anush
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Posts:3
Hi,
my broher alk +ve, diagnosed in 2014 december, Have brain, bone mets. Did brain surgery, WBR, spine radiation. was in crizotinib for 10 months after brain and bone mets progression was in ceritinib for 5 months, in the latest scan again desease progression in bone and one new brain mets. unfortunately in India there is no next inhibitor after ceritinib.. so what are the options next? here no clinical trials also. is there any chance to use crizotinib again? he has some bone fractures also. we are feeling helpless. he is just 35 only. he had WBR 2 times already. what are the next
treatment option? when he was on crizotinib he felt very active. but on ceritinib he was mostly on bed. kindly suggest any option..
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Reply # - July 25, 2016, 07:53 AM
Hello anush,
Hello anush,
Welcome to GRACE.. I am so sorry to hear that your brother's cancer has progressed. If ceritinib continues to control the disease in his lungs and the progression in the bones is not widespread, it may be possible to radiate the new bone and brain lesions and remain on ceritinib for the time being, with a follow-up scan after a relatively short interval. If radiating the new lesions is not feasible or there is additional progression, standard chemotherapy may be an option. Immunotherapy drugs may also be an option, depending upon availability in his location.
I am sorry that his cancer has been as aggressive as it has been, and resistant to treatment with ALK inhibitors. It is my hope that a new treatment regimen will effectively stop the growth of his cancer.
JimC
Forum moderator
Reply # - July 25, 2016, 11:38 PM
Thank you Jimc for the kind
Thank you Jimc for the kind reply.
Reply # - August 3, 2016, 01:43 PM
hello anush ,myself Dr nirmal
hello anush ,myself Dr nirmal raut from mumbai .
options for your brothers case
1.alectinib is marketed by roche .you can get the drug from ikrispharma in india .
2.Brigatnib is yet to get approval hence is available on compassionate grounds .
check
https://clinicaltrials.gov/ct2/show/NCT02784158?term=NCT02784158&rank=1
3. consider chemotherapy with pemetrexed carboplatin depending on general condition of patient
4.repeat a biopsy and recahllengqe crizotinib if molecular pathology suggestive
Reply # - August 6, 2016, 12:37 AM
Hi drnirmalraut sir,
Hi drnirmalraut sir,
I approached Ariad company for getting brigatinib in expanded access.But they said they could not provide it to India. We are in the economical situation that we could not import alectinib by high cost or travel to some other country for the clinical trials. Could you please tell me is there any way to get the drug alectinib, or lorlatinib in expanded access program in India.. We are in big stress as we are helpless to my brother's pathetic condition.. Please help us.
Reply # - August 7, 2016, 03:38 PM
Hi anush,
Hi anush,
You may want to contact the manufacturer directly. Here is the home page for patients and caregivers, https://www.alecensa.com/patient.html
I'm sorry but I'm not familiar with how or if they can help those in India but they may be of help.
You didn't mention that your brother has taken chemo such as typical first line treatment for those who don't have targeted options. That would normally be a platinum doublet,usually carboplatin with another agent often alimta. Alimta has a history of providing very good results especially in those with an ALK. Usually the course begins with 4 to 6 cycles of the platinum doublet then followed by either a break or continued with alimta alone or with avastin. These drugs can be issued and given immediately. If your brother is indeed experiencing worsening symptoms it's important to begin treatment before he is too weak to try anything. Also it's very possible that this course is the best course to be found anywhere at any price. It would truly be unfortunate to fish around for something that may not be available or helpful when there are options available now.
All best,
Janine