Second Opinion and Compassionate Use - 1269074

Dr. West,

My 45 year old sister's stage IV, nonsmoker metastatic lung cancer with neuroendocrine features and a mutation of the EGFR exon 19 appears to be aggressively resisting all treatments tried so far including 4 rounds of chemo and Tarceva. She's about to start new chemo of cisplatin -etoposide.

We want to seek a second opinion to get further ideas about treatment options--especially a chance at applying for compassionate use of a third generation TKI for her EGFR exon 19 mutation or immunotherapy or basically anything promising. She is too ill to travel far. She does not qualify for clinical trials (brain, spine mets and pleural effusions). (I have been searching).

Can you suggest a few names at either Stanford or UCSF that might be a good bet to address her aggressive NSCLC with neuroendocrine features and EGFR mutation. We are hoping that an academic cancer specialist might be better positioned to help us with compassionate use of something or on forming a treatment plan at this late stage.

Thanks