T790M after Tarceva, PD-1, on Afatinib/Erbitux since Oct but now failed that, to - 1262899

Fri, 03/21/2014 - 13:30

Hello; I am wondering if I have now exhausted all of my treatment options. I am currently on Afatinib/Cetuximab and just had CTs this week that now show progressive of my innumerable lung mets and now multiple new bony mets (never had disease beyond lungs/regional LNs before). I imagine they will discontinue this treatment but I don't know what, if anything, comes next. I just developed my first DVT last week, incidentally, and am on Xeralta.

I have been on the waiting list for CO 1686 for nearly one year now without any word that I am even close to receiving this. It is at the closest academic Ctr to us, which is 4 hours away, and I am not certain I could make the journey with any frequency.

Well, if anyone out there has any suggestions for us, we would appreciate hearing from you



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Dr West

I recently wrote a post about the encouraging early results not only with CO1686 but also AZD9291, if you might have more luck finding a center participating in a trial with that agent for the same setting of acquired resistance:


But the other obvious point I'd raise is that just about every general oncologist and lung cancer expert would favor trying chemotherapy, at least a single agent if not a platinum doublet, either instead of or in addition to an EGFR inhibitor, in patients with acquired resistance. While targeted therapies are appealing, standard chemotherapy can still provide meaningful benefit and is often far preferable to a completely unproven late line of investigational therapy.

Good luck.

-Dr. West