samdig1
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Posts:11
How well does Tecentriq work on EGFR positive patients who have progressed on Tarceva and/or Tagrisso? I noticed that Tecentriq can be used for EGFR patients and am wondering if there is any promise there.
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Reply # - May 8, 2017, 12:34 PM
Hi samdig1,
Hi samdig1,
At this time there hasn't been a lot of benefit shown from PD-L1 inhibitors against those with an EGFR mutation. It appears that those who have a significant smoking history do best. This is possibly due to the fact that smokers cultivate many mutations over the years and this is what the PD-1 and PD-L1 inhibitors respond to. Those with an EGFR mutation most often have little to no smoking history and the EGFR mutation seems to be the only (driver) mutation that drives the cancer. There seem to be a connection but again we don't fully understand the mechanisms of action.
There are currently clinical trials testing combinations of drugs with immunotherapies that have had promising results for those with single driver mutations. It may be possible to join one. It's usually best to join a trial when trying an unproven therapy for many reason. One reason is those who administer and collect the data keep a vigilant watch over the participants to avoid adverse affects of an untested treatment. Costs as well play a part. Insurance usually won't pay for an unproven treatment.
Here is a post on the subject of Tecentriq, http://cancergrace.org/lung/2016/09/01/oakpos/
Hoping for the best,
Janine
Reply # - July 21, 2017, 07:24 AM
Janine,
Janine,
I have to start every post on this site with thank you so much. This site is invaluable to cancer patients; I can explain this if it helps. Your post from May 28, 2017 12:34 pm, suggests there may be immunotherapy with other drug combination trials that are showing some success for egfr patients. Can you give any examples of either trials or specific combo's that rumor has it, may work? I am a daily user of clinical trials.gov and also researching options for my wife. We are usually ahead of our oncologists on new drugs/trial drugs, but I have not really seen anything suggesting any combo's are showing promise. Even if you only have rumors we will take them; I think my wife is progressing again. Please give us some bread crumbs/path that we can try to investigate. My wife is egfr/t790
Thanks.
Reply # - July 21, 2017, 11:24 AM
Ashes123,
Ashes123,
I happen to have a library of trials I've compiled in my bookmarks. One trial showing some promise in T790m positive patients who have progressed is Tagrisso + Portrazza:
https://clinicaltrials.gov/ct2/show/NCT02496663?term=AZD9291+and+Necitu…
Another trial that has been talked about a lot is Tarceva + MET or MEK inhibitors:
https://clinicaltrials.gov/ct2/show/study/NCT02143466?term=Tatton&recrs…
If you are looking specifically for immunotherapy trials, here is one I have heard of but have no idea of the success. This trial has the same chief investigator as the first trial I showed you (Dr. Jonathan Riess). I would definitely contact him because he is leading around 5 trials for EGFR patients who progress. This trials is for Afatanib and Keytruda:
https://clinicaltrials.gov/ct2/show/NCT02364609?term=UCDCC%23250&rank=1
Where are you located? Depending on where you are and where you are willing to travel for trials, I can point you to more. Let me know, and good luck.
Reply # - August 1, 2017, 08:39 AM
Janine,
Janine,
We are in Northern NJ. So the following works for us; NJ, NYcity, Philadelphia area....or any location if a trial only requires, roughly, a once a month visit. We have been scrambling for last 2 weeks. confirmed progression with new mets to liver. My initial email was referring to your May 8, 2017 post mentioning some hope with immune combo's (but you did also state for folks with a single mutation) My wife is egfr t790, 858 mutated. We research daily, but find that a different set of eyes often finds other options. So if you have any other ideas please share. Thanks.
Reply # - August 1, 2017, 11:09 AM
Okay, I will keep looking
Okay, I will keep looking into trials but look into this one...many people are talking about the promise of this trial with Met/Mek inhibitors. It says "not yet recruiting" in Phili but you might as well check. They also have a site in NY. I don't know how often you would have to travel to this one but this is one of the trials that show's promise and is frequently written about.
https://clinicaltrials.gov/ct2/show/study/NCT02143466?term=Tatton&recrs…
I'll keep looking through my library of trials when I am able to sit down and look but start here! Good luck.
Reply # - August 1, 2017, 11:15 AM
We will check that one out,
We will check that one out, but if I remember correctly this one is for patients that tested positive for either a met or mek mutation. Our Foundation One genetic analysis from January did not show any met / mek amplification. Thanks.
Reply # - August 1, 2017, 12:28 PM
Thank you so much samdig.
Thank you so much samdig. Your input is so appreciated. It's true that those who are in the thick of it know the most about it.
Ashes, a second opinion at an institute like Memorial Sloan Kettering, Presbyterian University Hospital of Columbia and Cornell or University of Pennsylvania-Penn Presbyterian, Philadelphia can help yield some of the best options available anywhere. All 3 of these centers are listed in the top 20 cancer research centers in the US. If they don't have trials specifically suited for your wife they are sure to be able to point y'all in a direction best suited for your wife.
I hope she is able to find something suitable.
All best,
Janine