Oligoptogression with Alecensa

Srdjan Ćurić
Posts:3

Hi, my mother was diagnosed with stage IV adenocarcinoma with brain metastases 15 months ago. After all the analyses, it was determined that he has a mutation for which he is suitable to take Alecensa-Alectinib. After the initial use, her condition improved drastically. An intermediate CT scan from more than a month ago shows progression at one point, in the primary tumor. Head metastases are smaller. So, oligoprogression is at one point. We are a little disappointed because we read that Alecensa works for up to 37 months. Now her oncologist has recommended SBRT therapy while continuing to use Alecensa. My question for forum members who have had a similar situation is how much can SBRT help her? If it helps her, what is the average when progression happens again? What can we expect? All the best and thank you!

JanineT GRACE …
Posts: 613
GRACE Community Outreach Team

Hi and welcome to GRACE.  I'm sorry mother is experiencing oligoprogrssion.  This often happens when some of the cancer cells acquire a resistance to alecensa's effects.  Those cells can be radiated or sometimes surgery is used to stop that particular cell progression and that person can continue with alecensa as before.  It sounds like your mother is getting what is presently the most appropriate treatment for oligoprogression.  That's good. 

 

About the "up to 37 months", that's not accurate.  In the ALEX trial the median (or middle number of months for all 150ish people) number of months before progression was 37.  Progression means the drug was no longer able to help the patient, not to be confused with oligoprogression where the progression can be stopped and the targeted drug can be continued.  Too, the 37 months number for the individual doesn't mean much because half the people did better and I hope your mother is on the better half.

 

Here are some video links to our most recent targeted therapies forum, Specific to ALK and here,  Specific to oligoprogression, and the entire forum playlist (note that the first one is the entire 6 hour forum and the rest is the forum broken into specific topics.

 

Take care and let us know how else we can help.

Janine

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

Srdjan Ćurić
Posts: 3

help Mom to continue using Alectinib. Thank you for the video list as well. Is there any experience or some period in which SBRT works, is it individual or are there any analyzes of how long it can help without further oligoprogression? I also hope that he will be lucky enough to use it for at least the next 34-37 months and maybe more :) Thanks!

JanineT GRACE …
Posts: 613
GRACE Community Outreach Team

Oh yes! SBRT (Stereotactic body radiation therapy) is a very focused type of radiation that is able to target and kill the tumor without the destruction of healthy tissue. The goal is to get rid of the cancer that is resistant to alectinib and be back on track for continued control with alectinib. I couldn't find specific numbers but the rate of success is high. My husband had chemo and radiation therapy (not this newer and improved sbrt) for stage III nsclc and he was cured 10 years ago. I don't mean to suggest your mother can be cured but that the radiation can stop the growth in that tumor.

 

Watch the videos about oligoprogression the oncologists are much better at explaining this than I.

 

Oligometastic disease is very individualized diagnosis (meaning a lot depends on the individual) and still a very new concept but depending on the number and size of brain mets your mother may be a candidate for oligometastatic treatment.  It's certainly something to discuss with her onc.

 

We also are having our annual OncTalk forum Dec 10. It's online, free, and there is a Q and A at the end for you to ask lung specialists questions. I think it will be worth watching. 

 

All the best,

Janine

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

Srdjan Ćurić
Posts: 3

Hi again, thank you very much for the detailed response. I hope that SBRT will help my mom and that she will use Alecensa for a long time and after Alecensa maybe some new medicament or whatever.
All the best and regards!

In reply to by Srdjan Ćurić

Amy B
Posts: 11
Executive Director of GRACE

Hello and welcome to the GRACE Online Forum! I see that you've already received some great information from our Forums Moderator as well as connected with other Forums users, which is terrific. We're here to help and will do our best to direct you to any resources that may be of help for your mother :-) We're here for you, and are pleased to welcome you to GRACE!

--Amy Bickleman, GRACE Executive Director

Executive Director of GRACE since 2017. Joined GRACE to ensure that all patients and caregivers are empowered to obtain equal access to education about treatment options.