keytruda for ext small cell lung cancer? - 1271746

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sonja
keytruda for ext small cell lung cancer? - 1271746

I have seen some promising results from keytruda w/ext small cell, and now see a few clinical trials offering this for patients.
My mom is currently on first line carb/etop and will be doing her 3 round successfully. What would be the normal 2nd line treatment? Would you consider keytruda w/chemo or keytruda alone for 2nd line? Is there any way to get keytruda without doing a trial? or travel as we are in seattle? mom is 69, in ok health, and responding great to first line 50% reduction on first round. I just want to prepare for second and immunotherapy looks promising. thank you!

JimC
Hi sonja,

Hi sonja,

Welcome to GRACE, and congratulations on your mom's great response to first round therapy. There are indeed early indications that immuntherapies can benefit extensive stage SCLC patients, as describe by Dr. Pennell here. But since this research is in the initial stages, it's too early to tell whether these agents are best used alone or with chemo.

The standard second line treatment for SCLC, which would be used at the time of progression, is topotecan.

As far as traveling to get access to a clinical trial, at times that is necessary but since your mom is still in first line therapy, it's probably too early to know whether there will be an open trial in the Seattle area at the time you need it. You can search geographically for trials at clinicaltrials.gov.

Good luck with the remainder of your mom's treatment.

JimC
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>

sonja
Hi Jim, thanks for responding

Hi Jim, thanks for responding. I have review trials and there is a trial for patients after first line starting in February in Detroit that is for keytruda alone every 21 days for up to 2 years if no tumor growth they continue. Here's my question- after her last dose of first line what is the next step? Do you wait to start topotecan or would this trial be a better idea? My understanding is the immunotherapy even alone offers up to 35% chance stable or reduction in tumors and not as much damage as chemo? And the 2nd line option for sclc now is a 7-25% success or something not so promising only allowing a few more months of survival? Do you wait for second chemo- or go for this immunotherapy? i would almost think having a chance to try immunotherapy seems like the best option and chance for survival? Thank you for your time and response- it's an amazing gift you are giving to help.

JimC
Hi sonja,

Hi sonja,

I don't think there's a right or wrong choice. Normally second-line treatment would begin at the time of progression, but since immunotherapy can take a while to show results you might not want to wait to use it until the cancer is progressing to try it, as you may be wasting valuable time on a treatment that is not effective. It's really too early in the trial process to know the chances for success with immunotherapy.

JimC
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>