My grandfather has been battling lung cancer for going on 2 1/2 years now. He was on Tarceva for 15 months until he became resistant. He is EGFR positive, but I'm not sure which sequence is affected. He then went back to chemo for 4 months until we found he had 10 tumors in his brain and on his spine, after which he did a round of WBR, which seems to be working. They also found a large tumor on his hip, which he is starting radiation for this week. After he is done with radiation his doctor said that he is putting him on 2 new kinds of chemo and piggy backing it with Tarceva. I was curious if anyone knew/is going through or knows of this treatment. His oncologist said that one type of chemo had just been approved, im not sure about the other one. I completely trust his doctor, he's the reason my grandpa is still with us today. I am just curious if anyone else is going through this or if their doctor is trying this type of treatment and what we can expect. Any advice or experience with this type of treatment is more than welcome.
Thanks,
Christine
Reply # - August 6, 2013, 08:29 AM
Reply To: New treatment for EGFR positive patients?
Hi Christine, Welcome to Grace. I'm sorry your grandpa is going through this. I can imagine how this affects the whole family. I'm not sure what combination of drugs you're talking about. Can you tell us a little more about the other drugs he'll be taking? There is a newly approved tki (drugs for those with EGFR mutations) call afatinib that you may be talking about and it may be given with cetuximab. this is a link to many discussion on the subject. http://cancergrace.org/search-results?q=afatinib%20and%20cetuximab
Also this is a link to a discussion on what many lung specialist are doing in the face of acquired resistance to tarceva. http://cancergrace.org/lung/2013/01/23/acquired-resistance-algorithm/
I hope this helps. Please let us know if you can give us a little more info.
Janine
forum moderator
Reply # - August 6, 2013, 10:11 PM
Reply To: New treatment for EGFR positive patients?
I think the most helpful place to start is by reviewing the info about "acquired resistance" that is included in the link Janine provided above, combined perhaps with other posts in this link:
http://cancergrace.org/search-results?q=acquired%20resistance
There are really a range of very reasonable options, and it remains debatable whether there is a value to continuing an agent like Tarceva (erlotinib) after progression, or in restarting it after a break from it. There are certainly some thoughtful people who favor each of these approaches, but there is no consensus and no evidence-based answer right now. In the meantime, it's appropriate to follow the best clinical judgment you can, with an understanding that this is really all anyone has to go by right now, in the absence of actual studies to direct us.
Good luck to your grandfather.
-Dr. West