What next after AZD9291? - 1272500

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What next after AZD9291? - 1272500

My mum was diagnosed with Stage IV lung cancer (NSCLC adenocarcinoma) in mid-2014. Was on Tarceva for a year after testing positive for EGFR then joined an AZD9291 clinical trial in July 2015 and has been doing well. Seems like effectiveness of AZD9291 is diminishing - we've just found out she's got brain mets (multiple spots) and will be starting radiotherapy in a week's time.
She's been lucky to have good quality of life since being diagnosed and despite symptoms from medication has been able to go about her daily activities. I'm worried about the side effects of radiotherapy (that the treatment will be worse than the disease). Her oncologist says there is no alternative to radiotherapy for her brain mets if she wants to prolong her life.
My question is this - what treatments are available besides chemo once AZD9291 stops working? Are immunotherapy drugs such as Keytruda or Opdivo potential options? Or are they not effective for EGFR / T790M cancer? By the way, thanks everyone for all the posts and info on this site - it's been very helpful and informative for me and my family.

When there are multiple brain

When there are multiple brain mets wbr is still the standard of practice and really the only choice. The side effects aren't normally chronic and pass within a month or so after therapy. Extreme fatigue is most notable for most people. It does have a very good chance of destroying the cancer in the brain then your mum can return to azd9291/tagrisso.

Yes immunotherapies can be of benefit to those with egfr mutation.

I hope your mum does well with wbr and is able to get a lot more time our of azd9291.


Thanks so much for your reply

Thanks so much for your reply Janine - really appreciate it.