Progression on Tagrisso only after 6 months.

[Bfowler]

I have been on Tagrisso 1st line for 6 months. my 3rd scan last monday showed slight progression, 2 new nodules ( 16mm- 1cm ) and one grew slightly. my next treatment plan is up in air pending PET, MRI and biopsy. Any recommendation or what your medical team is doing now will be helpful. Also, I am switching over from my general oncologist in NJ to MSK at NY.

[Neil-SueD]

I’m sorry this won’t be of any use to you, but I can’t help thinking that if Tagrisso is given as a first line of treatment, doesn’t this create a short-cut to a position where there are not yet any further drugs available to deal with the cancer mutations. I’m always impressed by the way the medical approach in the US seems to more quickly take up advances in medication, but is Tagrisso as a first line too hasty a course of action?

I only mention this as a comment to anyone about to embark on EGFR targeted therapy. I’ve been on Iressa (Gefitinib) for almost 3 years now and I keep my fingers crossed that as it is now starting to fail, perhaps the cancer has mutated to the one that Tagrisso can deal with for a while. Blood biopsies have shown nothing and the largest targetable tumours for needle biopsy are difficult to access.

Thank goodness EGFR drugs are out there at all. Any extra time they have bought us has been so valuable.

Neil

[Denzie Moderator Volunteer in reply to Neil-SueD]

Tagrisso was approved as first line treatment because peer reviewed studied established that it provided more patients with longer progression free survival as first line drug. It’s smart medicine to lead off with your best treatment first and save the others for later.

Here in the US we have been fighting a bill which would allow insurance companies to deny patients the best drug in favor of the one that is cheapest.

[Neil-SueD in reply to Denzie]

It’s very interesting the differences between healthcare (insurance) in the US and in the UK where we have the NHS. Having read these excellent pages in the various lung cancer forums for a long time, I have slowly come to the conclusion that doctors in the UK are spared a lot of the divisiveness than physicians more closely restricted by straight-up financial matters are. The result is that clinical decisions are more medically driven and less financially driven, i.e. “better”. Whilst funding may be limited across the board in the UK, doctor’s actions seem more measured and the apparent “foot on the gas or nothing” that the US health system is financially geared-up for isn’t what I’d wish for my own country. I have had private (insurance paid for) medicine in the UK for some things when I was working, but when it comes to cancer, give me the NHS any day. The older I get, the more I realise to “be careful what you wish for” and that there really does exist a world of lies, damn lies and statistics. A life working as a scientist has helped me assess what I see and hear and has brought me considerable calm during the close of my life when it could be a time of even greater upset about my own lung cancer. My own member of parliament wants to privatise medicine more in the UK. He’s lost my vote for being so shortsighted.

Neil

[Denzie Moderator Volunteer]

Excellent move there going to MSK. Hopefully they will do a new biopsy to learn how your cancer has mutated it’s way around the Tagrisso, and if it’s still EGFR & T790+.

I do not know much about EGFR treatments and alternatives but I do know one of the best sources of information when dealing with this. There’s an amazing group of EGFR patients that are driving research in concert with the G02 Foundation (the Addario Foundation that manages this webpage). They are called the EGFR Resisters and they have a Facebook page with the same name.

There are many EGFR patients there with extensive knowledge that parallels many oncologists. As a matter of fact I have met at least 2 members there that are MDs with adenocarcinoma.

[Bfowler in reply to Denzie]

Thank you Denzie!! I always love hearing from you. I am a member of EGFR Resisters FB. MSK information was provided by all the great souls on that group and thus I acted on it right away.