Jenny G. Posted April 13, 2003 Share Posted April 13, 2003 Hi everyone, I have just finished my 2nd round of carboplatin and VP-16 and have reason to believe that it isn't working for me. I would love to hear from everyone concerning the chemo drugs they have used for SCLC and what has worked for them as well as what hasn't worked. It's obvious from reading these posts that it varies greatly from person to person. I think it might be helpful to have this in one post to help gather information to be able to ask questions and consider other options. For what it's worth, if you agree, please participate. There are new drugs being introduced all the time and maybe we'll find out about something that looks promising. Thank you all for your help and support. Jenny Quote Link to comment Share on other sites More sharing options...
SandyS Posted April 13, 2003 Share Posted April 13, 2003 Jenny - I've completed all my carboplation and VP16 and radiation - last CT came back "inconclusive" - had PET scan on Friday, get the results Monday night, so I'll let you know! SandyS Quote Link to comment Share on other sites More sharing options...
Deanna M. Posted April 14, 2003 Share Posted April 14, 2003 Jenny, my mom is using Carboplatin and VP-16, just completed her 4th treatment. It is working excellent for her. Her catscans after 2 treatments showed significant tumor reduction. May I ask why you think it isn't working? Or have you had tests done? Praying for you. Quote Link to comment Share on other sites More sharing options...
Jenny G. Posted April 15, 2003 Author Share Posted April 15, 2003 Hi Deanna, Your mother was an inspiration for me. I know that we used the same chemo and I know that it has worked on lots of people. I just finished my 2nd round last thursday and on the previous tues. when I stared that round, my doc said he would schedule a CT and expected to see significant results. Well also on Thursday I went to the radiologist and they did a simulation for the radiation. On Friday I called him and ask him to tell me how my tumor looked. I think I probably put him on the spot, but he said he had just looked at it and it was about the size of a fist. Well, I'm freaking out because it was originally 6.4 x 4.6 cm and I'm thinking that's not any smaller and certainly not significantly. I know this is crazy, but I'm running around trying to find rulers with cm on it and trying to figure out how big a fist is and ..... Well I'm not scheduled to see my onc again until April 29 for the 3rd round so I called, but he wasn't in the office today. The nurse said she would let him know, but she didn't think he would do a CT until after the 3rd round anyway and that he probably wouldn't change anything. That's not acceptable to me, so I'm hoping to hear from him tomorrow. As fast as this stuff grows, I sure don't want to wait that long. Thanks for your input and I hope things continue to go well for you and your mother. Jenny Quote Link to comment Share on other sites More sharing options...
Laurie Posted April 15, 2003 Share Posted April 15, 2003 Hi Jenny, My Mom had VP16 and Cisplatin.. it worked.. she went from collapsed lung to cancerfree! I'm sorry that you feel yours isn't working. Why do you feel this way? I hope that this helps you. I will pray for good results for you! Laurie Quote Link to comment Share on other sites More sharing options...
Jenny G. Posted April 15, 2003 Author Share Posted April 15, 2003 Thanks Laurie, I realized that if I look back through the posts I can find a lot of good information about different drugs that have been used. Sometimes I get in a panic. Maybe they'll try the cisplatin next, I get the feeling it might be a bit stronger but maybe with more side effects too. Who knows, the Camptosar may be another possibility, it sounds promising. Isn't it strange how this stuff works so differently on different people? Quote Link to comment Share on other sites More sharing options...
john Posted April 15, 2003 Share Posted April 15, 2003 from cancernetwork.com New agents A variety of novel agents have been investigated in SCLC. Of these, the taxanes and topoisomerase I inhibitors, particularly topotecan (Hycamtin), have demonstrated the greatest efficacy. Taxanes Because of their novel mechanism of action and clinical activity in other solid tumors, including NSCLC, the taxanes¾paclitaxel (Taxol) and docetaxel (Taxotere)¾are particularly attractive agents for evaluation in the treatment of SCLC. Paclitaxel Ettinger et al reported that single-agent paclitaxel produces an overall response rate of 34% in untreated patients with SCLC. This taxane is currently being evaluated in combination with a variety of different agents, including etoposide and cisplatin (or carboplatin [Paraplatin]), in SCLC patients. Docetaxel Compared with paclitaxel, docetaxel appears to have a slightly lower response rate of 26% (12 out of 46), even when administered at a dose of 100 mg/m2, as reported by the Southwest Oncology Group (SWOG). This lower response rate with docetaxel was offset somewhat by the fact that median survival was promising at 9 months, similar to that obtained with combination chemotherapy. Disturbingly, however, median time to progression was only 3 months. Topoisomerase I inhibitors The topoisomerase I inhibitors¾topotecan and irinotecan (CPT-11 [Camptosar])¾are clearly active in SCLC, with single-agent response rates of 40%-60%. Due to their novel mechanism of action, the topoisomerase I inhibitors are currently being tested in patients with recurrent or refractory disease, as many of these patients have been previously exposed to topoisomerase II inhibitors (epipodophyllotoxins/anthracyclines) during the induction phase of therapy. Furthermore, preclinical data suggest that topoisomerase I levels are upregulated in cells resistant to topoisomerase II inhibitors, via downregulation of topoisomerase II levels. Topotecan A randomized, phase III trial compared topotecan vs CAV in patients who had a response to initial therapy and a minimum drug-free interval of 60 days. Overall response rates were 24% for topotecan alone vs 18% for CAV (P > .05). Time to progression and median survival also were similar in the two arms. However, topotecan offered superior palliation for many disease-related symptoms, including dyspnea, fatigue, and hoarseness, and also improved patients’ abilities to carry out daily activities. Moreover, topotecan had toxicities similar to those of CAV, with the exception of a slight increase in grade 4 thrombocytopenia. Irinotecan also has been investigated in recurrent or refractory SCLC in a limited number of patients. Like topotecan and other new agents, irinotecan produced a disappointingly low response rate among patients with SCLC resistant to primary chemotherapy, with only 1 of 27 patients exhibiting a response. In contrast, the response rate to irinotecan among patients with initially sensitive disease that later recurred was 29%. Preliminary data from Japan, published in abstract form only, suggests a 4-month overall survival benefit for irinotecan and cisplatin compared with etoposide and cisplatin as induction therapy for patients with extensive disease. These data await confirmation by two randomized US trials that are currently in the planning stages. Other agents, such as gemcitabine (Gemzar) and vinorelbine (Navelbine), have shown activity in SCLC, but this has been less impressive than that reported for the taxanes and topoisomerase I inhibitors. Phase II trials of new combinations, such as PET (Platinol, etoposide, and Taxol) and TP (topotecan and paclitaxel), have yielded promising median and 2-year survival rates in patients with extensive disease. The contribution of these regimens, relative to standard PE, is being evaluated in ongoing phase III trials. God bless Quote Link to comment Share on other sites More sharing options...
Deanna M. Posted April 15, 2003 Share Posted April 15, 2003 Jenny, I know what you mean about how fast this grows!!!!! THat's why even w/o any test results we knew my mom was getting better b/c she felt so much better. She got so much sicker just from the time of dx till the treatment started. How do you feel? Do you feel much better? Does your doc do the tumor marker blood test? My mom's does that and we knew even before the scans that the marker had gone down considerably. Can you ask your doc if he did that? Maybe that can help you see it is working. THe radiation guy probably was just trying to give you an idea, since he most likely was not measuring it. My mom's scan (after the first one) did not have measurements just the wording "significant tumor shrinkage." The first scan used cm's to describe, btw, her tumor was 13cms by 10cms!!! I am thinking when they actually measure that stuff it is pretty technical, so that's why he just gave you fist size. Think of it this way, if it shrunk 2 cm's so far, it would probably still look like a fist on an cat scan. I am sure it's shrinking, otherwise i do think your doc would pick up on that. I am sure if it wasn't working you would know it. I will keep you in my prayers, hang in there!!!! Quote Link to comment Share on other sites More sharing options...
Jenny G. Posted April 16, 2003 Author Share Posted April 16, 2003 Thank you all so much for your support. John, I really appreciate the info, and Deanna you have managed to make me feel better when the doctor couldn't. I'm much calmer now. I will definietly ask about the tumor marker, that's one area we haven't covered. The nurse called me back again today and confirmed that he wasn't worried and believed it was working and yes, I do feel fine, except for nodding off at my computer at work today. A little nap and I'm much better, but then I have trouble going to sleep again later. They said the CT the radiologist used wasn't as acurate as the one they do (that's kinda scary). But she said the doc felt confident it was working so I'm going to trust this for another few weeks. I don't know much about the radiation equipment. It looks like a CT machine, but it's a linear accelerator. I would hope they know exactly what they're shooting at. Praying for us all. Jenny Quote Link to comment Share on other sites More sharing options...
Carleen Posted April 16, 2003 Share Posted April 16, 2003 Jenny, I am so sorry your cancer is not responding well to the chemo. Although I am not too sure of the various chemo programs available, and my husband hasn't started his yet (starts Friday). However, one thing we learned on our visit to the Mayo Clinic was about a new chemo regimen developed by a Dr. Jet. We were told if traditional chemo didn't work for him after two to three rounds to try his program which is a combination of two different chemo drugs designed to attack the cancer cells in two ways simultaneously. I apologize because I don't remember the name of the drugs, but we were told if we called the Mayo Clinic oncology department, they would happily fax us and our doctors this new aggressive program. We talked to Dr. Kreuger, and Dr. Ma. I will research further, but would suggest maybe you could call there and they could offer more information. I will add you to my prayers, and wish you the best of luck. -Carleen Quote Link to comment Share on other sites More sharing options...
Candy Posted April 17, 2003 Share Posted April 17, 2003 Hi Jenny, Just to add our experience - Hugh is also on VP-16 and Carbo. He didn't show a significant improvement in xrays after his second treatment, but his tumor markers were way down. He had a CAT scan after his third round and it showed a significant improvement in his lungs and liver. Panic??? Us??? Not like we all don't have a good reason. Panic is what I do best. I tell my husband that I am the queen of worry. Quote Link to comment Share on other sites More sharing options...
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