Treatment for IIIB

[Andrea]

Hi everyone,

I just got news that my former boss's mother in law was diagnosed with the beast I don't know too much about treatment with effusions since my parents haven't dealt with that. Does anyone have any advice? Info is as follows:

Adenocarcinoma, non-small cell. It is in the mediastinal node, the pleura and pleural effusions. There is no primary that has been located, but it is suspected it began in the lung.

It has been suggested we treat with conventional chemo starting with Carboplatin/Taxol/Avastin. Also, that we put her into a trial that will, after 4 rounds of these are completed, add oral Tarsava. It is a blind study and thus 50% chance of placebo rather than Tarsava.

[recce101]

That's similar to my diagnosis, except I didn't have node involvement, and they did find the primary in my middle lobe. Treatment was the same as she is programmed to have, except for the Tarceva part.

The effusion may need to be drained (thoracentesis) if it's causing shortness of breath. Sometimes they gradually clear up with chemo. Mine has reduced in size, but there's still a hydropneumothorax (trapped pockets of air and fluid) in the lower half of the right chest partially collapsing the lung. If hers is still primarily fluid, it may resolve more completely than mine did.

Give her my best. If she still has questions after reading my profile, please let me know. Aloha,

Ned

[trish2418]

Hi Andrea,

Sorry to hear about your friend's diagnosis. I was also diagnosed IIIB, with hilar node involvement, no effusion (although I developed a pleural effusion during treatment). I started with carbo/taxol, added radiation 6 weeks into treatment, and then another 3 months of taxotere following radiation. I'm now NED and have been taking Tarceva for 15 months. Hope treatment goes as smoothly for your friend. Keep us posted.

Trish

[tiredmom959]

My mom's diagnosis was pretty darn close to that, if not exactly. You can see in my profile what her treatment was/is. Even the thing about the "primary" in the beginning ... they assumed (and obviously correctly so) that it originated in the lung after ruling out several other areas.

[RandyW]

this has had highly successfull results also if you can look into it. We had round table last nite at Chat about Stimuvax and results. Results ar epositive and I believe IIIB is stage that qualifies. Let me know if can help with anything.

Click on link below;

http://clinicaltrials.gov/ct/show/NCT00409188?order=1

[tkelley]

Hi Andrea,

Hope you guys and the babies are doing well...since we have been researching clinical trials for my dad this week and he is now stage 4 I didn't spend too much time looking at 3B...I did see alot in which the criteria would kick you out with a pleural effusion (my dad keeps getting kicked out due to the many lines of chemo and his heart). There are many things out there and like Randy said....you might want to look into Stimuvax. Since this would be his first line of chemo there are many options out there for him and hopefully some without a placebo. I know they need to do that but my dad just want to see if something works and make sure he is getting medicine. On the clinicaltrials.gov site they are pretty good about info regarding who is eligible and who isn't, etc...Let me know if I can help

Tammy

[DrWest]

It's important to make the distinction between "wet IIIB@ NSCLC with a malignant pleural effusion (cancer cells in the fluid) and "dry IIIB", which does not. Wet IIIB has basically the same prognosis as stage IV NSCLC, and these patients are generally excluded from the more aggressive trials for locally advanced (stage III) NSCLC and included in advanced disease trials. On the other hand, patients with dry IIIB NSCLC are included in chemoradiation trials and excluded from trials of advanced NSCLC.

The clinical trial of chemo/avastin followed by tarceva or placebo certainly seems interesting and appropriate, since we consider 4-6 cycles to be an optimal duration of first line treatment, and every patient can move to further treatment as soon as they show progression.

-Dr. West

[Andrea]

Thanks everyone! And thanks Dr. West for taking the time.