Hello,
My father was diagnosed with stage IV NSCLC in Dec 2014 and was later tested to be EGFR positive with exon 19 deletion. He started with erlotinib 150mb (Tarceva) in Jan 2015 and after initial shrinkage in first three month the disease has been stable till last scan on 6th September this year. His last PET scan shows he has few new lymph node near cervical, in his right lung with high FDG uptake and his mediastinal node is of size 2.5 cm (mediastinal node used to be in sub centimeteric in previous scans). There is also a 2.4x2.7 in middle lobe of right lung which is increased from previous size of 2.0x2.3 cm.
Apart from scan findings he did developed low grade fever for two months which now seems to have resolved of its own. Lost around 5-6 lbs of weight.There is also nightly cough and some hoarseness is voice for which our oncologist says is due to mediastinal node.
He had biopsy done on 17th Sept from node in right lung middle node tumor and we are sending it initially for EGFR test to determine T790M mutation.
However yesterday when i read the initial histology report it says "poorly differentiated NSCLC". I am little worried with the initial finding. Does this means the initial cancer cells has mutated really badly ? Based on this does this it means his cancer is now very aggressive ?
T790m mutation results will take a week to come and as we are in India where tagrisso is not available and it may take more weeks for us to get the medicine.
Are there any combinations that could be tried with Tarceva ?
Please help.
Mohit
Reply # - September 21, 2016, 07:42 AM
Hi Mohit,
Hi Mohit,
Welcome to GRACE. I am sorry to hear of the recent progression of your father's lung cancer. Though there are some oncologists who like to continue Tarceva even after progression, combining it with a drug such as Alimta (pemetrexed), most often if the progression is significant enough a third generation EGFR TKI such as Tagrisso will be chosen. In addition, some doctors choose a combination of afatinib and cetuximab, which can be effective but can be quite challenging in terms of the combined side effects.
EGFR-positive patients often overlook standard chemotherapy, which tends to be quite effective in this subgroup of patients. Regimens such as carboplatin or cisplatin, in combination with alimta or taxol are often used.
JimC
Forum moderator