Stage 3 a difficult stage - 1245189

Mon, 07/16/2012 - 00:04

It would be nice to know what is best for stage 3, why stage 4 drugs don't get approved for earlier stages when proven to help stage 4, etc. I am ROS1 positive going for cure. I had surgery, incidental N2, will have. Curative intent chemo next week but would also love to have access to the small molecule biological for ALK pts that seem to help ROS1 as well to kick this cancers butt.

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Dr West

The reason these drugs aren't accessible for people with earlier stage cancers is that they haven't been tested in people who may already be cured of their disease with the treatments that are well established. While we can understand the compelling rationale of giving XALKORI (crizotinib) in someone who is ROS1-positive, there was also quite a bit of appeal of giving an EGFR tyrosine kinase inhibitor to people with an earlier stage lung cancer positive for an EGFR mutation, and yet the limited, imperfect evidence we have indicates that it may potentially be detrimental, even potentially to people who have the target mutation in question.

So because we have no evidence it's beneficial in people with earlier stage lung cancer who may already be cured, it's a very expensive medication with some potentially significant side effects, and we don't have any endpoint about how long to take it in this setting, it's not a recognized standard of care.

-Dr. West