Tarceva for NSCLC negative for EGFR? AdenoSQUAMOUS diagnosis. - 1270639

Tue, 07/28/2015 - 15:30

What studies are there for Tarceva with NSCLC negative for EGFT?
Positive for MET and NF1.

My dad is Asian male 81 years old, former smoker for about 20 years, quit for over 20 years.
Diagnosed January 2015 with adenosquamous cell carcinoma (best to tell seemed to have characteristics of both. Major tumor 3.3 cm. Cancer appear contained within pleural walls when first diagnosed.

Treatment

1. 1rst line: Did a gemzar, carboplatin chemo. Results: Stable disease, major tumor went from 3.3 to 3 cm.

2. 2nd line: Opdivo for four months. First scan, major tumor shrank from 3 cm to 1.5, but possible neoplastic growth or inflammation seen in the liver for first time. Second scan, multiple new lesions in the lung area, possible neoplastic growth or inflammation still seen in liver. CONCLUSION: DISEASE HAS PROGRESSED!

3. Back to gemzar, carboplatin chemo, added Cyramza.

After scan in mid August, his Dr. states we should consider other treatment - either Tarceva or clinical trial.

NOW WHAT?
Targeted therapies with clinical trials seem like a crap shoot.
What studies are out for there Tarceva with NSCLC negative for EGFR?

Since Dad is Asian with some adeno and squamous component, worth a try?
Other ideas for treatment that don't seem like such a crap shoot that clinical trials seem to be?
Understandably, we were devastated that Opdivo did not work the miracles we had hoped, and lost four months, so now very wary of wasting precious time.

Thank you very very much for reading.

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catdander

Hi and welcome to Grace. I'm sorry about your dad. Cancer is a nasty disease and so difficult to treatment.

Since there was tumor shrinkage while on opdivo it's considered a positive outcome that may well have added 4 months or more to his life. Certainly not a waste of time. There is a phenomenon that occurs with opdivo in <10% of people on the drug where the scans appear to show progression but there are no worsening symptoms and with time begin to shrink. This is called pseudo-progression. More on it here, http://cancergrace.org/topic/keytruda-pd1-pseudoprogression-and-symptoms

There are no treatments for Tarceva with NSCLC negative for EGFT Positive for MET and NF1. Unless possibly in trials.

Trials are often an option and sometimes a very good one. You can read more about it here, http://cancergrace.org/cancer-101/2011/11/13/an-insider%E2%80%99s-guide…

Tarceva is an approved 2nd line standard of care treatment for nsclc even without EGFR mutation.

I hope this is helpful.

Best of luck,
Janine

mydadstage4

Brief read of your husband's dx. Wow.
Never heard of pseudoprogression before. Thank you for that, it's an encouraging thought.

So was your husband negative for EGFR?
How did his disease do on Tarceva?

mydadstage4

Brief read of your husband's dx. Wow.
Never heard of pseudoprogression before. Thank you for that, it's an encouraging thought.

So was your husband negative for EGFR?
How did his disease do on Tarceva?

catdander

He wasn't tested since it's a standard 2nd line treatment for wild type it wasn't needed. However 10 months is a long time to have tarceva respond to wild type (for someone with a smoking history like his and squamous cell it's overwhelmingly unlikely to have the egfr mutation). So it's very possible it wasn't cancer. I hope it wasn't and I hope the spine met wasn't and I hope he was cured with radiation chemo. This is one of those hopeful wait and see moments.

The nodule appeared just like his primary tumor and his biopsy caused a dramatic lung collapse so onc and neither one of us wanted another and was treated as if it were cancer. Often if it looks like a duck and quacks like a duck it is a duck or in this case lung cancer. Maybe we were wrong and won the lottery.

Thanks for asking I hope your dad does very well.

Janine