stein1
Posts:1

My mom was diagnosed with stage IV NSCLC via a malignant pleural effusion. 57 y.o., never smoker, sadly did not test positive for EGFR or ALK via a core needle biopsy. She has pulmonary fibrosis, dx 7 years ago which complicates the matter, but is tolerating chemo well. Pleural effusion is drying up after 3 rounds of Carbo/Alimta/Avastin.

From my understanding there are no evidence based trials published to date that compare maintenance therapy with Alimta vs. Alimta/Avastin. In patients that are treated with the first line combination of Carbo/Alimta/Avastin, and are tolerating therapy well and planning on maintenance, is there any preferred maintenance treatment in practice? While we all patiently await more trials, I am wondering if there is any harm in keeping Avastin onboard in hopes for prolonged PFS and OS? Thank you for your time!!!

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Reply # - September 18, 2013, 05:56 PM

catdander
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stein1, It's good that your mom's pleural effusion is drying up. There is much written on the subject of maintenance amilta and avastin. I've pasted links to a couple of discussions below plus the results pages from a search,

http://cancergrace.org/lung/2011/12/21/follow-up-on-avaperl-trial-of-ma…

http://cancergrace.org/lung/topic/is-anyone-tracking-long-term-alimtaav…

http://cancergrace.org/search-results?q=maintenance%20avastin%20alimta

I hope this is helpful and mostly I hope your mom is and will do alright moving forward,
Janine

Reply # - September 18, 2013, 09:30 PM

Dr West
Posts: 4735

Janine has provided a very good summary of the key points. I would say that the evidence suggests that Alimta/Avastin is a very fine choice for maintenance therapy in patients who haven't progressed on a platinum/Alimta/Avastin combination previously. The AVAPERL trial is the most relevant study on this question.

-Dr. West

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