PDL1 negative and ROS1+ on Alimta and Keytruda? - 1291053

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fanos
PDL1 negative and ROS1+ on Alimta and Keytruda? - 1291053

My daughter has Stage 4 adenocarcinoma NSCLC (ROS1+) dx in December 2015. Standard chemo, then Xalkori gave positive results. The Dr wanted to try Opdivo even though she tested negative for PDL1.This resulted in all masses tripling or more. Then the Dr returned to chemo: Carboplatin and Alimta, then Alimta for maintenance now for 5 months. The Dr has recommended a new combination for an unusual growth? around a previously radiated spot in the lung. I am not sure why this combination when the growth (?) is not identified. Is there any evidence that this should be the next course of treatment given the history of results and unknown cause of this smear in the CT scan?

JimC
Hi fanos,

Hi fanos,

I'm sorry to hear about the possible progression on chemotherapy. It seems to me that my response to your previous thread applies in this situation as well. You would like to get the maximum benefit possible from each line of therapy, so if the progression is not clear or significant, continuing with chemo might be a good idea.

Also, either returning to Xalkori, or another inhibitor, might be a good choice.

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>

fanos
What I am really asking is if

What I am really asking is if there is evidence that ADDING Keytruda to a PDL1 negative patient on Alimta has shown to be significantly effective in any progression? Is this a clinical trial or approved treatment?

JimC
Hi fanos,

Hi fanos,

Those types of combination therapies, including an immunotherapy agent plus either chemo or another immune checkpoint inhibitor, are being tested in clinical trials, but none of these are approved yet. Here's a post on that subject: http://cancergrace.org/lung/2015/12/08/gcvl_lu_immunotherapy_combination...

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>