Stage 4 adenocarcinoma on gefitinib with progresion and eye metastasis.Wat next? - 1288882

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thomachan
Stage 4 adenocarcinoma on gefitinib with progresion and eye metastasis.Wat next? - 1288882

64 male stage 4 Adenocarcinoma with BAC component on gefitinib from June 2016 having progression with mets in right eye. .started carboplatin and premetrexid since 2 days. .Anything more to be done? ??

thomachan
EGFR Exon 21 positive

EGFR Exon 21 positive

thomachan
MRI Brain and orbit showed a

MRI Brain and orbit showed a lesion( 1.5×1.1cm) in right eye near macula ..No brain mets

catdander
Hi thomachan,

Hi thomachan,

Welcome to Grace. I'm very sorry for your need to be here but I hope we can help. Metastasis to the eye is pretty rare in nsclc but nsclc will do anything. With a met in such a sensitive area it's important to knock it back pretty quickly and carbo and pem can do that as well as any systemic treatment. Even if a met shows up in an odd place standard methods of treatment for nsclc are usually the standard of choice in treating. Almost no one is a "typical" nsclc patient; they'll all individual. With that said individual circumstances call for individual treatment plans.

Sometimes if a tumor is causing pain or in jeopardy of causing catastrophic problems (like spinal compression, infiltration of the esophagus) radiation is used. Radiation or stereotactic radiation (more precise more intense radiation that is sometimes used for small spots) may be an option as well but that would need to be addressed by a team that is involved in the case. If that's not an option where you're being treated then a 2nd opinion at a large teaching/research hospital that has oncologists who specialize in nsclc can be a very helpful 2nd head on the subject.

Just one more thought. After this scare or as we like to call it "bump in the road" is over it would be reasonable to check the cancer for a t790m mutation. It's the most common reason for failure (acquired reisistance) of tarceva after a good run on it. There is 3rd gen treatment (tagrisso) that may be beneficial as well as promising trials for those who don't have t790m mutation.

I hope this is helpful.

Janine

thomachan
Thank you for the reply. .

Thank you for the reply. .