After 2 months on Tagrisso, my scan showed about slight progression on lung tumor (about 15%) and on some bone mets. No new mets. I don't know is I am T790 positive (no test). Should I stay with Tagrisso or move on. I have already had progression on Tarceva and stopped Gilotrif due to bad side effects. I would appreciate your thoughts.
Thu, 07/14/2016 - 17:45
I'm sorry to hear that the latest scan appears to show progression. With targeted therapies such as Tagrisso, it's not uncommon for many oncologists to stay the treatment course in the face of slight progression. The reasoning is that the drug may continue to be effective against most of the cancer cells and that, in words of Dr. West, "bad brakes are better than no brakes." In other words, the current therapy may not be bringing cancer growth to a total stop, but that's better than some as yet untried therapy (at least not by a particular patient), which may provide no impediment to cancer growth at all. If progression is deemed to be slow, than it may be a good idea to stick with Tagrisso and get as much benefit from it as possible.
On the other hand, if there is enough progression to warrant a change in therapy, patients with activating EGFR mutations such as your original exon 19 deletion tend to respond well to chemotherapy, so that would be a good option. Targeted therapies and immunotherapy may grab much of the press, but many patients fare very well on standard chemotherapy agents such as Alimta.
Sat, 07/16/2016 - 10:19
Jim, thank you for your response. We have decided to stick with Tagrisso until the next scan.