What's next after Tagrisso? - 1294947

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bsheif
What's next after Tagrisso? - 1294947

Dx 11/2016. + for exon 19 deletion, Rx. with Tarceva for 18 months. Tolerated well. Now on Tagrisso, not sure how well I'm tolerating as it's only been 2 weeks, + for T790. Trying to be proactive and think a step or 2 ahead. What is next. Is there a proven standard of care for 3rd line treatment or am I done? I'm scared of trials as I don't find that most are in MY best interest. But I do think there are some that might apply. Just don't know how to find. I'm not interested in early phase, dossing trials. But if there is a phase 3 trial that is promising I might consider. The process is daunting as I have learned each well respected medical facility only talks about the 1 or 2 trials they are working on. I can't tour the country to find out what is best for me!.
Any advise on What to expect if Tagrisso stops working would be appreciated.
Other specifics Dx with stage 3B NSCLC, adenocarcinoma. Met to spine (L5) and rib. All sings of cancer gone with Tarceva Rx. New growth since then only in lung (one old spot, one new spot).
Thanks for your help

onthemark
hi bsheif,

hi bsheif,

Welcome to GRACE. Hopefully you will have a long run with Tagrisso.

There are some promising results for EGFR+ patients (previously treated with a TKI) in the IMPower150 trial although it is too soon to be definitive. The study is a little complicated since one arm involves taking 4 drugs concurrently and not all the arms were tested yet for EGFR+ patients.

It is something to keep an eye out for the future. I find it easiest to follow Dr. West on twitter for up to date information on the latest studies of clinical importance.

I believe the standard of care following TKI at the moment is still a chemotherapy doublet. If it is only one or a two areas that are progressing they can also do targeted SRT radiation on those areas, whilst staying on Tagrisso for overall control.

There are other studies with combining TKIs as well as many new TKIs including 4th generation ones (Tagrisso is 3rd generation). For one discussion from January 2017 see: https://www.frontiersin.org/articles/10.3389/fmed.2016.00076/full

If I see a more recent review, I'll post it.

bsheif
Onthemark, thank you, I'll

Onthemark, thank you, I'll keep a look out for your posts