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Bad news about brain mets


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A few days ago, four and a half years after her diagnosis of stage 4 NSCLC, we got the terrible news that my Mom has brain mets. Since she has numerous nodules in different parts of the brain, the only option for her is WBR, which the doctor opted not to do because of the side effects, he said he will wait to see if Tarceva, which my Mom started a few days ago, works.

My Mom is very scared, and I would like to hear if there are members who had long term survival after diagnosis of brain mets, and if anyone had sucess treating the brain mets with Tarceva (or any other systemic treatments).

Thanks as always for your support.


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The problem with treating brain mets with drugs is whether or not the drug you are giving crosses the blood brain barrier in substantial levels to actually exact any sort of effect on the lesions. I know that in animal studies, Tarceva had minimal crossing of the b-b-b. I am less informed about any clniical information regarding that topic.

You may want to ask Dr. West(http://cancergrace.org/) his take on this. It could be other factors are weighing in on the dr's decision to not do WBR.

I can't add anything about long-term survival but these are the folks that will know. Good luck to you and your mother!

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My husband Alan had 1 large brain met back in july 2005. He was treated with WBR and IMRT radiation. Alan's brain met is gone and he never had a recurrance to his brain. So for 3 years all his brain MRIs have been clear. Prayers to you and your family

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Tarceva (erlotinib) is one of the rare drugs that has shown the ability to cross the blood brain barrier, but I would also be very interested in knowing the reason for recommendation not to undergo radiation to brain as there are some great success stories re this extending survival significantly.

An ASCO abstract re Tarceva and blood brain barrier is at:

http://www.ascocancerfoundation.org/ASC ... ctID=34341


Life is a Terminal Condition

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Thanks everyone for your response.

Debbie, it is very encouraging to hear about Alan, I wish him continued succcess in fighting this disease.

Carole, the radiation oncologist did not recomment WBR due to the side effects, and felt that since my Mom had just started on Tarceva and she had no symptoms from the brain mets, he would not do radiation at this point.. I don't know if I am comfortable with that decision, but she is meeting her oncologist next week and will discuss this further with him...Thanks for the article, it is encouraging to hear that the response to Tarceva happens early... I had also heard that Tarceva crosses the blood-brain barrier, and the response in brain mets was similar to response in other parts of the body...

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