Non-smoker squamous carcinoma EGFR -positive stage IV lung cancer/Tarceva - 1269921

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deeperfreedom2
Non-smoker squamous carcinoma EGFR -positive stage IV lung cancer/Tarceva - 1269921

Hi everyone,
My father (non-smoker, 70 years old) was diagnosed with stage IV lung cancer last spring and had amazing results with his chemotherapy treatment- 90% shrinkage and then the last of it removed by cyber knife. We are over the moon. He is currently on Tarceva and is NED. His oncologist wants to start spreading his PET scans out to every four months rather than three months. I'm concerned about the possibility of resistance to the Tarceva occurring, and am wondering if because he was a non-smoker (?) there is less chance of that happening? From what I've read, resistance occurs on average between 10-14 months after beginning the drug. Any light or experience you can shed on this would be greatly appreciated. Thank you!

JimC
Hello,

Hello,

Welcome to GRACE. Congratulations on your father's great response to chemotherapy and his NED status while on Tarceva. Usually when resistance to an EGFR inhibitor begins to occur, the progression begins rather slowly, allowing enough time to change treatment before a patient declines too quickly to do so. In addition, regular follow-up visits to his oncologist to monitor new symptoms (as well as self-monitoring) usually gives an early indication of something more than slight progression.

In response to a similar question about the frequency of follow-up scanning, Dr. West said:

"There really isn't an established protocol, which is why there is such variability. We don't have any real evidence that routine surveillance even improves outcomes -- for the clear majority of people with a recurrence after surgery, they are going to have metastatic disease, for which there isn't really an expected benefit to diagnosing it a few months earlier instead of a few months later. The truth is that most of our practice is guided by ritual and expectation -- and anxiety. A rare patient may be found to have a cancer that can be treated with curative intent, but there's no evidence that outcome are better for doing surveillance scans every 3 months vs. every 4 or 6 months. Frankly, I think it's almost unimaginable that there would be a difference between a recurrence detected after 4 months vs. one 6 months after the last scan." - http://cancergrace.org/forums/index.php?topic=1639.msg9687#msg9687

He discusses follow-up scans more thoroughly here.

[continued in the next post]

<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>

JimC
[continued from previous post

[continued from previous post]

Although your father is probably less than a year into his treatment with Tarceva, as time goes along the only way to tell whether he continues to need it to keep his cancer at bay would be to stop it and closely monitor for recurrence. But that's always a good problem to have!

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>

deeperfreedom2
Thank you, Jim! That

Thank you, Jim! That information helps very much :)