neilb

Andy's is indeed a great story, and the story of this drug is fabulous as well. It's important to note that this "magic bullet" only works for the 4-5% of NSCLC patients with the EML4-ALK mutation (I was just tested for it and don't have it). Those more likely to have the mutation are never-smokers (or very light smokers) with adenocarcinoma. They also appear to be more likely to be male, younger, and without the EGFR mutation. One last caveat: just as with Tarceva for the EGFR mutation, there's no guarantee that this new drug will continue to work forever. The two trials currently underway hope to get at this question.--Neil

Judy: Tarceva IS used for NSCLC. In fact, that (and pancreatic cancer) is what it's approved for. Without giving medical advice (which would not be good, since I'm not a doctor), Tarceva would be a major consideration for someone in your situation after Alimta (though hopefully you'll do well on Alimta for years!). You can find informative posts on Tarceva from the doctors at GRACE. Best, Neil

Cat: Thanks. That was sloppy of me.--Neil

Randy: Thanks for the report. Just to clarify, Tarceva, which is approved for NON-small cell lung cancer (I assume that was just a typo in the release you were quoting) in 2nd (or later)-line use, was rejected by the FDA (by a 12-1 vote) in December as a maintenance drug (to be used immediately after successful first-line treatment), due to an insufficient level of supporting data. OSI and Genentech then submitted more data, and the revised application will be considered for a decision by April. One key point is that Tarceva remains approved for 2nd-line and later NSCLC.--Neil investor.osip.com/releasedetail.cfm?ReleaseID=438052

Cat--Thanks. I don't know if my mom will qualify, but I passed this on to her.--Neil

thanks!!

Not sure if this is the right subject area, but it's the closest I could figure. My sister asked me to find out if there are "legitimate" discount drug sites that might be helpful to our Mom, who is on (among other things) abilify, which is running her $500 per month (in the middle of the Medicare donut). Any ideas? Thanks!--Neil

Randy--I appreciate all your work on this forum. It's tremendous. I posted because: a) there was no identification of the source. You simply copied from the web site. they have a clear and non-mainstream agenda. c) people should know that when they evaluate their information. d) through no fault of yours, people often take what you post here as gospel (ignoring the warning at the top of the forum as well as previous posts from Katie). Thus, I, too, was just giving another perspective. I don't think you have anything resembling a hidden agenda or ulterior motive. I don't even think that they do. It's right out there on their web site. My other remark (somewhat tongue in cheek) was a response to previous attacks on anything that questions "alternative medicine" or demands evidence to support its claims. I make use of alternative medicine, and I agree that it has much to offer. However, it is best when it is evidence-based. And, again, on the substance, I don't know that I'm going to get an H1N1 shot if it becomes available to me. It's a tough call.--Neil

Not sure what I think about the H1N1 vaccine (and I'm figuring I'll get H1N1 before the vaccine is available anyway), but note that Randy has reprinted an article from a British "natural health" website. Note also that they think the cervical cancer vaccine is bad (they're in a very distinct minority there) and that laetrile is good (again, they're in a minority). I'm not sure they're that reliable, but I'm probably just a tool of the medical conspiracy. Good luck to all!--Neil

Would be scary if it were true. Don't believe everything you read! http://www.snopes.com/travel/trap/congress.asp

Come on people! How many times does this have to happen? http://www.snopes.com/legal/lawsuits.asp

Ned--I have hiccups every Alimta cycle. They start the night before the infusion, and they end the second day after. Thus, they are clearly Decadron-related. Best, Neil

Hi, Ned! As you know, I've been on Alimta and Avastin for a year now. I hope Alimta is as successful for you as it's been for me. I've never had a Neulasta shot. The couple of times that blood work was done in between treatments, white count was down but not hugely so. The bigger issue with Alimta is red counts, and it has been for me (thus, the shortness of breath and fatigue), but that was cumulative. Best of luck!--Neil

OK, the most amazing thing in this whole thread is that Ned reads his own scans!! At my center, the scans go into the system right away. Typically, I have a scan on a day that I'm supposed to have treatment. I have labs, then the scan, then I go see the oncologist. He reads the scan and gives me the results (consulting with the radiologist if necessary). If they're good, we proceed with the treatment. I get the radiologist's report either at the end of the day's treatment or the next time I go in (depending upon whether it's ready in time). I can't think of a more ideal system (unless I were to hand-carry the films to Hawaii for Ned to read while I gaze into the Pacific!).--Neil

It is my understanding that, prior to B12 and Folic Acid supplementation, Alimta side effects were much worse (during the trials). That's why they're part of the regimen.--Neil

Cat--Congratulations to you and your sister! I can't help but mention that you touched on one of my pet peeves. When I see the doctor, first I see either a resident or a PA. The previous resident (who was otherwise wonderful) would always make me go through 10 minutes of questions and exam before telling me the scan results. The PA walks in, says hi, gives me scan results (as read by the senior oncologist and/or the radiologist), and then does the other stuff. Much more humane!--Neil

I've had 10 cycles of Alimta and Avastin as 3rd line treatment. First two cycles resulted in 50% shrinkage of everything bad. Since then, stable. If my upcoming scan is OK, I'll have cycle #11 on Tuesday. Side effects (most probably from Alimta, as Avastin has a longer half-life) early in each cycle include some nausea, fatigue, and loss of appetite (which then comes back with great strength in the last 10 days of the cycle). Maybe a little shortness of breath as well. Good luck!--Neil

I start to get hiccups the night before chemo (so they're not from the chemo per se). They go away two days after chemo. In my case, they're clearly from the steroids (which start the day before chemo).--Neil

From your description, I would assume that it's in trial status because of the brain mets. That's one of the remaining questions about Avastin (see Ned's post above). I'm on Avastin in combination with Alimta right now. The main side effect appears to be nosebleeds. Good luck to your mom!--Neil

Julia--I'm so sorry to hear your news. I hope Aaron finds peace.--Neil

Thanks to all for your kind wishes. I hope my good news is contagious. And thanks to Welthy for skipping the Happy Dance!--Neil

I saw the doctor today prior to cycle 3 of Alimta and Avastin. The news was great! Specifically, the four enlarged (and presumably malignant) lymph nodes in my chest shrunk by 30-80% each after two cycles of my new treatment. I took cycle 3 this afternoon. After two more cycles, they'll take more pictures. I have less cancer in me than I did when they discovered the recurrence exactly a year ago today. Lung cancer is very sneaky, but I'm, as always, optimistic. -Neil

Cat--Best of luck to you and Kelly. I hope she zips right through surgery and it does the job!--Neil

Tarceva is indeed more likely to generate a response among lifelong nonsmoker, those with adenocarcinoma, and Asians (the gender issue is less clear, as women with lung cancer are more likely to be Asian, have adenocarcinoma, and be nonsmokers). However, the evidence is also clear that Tarceva provides (on average) a survival benefit for people in every subgroup (even male, non-Asian, smokers with squamous cell). It certainly should be on the table. Whether it's the best choice right now is something that you and your oncologist need to figure out. Good luck!--neilb

Eccentric friends. Disclaimer: this is not a comment on the post that preceded it (even if people think it might be, and even if people think that might be an appropriate characterization).