sunshine4me
Posts:4

Diagnosed in 2012 Stage IV NSCLC, malignant pleural effusion. EGFR positive, started Tarceva which kept cancer at bay for 20 mos. Negative for T790 mutation so I started Carbo and Alimta and then Alimta maintenance. After a few months on Alimta, more progression. Was able to start Opdivo (Nivolumab) off label before FDA apporoval. Did well on it together with some radiation of a tumor that was occluding the bronchus.
To date, I have been on Opdivo for 11 mos. Recent CT scan shows new progression. Looking into other options and was wondering if anyone had success trying Tarceva a second time? I have been off it for about a year now. Are there any new drugs that are being used successfully with Opdivo?

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Reply # - May 10, 2016, 11:47 AM

JimC
Posts: 2753

Hi sunshine4me,

Welcome to GRACE, and congratulations on the good responses you've had to treatment. When a patient has an extended response to a first-line TKI, as you did with Tarceva, rechallenging at a later date is a viable option, even if it's not really expected to be quite as effective as it initially was. Other options include further targeted therapy, either using one of the third-generation EGFR TKIs, which may be effective even in the absence of a T790M mutation, or one of the options Dr. Pennell discusses here. It's also possible to try a different chemo regimen.

Immunotherapy combinations are just beginning to be studied, and are the subject of a recent podcast by Dr. Garon.

Good luck with your next line of therapy.

JimC
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