Hello all,
First off, it is really great to have such an org to assist people who are fighting against such a disease and thank you all so much for sharing your knowledge and wisdom.
My father was diagnosed with Squamous Cell NSCLC stage4.
29th of March 2015 with the CT scan result:
1- a malignant tumor size of 4cmx6cm on the upper lobe of the right lung
2- lymph nodes around this tumor mainly on the right hand side with largest one being 25mmx14mm
3-Multiple nodules on both lungs with radius length less than 0.5 cm
4-PET scan confirmed the spread to spine(on L1,L2,L3,L5) also to scapula
Treatment: 4-6 rounds Chemo with carboplatin(AUC6- 660mg) and Paclitaxel 175mg/m2 -350mg.
6 rounds of radiotherapy for his spine
ECOG 0 and weighing 98KGs.
After 4 rounds of Chemo (no change for the doses nor drugs) he is 81KG with ECOG 1-2. new symptom is fatigue in addition to the cough. Not enjoying eating as much compared to pretreatment.
On 27th of June another CT scan after 4 rounds of chemo, the results are below which indicates that the main tumor is growing although he is still receiving chemotherapy.
1- The main tumor grew to 6cm x 11cm from the size of 4cmx6cm on the upper lobe of the right lung
2- The lymph nodes around this tumor mainly on the right hand side with largest one being 45mmx32mm
3- Left lung seems stable as there is no significant growth here
4- Scapula is clean and on the spine seems like L2 and L5 are clear and spread on L1 and L3 are minimised.
It seems that while there are some good news(scapula and spine is getting better and left lung is stable), the main tumor and the lymph nodes around it are not really responding to chemo.
What are our options now as this would be regarded as failing 1st line?
Or is it really failing considering the scapula is cleared and left lung is stable?
We will have an appointment with his doc this week but needed your advise before we talk to the Doctor about therapy options.
Many thanks in advance,
Oz
Reply # - July 5, 2015, 04:46 PM
Hi Oz,
Hi Oz,
I'm so sorry about your dad. While it is good that some of the tumors responded it sounds like the majority and the largest didn't. Unfortunately if the first line chemo especially a doublet with a platinum drug like carbo doesn't work well then further line of chemo based treatment isn't likely to help.
The good news is there are immunotherapy drugs (specifically Opdivo (nivolumab) very recently approved that are shown to work very well for a good percentage of people with squamous nsclc. It has become the second line option of choice.
http://cancergrace.org/lung/2015/06/17/asco_2015_immunotherapy_opdivo_s…
Please keep us posted. Best of luck and hopes,
Janine