I know its hard to give an advice on drugs to a patient just like this but any information would be great at this point that could help me to choose the path for my Dad.
He has been on Keytruda for 18 month with good progress with PDL1 positive. Last week he was told that he has LEPTO and he is starting whole brain radiation soon. Praying that everything will go Ok.
When we asked his doctor what kind of drugs we should continue after the radiation ,that will help brain meta too., she said that there are few drugs penetrating to the cerebrospinal fluid and brain; capecitabin,temozolamid and for targeted agent gefitinib(iressa) and trastuzumab.
Looks like some of these drugs are not for lung cancer or they are for patients with EGFR mutation positive and my dad is not. The doctor also said we can try any of these drugs anyway as a last option.
I also read Tagrisso and Avastin may help but these are also for EGFR positives.
How can we choose a drug now out of these options that may work? Are there any studies or cases showing that any of them worked even if these drugs were not meant to work initially?
At this point doing another biopsy to check if cancer became EGFR positive now (dont even know if its possible to change) is not an option. We are planning to do other types of genomic tests on the same tumor sample that he took initially but that may take time .
🙏🏼
Stage IV Lung Cancer Diagnosed/ Life Expectancy 
Been wanting to write this for awhile
Stage 4 adenocarcinom
