Tarceva after Surgery?? - NSCLC EGFR Exon deletion 19 Stage IIIB - 1265351

I think there is no answer to your question and no good data to answer it. Unfortunately, all we can speak to is the evidence, and there is a good premise, but all we know is that in molecularly unselected patients (most of whom didn't have an EGFR mutation), giving EGFR inhibitor therapy after chemo and radiaiton is not associated with a beneficial effect, and it seems to be detrimenal (based on the SWOG 0023 trial described alsewhere on the website). I wouldn't presume that this applies to patients with an EGFR mutation, but we don't have any evidence at this time that giving EGFR tyrosine kinase inhibitor therapy to patients with stage IIIB disease do better with EGFR TKI therapy.

Nobody has ever been treated in the exact same way as your brother, so the best answer is that we simply don't know the best treatment and whether people should receive an EGFR TKI for EGFR mutation-poisitive stage III NSCLC.

Good luck.

Dr. West

I agree with Dr West. The chances of recurrence for Stage IIIB lung cancer are still fairly high, even when treated with the triplet of chemotherapy / radiation/ surgery you describe. The problem is, that we don't think that Tarceva "cures" anyone, it may simply delay the time to tumor regrowth. Most also have some side effects from it. So it seems reasonable in this situation to postpone restarting the Tarceva, and resume it if there is any evidence of recurrence. You never know, he may never need it again.

Other the other hand, I think the one year of Tarceva also seems quite reasonable as well, albeit without solid evidence, especially if he is tolerating it well. Good luck!