My SIL achieved NED after 1 year of aggressive treatment (for her Stage IV NSCLS Dx with multiple mets) and continued NED for a few months while on Alimta maint. In her last PET, progression in one of her adrenal glands was found. This particular met was the only met that was basically treated only with chemo (the other mets were also radiated), thus, my SIL has been told that probably the cancer became resistant to Alimta and it was suggested for her to stop Alimta, wait for 2 months and re-scan. However, the decision to stop or continue with the Alimta is still hers.
My SIL is young (46 yo) and tolerating Alimta well (with the typical fatigue of course) and stopping treatment is really frightening for her.
My question: is it common to stop giving maintenance treatment to a Stage IV patient when it is believed that the cancer got resistant to the chemo drug? Shouldn't she be switched to another maintenance drug maybe?
Any information on this matter will be greatly appreciated. I am trying to help her make an informed decision on this matter and she is struggling to come up with a decision she is comfortable with (no treatment at all seems too risky but if Alimta does not help her at all she does not want to get toxic treatment for no reason).
Reply # - July 20, 2015, 06:40 AM
In general when there is
In general when there is progression in Stage IV lung cancer, the current treatment is discontinued and new therapy begun. That being said, in the context of a well-tolerated regimen that seems to be controlling the cancer in other areas, it may depend on how significant the progression is, both from the point of view of size and rate of growth. When there is slow progression in just one spot, the current treatment is often continued, at least until more significant progression is detected.
If you stop Alimta and the scan two months later shows further progression, you won't know whether the cancer was progressing through Alimta or because it was stopped.
Although ongoing research continues to produce new therapies, there is a finite number of options and it's preferable to get the maximum benefit from each of them.
JimC
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