Hi all,
I just had my first scan after taking Tagrisso for 6 weeks. The scan showed mixed result: slight progression on the primary tumor, more nodules, slight increase in fluid build up. But some nodules have also shrunk. My doctor suggested continuing Tagrisso for another month since the old scan used for comparison was done when I was still on Tarceva three weeks before I started Tagrisso. I was told my best option for next treatment would be chemo (Carbo, Pemetrexed, Avastin).
I am considering other options since I read studies that Avastin has not been proven to treat brain metastasis and if I have specific mutation, chemo would not work effectively. So far, I have been tested positive for 790M. I read studies that depending on the test result detecting C797s, cancer cells would be resistant to third line TKIs but sensitive to first and third line TKIs. http://clincancerres.aacrjournals.org/content/21/17/3924.long
Anyone have any information on detecting c797s and combinations of TKIs?
I would appreciate any thoughts. Thanks.
Sunday
Reply # - April 29, 2016, 06:29 AM
Sunday,
Sunday,
As your oncologist said it's very possible the tagrisso hasn't had a chance to show its worth. It would be a shame to discard a treatment that might last for a very long time even years. Otherwise when it is time to change and if the best data is the same Carbo, Pemetrexed, Avastin is the best next treatment to try. Not only has chemo been shown to work as well for egfr mutation positive people but it may even have better efficacy than for those without the mutation. So chemotherapy is still a very good option for people with an egfr mutation.
Avastin is a drug that is often added to chemotherapy but isn't a mandate for every person with non squamous nsclc. Dr. West recently made a video on the subject. http://cancergrace.org/lung/2016/04/16/gcvl_lu_bevacizumab_role_stage_i…
Non of these drugs typically cross the blood brain barrier (bbb) but pemetrexed has been known to do so in some circumstances, but there's no way to know for whom that may be. Typically brain mets are radiated with stereotactic radiosurgery or wbr.
I hope you don't need to make any changes for a long time.
All best,
Janine
Reply # - April 29, 2016, 05:37 PM
Dear Janine,
Dear Janine,
Thanks so much for your information.
Reply # - April 29, 2016, 08:02 PM
I misspoke a little.
I misspoke a little. Actually a next best treatment may always be a trial if applicable.