Treatment of lung adenocarcinoma

@flusshund "Thank you for your reply, I feel much more relieved now. My mother has the Exon 21 mutation, and we will be starting her on Tagrisso. I have heard that resistance usually develops after a few years; what is your take on this? Wishing you good health.

@tongxiaozhi, I don't know that the word "usually" is appropriate, maybe "sometimes". My friend Frank has the same Exon 21 mutation and has been taking Tagrisso for 10 years with no resistance. I know an MD Anderson Dr who has a patient that has been taking Tagrisso for 12 years without resistance.

Tagrisso is a targeted therapy that does not hunt down and kill cancer cells. Rather, it keeps existing cancer cells from infecting healthy cells and spreading. So if surgery and/or radiation can eliminate the visible nodules, then the idea is that Tagrisso can keep any isolated cells from multiplying and becoming a problem. I wish you and your mother all the best.

@mamajite Yes, we’ve since learned that my mom has an EGFR exon 21 mutation, and we’re hopeful there will be a good targeted therapy option for her. It’s reassuring to know there are treatments available for this type.

I’m very sorry to hear about your parents. It sounds like they both went through difficult journeys, and I’m glad your mother was able to have those extra years with you—that time is truly precious. Thank you again for sharing that with me. 🙏🏻

@flusshund Thank you so much for sharing this—it’s really encouraging to hear about your friend and the long-term responses some patients have had with Tagrisso. That gives us a lot of hope.

I also appreciate your explanation of how Tagrisso works. It’s helpful to think about it as controlling the cancer and preventing spread, especially in combination with treatments like surgery or radiation when appropriate.

If you don’t mind me asking, what stage was your cancer when you started taking Tagrisso? My mom is currently stage IV, and her doctors in China have mentioned that resistance can sometimes develop after one or two years. Hearing your experience makes me feel more reassured.

Also, at the beginning of your treatment, were you taking Tagrisso alone, or was it combined with chemotherapy?

Thank you again for your kindness and for sharing your experience. Wishing you continued good health and all the best. 🙏🏻

My mother has stage IV lung adenocarcinoma. She currently has no obvious symptoms. She has an EGFR exon 21 mutation. Some doctors recommend osimertinib alone, while others suggest osimertinib combined with chemotherapy. We are feeling very conflicted about how to choose. I would really appreciate any advice. Thank you very much.

@tongxiaozhi there is research showing that patients like your mom that do both chemotherapy and osimertinib have a better/longer response. that said, chemotherapy has more difficult side effects. it's a case where you have to balance quality/quantity of life and consider your mom's overall health and priorities.
https://www.nejm.org/doi/full/10.1056/NEJMoa2306434

@tongxiaozhi, I started taking Tagrisso after my lung cancer metastasized to my brain. My doctors surgically removed the cyst, and then I had four rounds of targeted radiation. A month after the radiation, I started taking Tagrisso alone in December 2020.

I did not have chemotherapy because chemotherapy does not cross the blood-brain barrier. However, since then, the Flaura 2 Phase III study has shown that the combination of Tagrisso and chemotherapy improves both progression-free survival (PFS) and overall survival (OS) compared to Tagrisso alone, https://www.ilcn.org/final-flaura2-os-data-show-osimertinib-plus-chemo-offers-benefit-compared-with-monotherapy/. But your oncologist will take into account your mother's age and overall health before prescribing chemotherapy. These decisions are never as simple as they look.

Your mother is lucky to have a child that is doing all this research on her behalf. I wish both of you all the best.

Matthew

At age 85 I've just been diagnosed with Stage 4 metastisized NSCLC lung cancer (PET scan showed it also in adrenal glands and lymph nodes). The lymph node biopsy showed MET exon 14 and I'm about to start the targeted Rx Tepotinib (TEPMETKO). However, I was offered a clinical trial that combines Tepotinib with Ramucirumab. IF I start Tepotinib alone, I won't be allowed in the trial. So confused. Some people say "if there's a trial that's specifically for you, you are crazy not to do it." I've declined so far (but haven't started any Rx yet) as I think at my age, dealing with the probable complications of 1 drug is enough. My objective is to stop the cancer from spreading, if possible, but to have a somewhat decent life too. Thoughts? Experience?

@mangolinda8191
Are you the first group on the clinical trial. I was in a clinical trial that was the 3rd i think group. It was to prevent GVHD after my bone marrow transplant. Well, I did it and i did not have GVHD. No side effects from the transplant. I got to than the dr yesterday at a Bone Marrow Reunion City of Hope holds yearly.
See what group this is. I just took one more pill daily for the first 90 days.
If by some chance you had a reaction, they would take you off it.

@katgob Thanks for sharing your experience. The clinical trial I'm considering is a Phase II (not 3). It's all so individual, like rolling dice, and also somewhat dependent on age.