After 1st line chemo, how soon can you start 2nd line?

[teriw]

I know a lot of people here have had Topotecan as a 2nd line chemo. Don just mentioned in a recent post that he had it a few months after completing his first 6 cycles of carbo/etoposide.

My hubby is going for PET/CT today. We should have the results of this on Friday. We know from a CT in Feb that there has been some progression in the chest tumor since a PET/CT in December, but it was characterized then as "minimal growth." Regardless of the results, we're meeting with the radio onc next week to discuss radiation. And if we don't like what we hear from either doc, we'll look elsewhere.

I have two questions. One is, how long do you have to wait before starting a 2nd line chemo, if it's decided if one is needed? (Just FYI, hubby has handled chemo very well.)

Second question, our med onc mentioned "salvage chemotherapy" as a possibility (when I asked about what next). He mentioned a med that started with an "H". After looking through the list at ChemoCare, I'm guessing it was Hycamtin. He didn't want to discuss this any further until we knew the true story.

There's so much experience here, I like to put it out there now and see what comes back. And if Dr. West is reading, his comments are always appreciated.

As always, thanks in advance.

[laban]

Hi Teri,

My Bill had recurrence and was told that he didn't need to start right away with the Hycamtin (Topotecan) because the mets to the bone was caught early and was not that big. He has had 2 rounds, 1 time per week for 2 weeks and the 3rd week his counts were too low to continue. He had 2 weeks off and started again last week and had #2 today.

As far as I know, he should be able to start right away if there is progression. If he should have radiation and chemo at the same time, he'll probably have the fatigue and low blood counts again.

I hope and pray tonight that his PET/CT results are good.

Keep the faith.

Laurie

[teriw]

Thanks Laurie. I appreciate the info (and the support). Stupid question, but are Hycamtin and Topotecan the same?

[RandyW]

Not a small cell person but a researcher. Yes tehy are the same thing Teri, Try this Link;

http://www.hycamtin.com/

[teriw]

Randy -- as always, thanks for providing a useful link. I had no idea they were the same.

Any sclc folks -- Even with these therapies, it talks about "recurring" sclc. I'm wondering how soon do you try Plan B (2nd line) if the first 1st line doesn't completely knock it back? (I'm still hoping that cycle 6 did the trick and we go straight to radiation.) Of course, our doctor will go over this with us. I'm just seeking any personal experiences.

It's always good when you're at the doctor appointment if you can ask a "what about this" questions with some level of confidence.

[Welthy]

Teri,

My friend finished six cycles of chemo for her ex-SCLC, then went straight to radiation on a spot in her lung and brain (spot treatment & WBR). I don't know if they didn't move directly to second line treatment because she was not in good health (other than the cancer) or if radiation & chemo isn't combined if also doing WBR.

Good wishes to the both of you.

Welthy

[teriw]

Thanks everyone. I'll probably post an update in the Update forum next week, because we'll receive the results of yesterday's PET and tomorrow's brain MRI then.

As always, I appreciate the info and support.

[Flowergirlie]

I have you both in my thoughts and hope for great results! I am happy that Bill has handled the treatments so well. That is so helpful in second line treatment for sure.

I know the in between anxiety for scans and tests but just take deep breaths and know that we are here (and I am here pretty late these days).

Hugs, Love, Peace, Comfort...Flowergirlie

[Marco Jo]

HI Teri-

My sister tolerated the first line well as well(8 rounds). Then she had radiation for some small spots on her brain, and her back about a month later. Then about a month after that finished, she started topotecan(Hycamtin). Unfortunately, the topotecan did not work as well for her. She tolerated it ok, but it isn't as effective for as many people. Radiation seems to be more reliable, but you can't have it everywhere.

Best of luck to you!

Marco Jo

[enyaw061032]

Teri, I don't know much if anything about second line treatment, but just wanted to send my best wishes and prayers that the PET and other scans will show the tumors gone or shrunk.

Barb

[mitzu]

My Dad had spinal and brain mets, and the docs wanted to try Topotecan, however they did radiation first, which lowered his platelet count to the point he had to wait 6 weeks for it to return to normal. By then, he was too sick to tolerate Topotecan (side effects are harsh).

The oncologist told me that with mets or SCLC recurrence, Topotecan would only prolong life by 26 weeks or less.

[teriw]

Thanks everyone for the info. I guess the answer we got is "right away." Scheduled to start Topotecan on Monday.

[trish2418]

I'm sending lots of prayers that the Topotecan does the trick. Take care of yourselves.

Trish