty most drugs have in crossing the blood brain barrier in therapeutic concentrations. Instead, if the systemic therapy is controlling the disease elsewhere and is well-tolerated, those mets will be treated with radiation and the systemic therapy will be continued.

Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>