I wonder whether re using afatinib may benefit my mom again. She was previously on the drug for about six months with very good results. When it stopped working, and even then the progression was quite slow, she was found positive for t790m, and started Tagrisso. However, she, from the get go, didn't seem to do well on the Tagrisso, and when we got our scan 3 months later it showed dramatic progression. We did another biopsy and sent it to foundation one and it showed no t790m, it did show the original exon 21 and several others, including the very problematic mutation, KRAS. Her mutations load was also quite high, so immunotherapy was listed as a viable option. She recently started Opdivo, 2 infusions thus far, unfortunately by the time she went into the clinic to get her third one she fell and fractured her hip, she went into surgery couple of days later. As I understand, it takes time for any immunotherapy drug to work, as of the need to get to a critical mass sufficient enough to trigger one's immune system into action. With mom's very progressive disease (she doesn't feel well at all, doesn't eat, sleeps a lot, and has right side abdominal pain, probably from the liver mets), I think it's critical to put her on a drug that works fast without having to wait too long. So my question is, would it be possible for her to take afatinib again, it would be about six months since the last time she took it, and it makes sense that some cancer cells, especially the new ones, would be sensitive to the drug. We need to stabilize her situation, to have enough spare for her to have the time to wait when trying Opdivo again. I'd greatly appreciate your thoughts, insights, or experience on re challenging afatinib.
Thank you all,