Lung cancer with mets to liver and brain stage IV - 1255835

Sun, 04/21/2013 - 10:01

hi! my dad has been diagnosed with stage IV adenocarcinoma lung cancer(Rt middle lobe, metastasis to liver and sternum) 20 months back.

PATIENT PARTICULARS: ASHOK KUMAR, 58yrs, MALE.
DIAGNOSIS: ADENOCARCINOMA LUNG STAGE 4, EGFR POSITIVE (EXON 21) on 19/08/2011

After resistance of 2 targeted medicines ( GEFTINIB & ERLOTINIB ) and 2 types of chemo-therapies ( PEMETREXED AND CARBOPLATIN ) , (Docetaxel) my dad has recently developed mets to brain. He received 5 fractions of Palliative RT TO BRAIN . Now our doctors will be starting LAPATINIB for his further treatment .

P.S. Alk Mutation was also negative.

Please advise me what should we do. Are there any other treatment or any combinations such as Cetuximab with Lapatinib would work better for him

Regards

Ravi Ashok

Forums
Revision log message
Created by FeedsNodeProcessor

Dr West

Ravi,

I'm sorry, but we are specifically not allowed to tell people what they should do, as it is illegal to provide medical recommendations to people who aren't our patients. At this point, he has received all of the therapies that have any established role in treating patients with advanced non-small cell lung cancer that has progressed on prior therapies, specifically Alimta (pemetrexed), Taxotere (docetaxel), and Tarceva (erlotinib). It is reasonable to consider other chemo agents that might possibly have some activity, such as Gemzar (gemcitabine), Navelbine (vinorelbine), perhaps Camptosar (irinotecan) or Hycamtin (topotecan), and certainly an agent like lapatinib is reasonable as well, though it isn't particularly well studied. But the truth is that there is no information to say that any treatment is a right choice or could be expected to be helpful for someone who has lung cancer metastatic to the brain and has already received several lines of treatment, so all decisions at this point need to be individualized clinical judgments.

Good luck.

-Dr. West

ravi88111

Thank you Dr. West for the reply. We are getting the treatment done at AIIMS, New Delhi under guidance of Dr. P.K. Julka. Sir I would like to know that is there any better treatment available in USA for such cases.
Moreover should we consider Clinical trials as an option or go with Lapatinib for his treatment for now.

Presently after 5 fractions of RT - brain he has not improved at all. He sometimes gets blank and often is confused, also having headache and not able to walk since 15-20 days. Actually he twice fell in the washroom, though before this problem he used to go morning walk .

looking forward for your help.

Thanking you

Regards

Ravi Ashok

catdander

Hello Ravi, I'm very sorry your dad is in this position. As Dr. West said, ..."there is no information to say that any treatment is a right choice or could be expected to be helpful for someone who has lung cancer metastatic to the brain and has already received several lines of treatment, so all decisions at this point need to be individualized clinical judgments."

Also I'm afraid trials usually require there to be no active adverse effects from brain metastases. Often at this point the best care is palliative/comfort care. But again that needs to be judged by the treating doctors.

We have an extensive library that covers these topics.

Again I'm very sorry your dad and family must confront such issues. You are in my thoughts,
Janine
forum moderator