55 yo wife long term smoker, dx mid Feb w/poorly diff NSCLC Adeno w/4cm mass middle rht lung. Inop due to compromised lung function due to COPD dx 4 years ago.Late Feb PET shows hot lymph nodes, spine/rib. Mar medialstinoscopi confirms, ends up in ICU 3 days as lungs didn't want to work. Good news- + for ALK and she starts Xalkori. Did go from 230 to 180 lbs. in a month and a half but holding steady at 180 since starting Megastrol and Xalkori. 14 days radiation to spine due to pain and pressure. Early April 911 to hospital and 3 days ICU again as o2 sat @72% and co2 off the hook. Home o2, pain meds for fibromyalgia, and compromised lung function don't mix! April 20th seizure, CT showed 3 lesions to brain. Started at 300 mg and now at 600 mg/day Dilantin. 14 days WBR. Has some short term memory issues. Week before last CT of chest. Met w/medical onco last Friday. CT shows 6cm mass on lung at start of Xalkori reduced 40% as well as lymph nodes except the one rht clavicle which is growing steady. Dr refers back to radiation onco which we see tomorrow to see if can be treated that way otherwise chemo. I had to ask but Dr stated this is indication of Xalkori resistance and additional mutation. Is it realistic to expect response to chemo, or will It be palliative in nature? Wife going home to Michigan for month of September to see family she hasn't seen for over 6 years. She is hesitant to do chemo as she doesn't want to be sick while home, and timelines are going to be tight. We live north of Seattle. I asked about trails for 2nd gen inhibitors and Dr stated nothing where we are at and not aware of anything in the area. Trying to remain positive but it seems the hits keep coming. Only thing Dr was blunt about was to consider treatment continuation may be a waste of time as she still smokes. She has tried to quit via different options but stress and long term treated anxiety issues are making it tough. Thoughts, ideas, suggestions?