Stopped Pemetrexed due to pleural effusion.. now, Docetaxol

[PD121296]

My father (52) diagnosed with NSCLC in Sept'20 received 4cycles of Pem-Carbo + 2 cycles of Keytruda, followed by 2 cycles of maintenance Pemetrexed+Keytruda. The PET scan (Jan'21) performed after initial 4 cycles showed >40% shrinkage in his tumor.

However, he started getting breathless in last 2 weeks. So doctor performed an x-ray and found severe pleural effusion in right lungs. After 4 days of tapping, we successfully got the entire fluid (3.875 litres) drained and he feels very comfortable now.

But now doctor has prescribed him Docetaxol in lieu of Pemetrexed. Does the effusion in any way indicate that there could be progression? Our next PET scan would not be before April or May.

[Denzie Moderator Volunteer]

While I have never been on pemetrexed I have had a pleural effusion that required surgery to place a drain. This occurred 9 months after my chemotherapy ended and was not related to treatment.

They would have done a biopsy on the fluid they removed. Did they indicate they found any cancer cell in it?

[PD121296 in reply to Denzie]

Yes, it showed malignancy.

[Denzie Moderator Volunteer in reply to PD121296]

The presence of cancer cells does indicate possible progression. It also indicates that a change of treatment is in order. I send hope the docetaxol makes a difference.

[PD121296 in reply to Denzie]

Thank you very much. I am positive that the new treatment will help him! 🤞🏻