niftyd
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Posts:5
I was originally dxed as adeno. Last month I had a biopsy that showed squamous. Put on Tagrisso due to T790 mutation. Now squamous and other tumors are shrinking or stable after 4 weeks, except for one tumor that has doubled in size in that same time period.
Doctor wants to do another needle biopsy before jumping into a different treatment because it isn't clear what this tumor is. Not thrilled about this but the rapid growth is a concern. Staying on Tagrisso for now.
Any thoughts?
Forums
Reply # - November 15, 2016, 10:47 AM
Hi niftyd, It's good to hear
Hi niftyd, It's good to hear you're doing well (ish) with tagrisso. While it's not the norm for there to be a mixed bag of squam/adeno nsclc it's certainly not all the unusual.
Another phenomenon seen not too rarely is for there to be a mixed response to treatment. There is a growing trend in these cases to treat the growing tumors with local treatment like radiation (if possible stereotactic body radiation therapy or sbrt).
An important question to answer before undergoing an invasive procedure/treatment is, will this help lengthen my life and or benefit its quality. If the answer is no then it's not necessary. I would what a biopsy would give you that could change your treatment
We have a bit of info on the practice of local therapy for "oligoprogression". Dr. Weiss, one of our dearest faculty/board members has studied this for some time. It's not unusual to take copies or virtually to planning meetings with oncologists. I've taken plenty and have had excellent conversations with my husband's onc (we love him :)) This link, Dr. Weiss discussion on oligoprogression. http://cancergrace.org/lung/tag/oligoprogression/
I hope this helps,
Janine
Reply # - November 15, 2016, 12:45 PM
Thank you for the link. I
Thank you for the link. I have brought this up several times with my onc who feels my cancer is too generalized for spot treatment to be meaningful long term. However, he did not rule it out, but he wants a tissue biopsy first in case this cancer is yet a different type.
We're trying the "let's see what this is so we can target it effectively" approach for now, but that includes a tissue biopsy. On one level it makes sense to get in there and find out what this thing is. On the other hand, I had a lung biopsy in October, we could try chemo and see how that goes. It's hard to come up with an informed answer to "will this extend my life." The information from the tissue biopsy might lead to a treatment that's more effective than a different approach. Chemo can pull down quality of life. Targeted therapy has a better track record there. The truth is, I really don't know which would be better for me now.
Reply # - November 15, 2016, 01:33 PM
If a lung cancer is under
If a lung cancer is under control with tagrisso and there's no problematic side effects with it then staying on course should be an option. Certainly the best care for metastatic nsclc has been to not treat each tumor as it shows up because it will be a generalized disease. So what Dr. Weiss and many of his fellow lung cancer specialists are testing is new and has shown very real survival benefits. Data is showing that people with a single driver mutation such as ALK or EGFR who have done well on targeted therapies and are now showing one or 2 sites of progression is different than the generalized progression where there are multiple sites of progression. It would be unfortunate to ditch a treatment that may have more life left in it. There may be an obvious answer so please don't think me rude, what biopsy findings would drive what kind of treatment?
These are the thoughts lung cancer specialists are having today about single progression sites, at least for those on targeted therapies.