hi my dad as nsclc squamous but not egfr positive at the start they said it was operable but the more they looked into it because of his heart condition they wont operate he was diagnosed last june they tried to get tissue 4 time to determine the cancer type but couldent get to the tissue to be able to treat it I encouraged him to go again in february and this time they got the tissue and determined it was nsclc squamous and hoped he could take tarceva to help but because hes not egfr positive they wouldent prescribe them they have denied him chemo just said he can have 2 rounds of radiotherapy I have spoke to people around the country who say they take tarceva for squamous with not being egfr positive please can you help me thankyou so much
squamous lung cancer not egfr positive - 1263675
wenwoo
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Reply # - May 9, 2014, 08:00 AM
Reply To: squamous lung cancer not egfr positive
Hi wenwoo,
I am sorry to hear of your dad's diagnosis. Treatment recommendations for a particular patient often are individualized based on that patient's overall health and the specifics of their cancer. If your dad's cancer is metastatic (Stage IV) then systemic treatment such as chemotherapy or targeted therapy is usually recommended. If the cancer is at an earlier stage (localized), then surgery or radiation are often chosen in an effort to remove all of the cancer.
From what you posted, it is unclear why his doctors have refused chemotherapy, although it could be because of other medical conditions he has. In general, if systemic therapy is chosen for a patient with squamous NSCLC without an activating EGFR mutation, chemotherapy is preferred. If further treatment is necessary, or if for some reason a patient cannot receive chemo, Tarceva is an appropriate choice. Dr. West has written about the benefit Tarceva can provide for patients with squamous NSCLC:
"...many oncologists perceive there to be little to no value in giving tarceva to patients with squamous tumors, and many don’t even bother to offer it to these patients. However, it’s worth highlighting the evidence that suggests a meaningful survival benefit, even if it falls short of the “swinging for the fences” idea we have when we give tarceva to some patients. At the same time, we need to remember that agents like Alimta (pemetrexed) and Avastin (bevacizumab) are not generally indicated or used for patients with squamous NSCLC tumors, due to efficacy or safety concerns, respectively. Options in advanced NSCLC are limited, but more so for patients with squamous tumors, so we need to ensure that we don’t leave good alternatives unused." - http://cancergrace.org/lung/2009/09/25/tarceva-for-squamous-nsclc/
Good luck with whichever therapy is chosen.
JimC
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Reply # - May 9, 2014, 07:16 PM
Reply To: squamous lung cancer not egfr positive
To supplement my own comments that Jim provided above, I should say that this is speaking to the question of giving Tarceva (erlotinib) to patients who have a good performance status and received prior chemotherapy. While Tarceva can have some measurable, albeit almost always rather modest, benefit in patients who don't have an EGFR mutation, chemotherapy would always be the preferred first line therapy in such patients. If a patient had circumstances that made chemotherapy infeasible or inadvisable, I'm afraid it would be a mistake to presume that Tarceva would be beneficial for such a patients -- these are not the people in whom Tarceva has ever been shown to improve survival.
Good luck.
-Dr. West