Tarciva didn't work.

[paul verdon]

Michael had disapointing news with the Tarciva considering he was covered in a rash all over his torso. We had the visit with the oncologist this morning to review the results

of the latest scans last Friday and the tumor has grown a little. One

of the spinal lesions is slightly bigger also, but everything else is

the same or even a bit smaller.

This means the Tarceva pill did not work and we now proceed to

step three of treatments with a chemo drug called Alimta. It's

administered intravenously every three weeks for six session with scans

after three sessions to see how it's going.

Anybody got incouraging news for us on this disapointing day? Any one on Alimta?

Thanks all of you for all your support. It was a blow to me today maybe more so than Michael.

Paul

[recce101]

Paul, I'm very sorry to hear this disappointing news. Let's all hope and expect Michael to get a great response from Alimta. It's probably the drug I'll move to when Tarceva stops doing its thing for me. Best wishes and Aloha,

Ned

[Ry]

I am sorry the Tarceva didn't work. Alimta was a hard chemo for my husband to tolerate but it helped-- and that's what counts. Good luck with it.

[Patti B]

Paul -

I am so sorry that the Tarceva did not work for Michael.

I have been on Alimta for several months now after Avastin stopped working for me. It has not been that hard on me. It does cause fatigue and SOB and some muscle aches and pains but its still not as bad as Carbo/Taxol was. He will need to take Folic acid every day in pill form and get an injection of Vitamin B12 after every 3rd chemo to help with his blood counts.

If you have any other questions about Alimta, please feel free to PM me.

Will be thinking of you both and hoping for the best.

Patti B.

[Muriel]

I'm so sorry - and disappointed - that tarceva didn't work for Michael. Let's hope and pray that alimta works for him. Let us know how his first treatment goes.

Muriel

[fillise]

I'm sorry to hear that the Tarceva didn't work, but perhaps the Alimta will. I will pray it is so!!!

Susan

[Leela]

My mom is on Alimta right now. She's had 3 infusions and gets her scan results tomorrow. My mom's side effects are similar to Patti's, plus a dull headache for a few days after treatment. The infusion is short - usually an hour or less - unlike the Carbo/Taxol which was 5 hours. Along with the folic acid and B12 shot, she also takes steroids the day before, of, and after chemo. Here's hoping the Alimta is the magic bullet for Michael! Keep us posted.

Hugs,

Lisa

[Don M]

I hope the alimta works. It is not bad. the infusions don't take long.

Don M

[carolhg]

Praying that the Alimta works! Keeping you both in my prayers.

Carol

[dadstimeon]

Sorry the Tarceva did not work. Had Alimta-- other then fatigue had no problems with it and had very good results with it. It is discouraging when a treatment stops working/does not work but keep in mind there are other treatments to keep the ball rolling. As long as there is life there is hope and never never never give up!

[TracyD]

I was on alimta for four months last summer after avastin stopped working. I found it to be very tolerable and was able to live a very active life style. The infusion is very short, and other than being a bit tired at the end of the infusion day, I was good to go on day two. While I did not have any improvement, it did keep me stable for those four months.

Good luck.

Tracy

[paul verdon]

I want to thank all of you for the info for Michael. We started a bad week last week because of the growth in tumors with Tarciva. I have been reading everyones back ground and realize that some chemo treatments don't work for all but there are other treatments to try. A step at a time and by the way Michael looks and feels good so that's a good start. Again thanks everyone!

Paul

[Connie B]

Paul, that's very true about chemo's working or not working for people. It's a crap shoot and no one person seems to be the same during chemo or after chemo. What works for one, may not at all work for someone else. No rhyme or reason for it either, it's just how it is!

Best wishes to you and Michael

[JenkazMrs]

Hi,

so sorry that Tarceva did not work for Michael. Hope that the Alimta gets good results. Everything crossed!

Deanne

xxx

[gpawelski]

Tarceva is a "targeted" therapy, in that it halts the growth of certain cancers by zeroing in on a signaling molecule critical to the survival of those cancer cells. The drug is effective in about 10-15% of patients with non-small cell lung cancer. The drug works specifically in patients whose cancers contain mutations in a gene that encodes the epidermal growth factor receptor (EGFR). Lung cancer patients with these mutations are often people who have never smoked.

Although this targeted therapy is initially effective in this subset of patients, the drug eventually stops working, and the tumor begins to grow again. This is called acquired or secondary resistance. This is different from primary resistance, which means that the drugs never work at all. The change of a single base in DNA that encodes the mutant EGFR protein has been shown to cause drug resistance. The story is the same as for Erbitux and Iressa. Drug resistance evolves by multiple mechanisms.

Initially, tumors have the kinds of mutations in the EGFR gene that were previously associated with responsiveness to these drugs. But, sometime tumors grow despite continued therapy because an additional mutation in the EGFR gene, strongly implies that the second mutation was the cause of drug resistance. Biochemical studies have shown that this second EGFR mutation, which was the same as before, could confer resistance to the EGFR mutants normally sensitive to these drugs.

It is especially interesting to note that the mutation is strictly analogous to a mutation that can make it tumor resistant. Non-small cell lung cancer makes up about 80 percent of all lung cancers. Mutations in a gene called KRAS, which encodes a signaling protein activated by EGFR, are found in 15 to 30 percent of these cancers. The presence of a mutated KRAS gene in a biopsy sample is associated with primary resistance to these drugs.

Tumor cells from patients in a study who developed secondary resistance to Tarceva after an initial response on therapy did not have mutations in KRAS. Rather, these tumor cells had new mutations in EGFR. This further indicates that secondary resistance is very different from primary resistance.

All the EGFR mutation or amplification studies can tell us is whether or not the cells are potentially susceptible to this mechanism of attack. They don't tell you if Tarceva is better or worse than some other drug which may target this. There are differences. The drug has to get inside the cells in order to target anything.

EGF-targeted drugs like Tarceva are poorly-predicted by measuring the ostansible target EGFR, but can be well-predicted by measuring the effect of the drug on the "function" of live cells. An EGFRx targeted therapy profile includes analysis of the following targeted drugs: Tarceva, Iressa, Nexavar, and Sutent.

Literature Citation:

PLoS Medicine, February 22, 2005

Eur J Clin Invest 37 (suppl. 1):60, 2007

http://meeting.ascopubs.org/cgi/content ... uppl/17117