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neilb

alimta, tarveva, halichondrin B??

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Unfortunately, I've progressed slightly after two cycles of Carboplatin, Docetaxel, and Velcade. I still have two enlarged lymph nodes in the mediastinum and one in the right, supraclavicular area (and the mediastinum ones are slightly larger). So, we're discontinuing this combination. So, what next?

Alimta? Seems safe but unlikely to hit a home run?

Tarceva? I do have adenocarcinoma, and I am a lifelong nonsmoker. I'm not a woman or Japanese, but you can't have everything! I'm leaning this way.

I'm also being offered a clinical trial of Halichondrin B (also known as E7389). The little I've found about it suggests that researchers hold out high hopes for it, but I know very little.

Any thoughts would be greatly appreciated. I'm a little frustrated in that I feel fine. If we didn't have pictures and a biopsy to prove otherwise, I'd think I was in great shape.--Neil

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Ernie--Thanks. I'm not writing off Tarceva. Actually, it's the frontrunner right now. The remark about not being Asian or a woman was mostly a joke. Indeed, my review of the New England Journal of Medicine article on Tarceva suggests that the gender finding is largely statistical artifact (women with lung cancer are more likely to have adenocarcinoma and to have been lifelong nonsmokers than are men with lung cancer; once you control for those variables, the gender effect pretty much disappears). Unless my doctor gives me a really convincing argument otherwise, I'm likely to go with Tarceva.--Neil

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hi neil,

i am on a clinical trial with alimta and gemzar every two weeks. I think the first cycle worked, because my pain disappeared, (although, now, at the end of the second week, its starting to creep back). Its fairly tolerable. tarceva had no effect on me, other than mad diarrhea and rash. Houston has a great looking phase 1 trial i will post about in the near future.

aaron

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