Protocol after 6 Chemo of Taxol/Carbo/Avastin

[Notts]

What is the usual protocol for Adenocarcinoma 111 b after receiving 6 Chemo treatments of Taxol/Carbo/Avastin. If the Chemo has worked, fluid is not building up and the growth has shrunk I was under the impression that there would be follow-up Chemo of Avastin every 3 weeks (more or less as a maintenance type thing). Know of several others with same diagnosis and prognosis who are getting this treatment. Asked the Dr. about what would happen after the 6th Chemo and he said no further treatment. That makes no sense to me. He said he would research it for me. Not very reassuring. Would appreciate any feedback. Thanking you in advance. Seems I have to be my own Advocate!!! Ceedee

[Larry's Wife]

CeeDee, yes, you certainly will be your own best advocate. It's absolutely necessary to ask all questions of your onc doc. But it may also be that monitoring is all you need right now. I'm sure others will chime in that have more experience in this area.

Lynn

[Notts]

Thanks Lynn:

So sorry for your loss. Just lost my husband Tommy 14 months ago from lung cancer also. He did last 2 1/2 years, thank God. Thanks for your response. Ceedee

[recce101]

Seems I have to be my own Advocate!!!

That's for sure. I'm glad you spoke up because yes, Avastin is quite common as a maintenance therapy every 21 days after completing Taxol/Carbo/Avastin. I'll find some references for you on cancergrace.org and PM or post them later this evening.

Ned

[Notts]

Thanks Ned. Will be looking forward to your references. Didn't have to have the Neulasta shot today afterall as my blood work came back fine. Told the Dr. about the unbearable pain last time and he decided to forego it this time. We'll see how that goes too. Will be looking forward to hearing from you and thanks again. Ceedee

[recce101]

CeeDee, this article by Dr. West includes a discussion of maintenance Avastin:

http://cancergrace.org/lung/2008/10/12/ ... -2nd-line/

This portion of the first paragraph sums it up well:

...But now, a growing proportion of our standard treatment protocols include a maintenance phase of ongoing treatment with a targeted therapy after 4-6 cycles, usually of platinum-based chemo with that same targeted therapy. So while we don’t have established proof of the value of maintenance therapy, it’s most common to continue avastin (bevacizumab) as a single agent after 4-6 cycles with platinum-based doublet chemo.

Since there's some controversy as to the effectiveness of maintenance Avastin, an onc who does not offer it cannot be said to be "wrong," but a growing number of oncs do recommend it.

Ned

[kukla]

Hi CeeDee - we're not thru with chemo yet, but we've been told that my husband will go on avastin maintenance after the chemo. We were told that's what all of the major cancer centers are doing now as long as the chemo was successful.

Sometimes it can be a matter of what insurance is willing to pay for. If that's the case, I understand from our oncologist that genentech, the maker of avastin, provides grants to cover the cost...

Good luck.

[jaminkw]

CeeDee, I am IIIb also and did 6 of the same cocktail as you. I did go right onto Avastin maintenance and understand it is the standard now at major cancer centers. I'm at MD Anderson in Orlando. I had raging blood pressure before the six cocktails were over and it was attributed to Avastin. Because they wanted me to stay on the Avastin my PCP kept working until he got my bp under control: 200 mg Toprol XL, 160 mg Micardis, and 10 mg Norvasc. I'm a little lady and I said I was taking enough bp med to down an elephant. Fatigue was a major issue. I also suffered pretty serious aches and pains throughout my body. Consequently, I cried uncle after 11 maintenance treatments. You'll have to be your own advocate no matter where you are or what treatment you are offered. I've cut my bp meds in half, the most severe aches and pains subsided after 2 or 3 months, and my energy level is coming back up although I still complain of fatigue.

Judy in Key West