Tarceva resistance without T790M mutation - what next? - 1270214

bmt330
Posts:1

New here.

My long-time boyfriend (age 46, and otherwise healthy) was dx Stage IV Adeno EGFR+ in February 2014.
His first treatments were 6X radiation to relieve pain from bone mets, followed by & X Carbo/taxol and started Tarceva at that time as well. He responded VERY well for about 15 months - even NED in March 2015, but has now shown progression. His Dr. took him off Tarceva rather abruptly about 3 weeks ago, and a new biopsy shows he is NEGATIVE for T790M.

What would be the likely next treatment options?
(and was it wise to stop Tarceva so abruptly?)

Thank you,

BMT330

Forums

catdander
Posts:

Hi and welcome to Grace. I'm very sorry for your need to be here but glad to help.

Whether or not one would want to go off tarceva after having good stability for as long as 15 months is a question of whether the progression was slight or in just one or not all places of cancer. If the cancer progressed just a few mm or in one but not all sights then continuing tarceva after progression can sometimes be like using bad brakes instead of no brakes. But for others it may be that tarceva has just stopped working but without the T790M mutation it's not known why. You might want to talk or have you BF talk to the oncologist about this.

Another thought about the previous treatment is that 1st line platinum based doublet like carbo/taxol can have an extremely good efficacy and may be part of the reason his cancer was so well held back for 15 months. It may not be possible to establish from where the benefit came.

Other chemo drugs as well as immunotherapies may be a good next step.

I hope this is helpful and please let us know if you need further help.

Janine