Unable to join AZ9291 the first try. What´s next? - 1267493

Tue, 12/09/2014 - 09:58

HISTORY

Female 52 yrs diagnosed stage IV Adenocarcinoma Jan 2012 (pleural malignant effusion, nodes involvement and bones met in T6)tested for mutations EGFR + exon 19 deletion.
Firstline treatment was Tarceva with excellent reponse after 5 months treatment only 1 small node left

Jan 2014 review scan showed progression in my lymph nodes. My oncologist requested an guided ecobronchoscopy to biopsy my nodes with the result of T790M mutation.
Onc informed that the best option for me was AZ9291, clinical trial.
That shows very good results.
Organized all paper and tests, waited for 6 months. The last test was a histological biopsy or the remaining of my main tumor. Confirmed from the trail hospital everything OK. After washout from Tarceva I could start the trial
The morning I was going to start the trial , the trial onc team informed me that there was a mistake and histologically my Tumor did not show T790M mutation,( according to the AXZ lab in Belgium) although cytological the mutation was evident and clear and they have checked the same method was used in both labs -AZ refused the idea of a 3rd test to reconfirm. I was out ot the trial

Back to my originals hospital and onc I was offered chemno I did 6 rounds.Carbo/Taxol/Avastin .Good response. Only scar tissue in the upper right lobe. Maintenance with Avastin. 2 months after this, the follow up scan shows lungs& lymph nodes OK but multifocal progress in liver with several tiny lesions.
Again offered AZ9291 as best option. Onc will try to enroll y trial with dif, inclusion criteria, tomorrow I have an hepatic TAC AC....

QUESTIONS

IF I HAD AGAIN ANY ISSUE TO ENTER THE TRIAL IS THERE A WAY TO OBTAIN THE AZ9291 MEDS ´COMPASSIONATE USE OR EXTENDED USE? I´VE HERD THAT IT SILL BE APPROVD VERY SOON…….

ANY OTHER TREATMENT OPTION,?
ANY OTHER TRIAL I COULD JOIN ?

Many thanks in advance
Nerea
PD. I live in Madrid Sapin, but will be willing to travel

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Dr West

Unfortunately, I don't know of a mechanism for getting AZD9291 on a compassionate use basis at this time.

As far as other treatment options, there are certainly other chemotherapy approaches that could be helpful, and Taxotere (docetaxel) has a proven survival benefit in patients with advanced NSCLC who have received prior chemotherapy. Other chemo agents may also be helpful but aren't as well studied.

There may well be other studies, but you would need to go to a larger cancer center, perhaps an academic center, to get a better understanding of the range of options.

Good luck.

-Dr. West