We met with Lisa's primary oncologist today. He said he was disappointed by the scan but not surprised. This is common -- cancer is "smart", especially Lisa's type of cancer (Non-Small Cell Lung Cancer, NSCLC), and over time it adapts to chemo thrown at it, eventually rending the chemo ineffective, forcing a change. The oncologist would have been ready to start with a new chemo mix today, but is going to wait until Monday after we've seen the radiation oncologist, since the radiation dose can affect how chemo is administered. The primary oncologist is suggesting that low-dose radiation treatment be limited to the affected vertebrae and/or perhaps also a section of the pelvis.
For the new chemo, the oncologist told us that it's a matter of trial and error -- there's no way to know what is going to be effective on Lisa's cancer. They'd administer the chosen chemo mix for two "cycles", which equates to between 6 and 8 weeks depending on the type of chemo, and then run another scan to determine if it's having a positive effect. If it is, we continue it... if it is not, we change to another type of chemo.
His recommended mix right now is Abraxane and Carboplatin. This is a relatively new chemo combination for NSCLC, approved for that use by the FDA in 2012, though it's been used for breast cancer for almost a decade. Abraxane can also be given alone, but studies show that it is not nearly as effective as when combined with Carboplatin. The combination produces at least some positive effect in approximately 33% of NSCLC patients.
The next-in-line alternative (but harsher as far as side-effects) would be a mix of Etoposide (VP-16) and Cisplatin. This has been used as a first-line treatment for Small Cell Lung Cancer (SCLC), but has also been studied for use as a down-line treatment for NSCLC since the 1980s, producing at least some positive effect in roughly 25%-35% of patients (depending on the study).
For the new chemo, the oncologist told us that it's a matter of trial and error -- there's no way to know what is going to be effective on Lisa's cancer. They'd administer the chosen chemo mix for two "cycles", which equates to between 6 and 8 weeks depending on the type of chemo, and then run another scan to determine if it's having a positive effect. If it is, we continue it... if it is not, we change to another type of chemo.
His recommended mix right now is Abraxane and Carboplatin. This is a relatively new chemo combination for NSCLC, approved for that use by the FDA in 2012, though it's been used for breast cancer for almost a decade. Abraxane can also be given alone, but studies show that it is not nearly as effective as when combined with Carboplatin. The combination produces at least some positive effect in approximately 33% of NSCLC patients.
The next-in-line alternative (but harsher as far as side-effects) would be a mix of Etoposide (VP-16) and Cisplatin. This has been used as a first-line treatment for Small Cell Lung Cancer (SCLC), but has also been studied for use as a down-line treatment for NSCLC since the 1980s, producing at least some positive effect in roughly 25%-35% of patients (depending on the study).
